Atherosclerosis: Symptoms, Causes, Complications, Treatment, and Prevention

Have you ever felt tired or short of breath after light activity? Or do you often ignore chest pain that comes and goes? Did you know that these symptoms can be early signs of atherosclerosis, one of the main causes of heart attacks and strokes worldwide?

According to data from the World Health Organization (WHO), cardiovascular disease, including atherosclerosis, is the leading cause of death globally, with about 17.9 million deaths each year. In Indonesia, Indonesia’s Basic Health Research (Riskesdas) 2018 showed that the prevalence of heart and blood vessel disease continues to rise, while risk factors such as an unhealthy diet, lack of physical activity, and smoking remain common.

Atherosclerosis may sound unfamiliar to some people, but this condition is actually very close to our everyday lives. Without our realizing it, a modern lifestyle of instant everything and too little movement can trigger plaque buildup in the blood vessels, which gradually blocks blood flow to vital organs. If left untreated, atherosclerosis can be fatal. The good news, however, is that this condition can be prevented and managed with the right steps.

This article discusses in full what atherosclerosis is, its causes and symptoms, and how to prevent it. By understanding this condition more deeply, you can take proactive steps to protect the health of your heart and blood vessels.

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What Is Atherosclerosis?

Atherosclerosis is a condition in which plaque builds up in the walls of the arteries, causing the blood vessels to narrow and harden. The plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, this plaque can build up and block blood flow to vital organs such as the heart, the brain, and other parts of the body.

How Plaque Forms in the Blood Vessels

Plaque forms when the inner lining of an artery is injured or damaged, often because of high blood pressure, high cholesterol, smoking, or other factors. When the arterial lining is damaged, fat and cholesterol build up in that area. Over time, blood cells and other substances also get trapped there, forming plaque. This plaque can harden or rupture, and if it ruptures, it can lead to the formation of a more dangerous blood clot that blocks blood flow completely.

Differences Between Atherosclerosis and Other Cardiovascular Conditions

Atherosclerosis is often confused with arteriosclerosis, even though the two are different. Arteriosclerosis is a general term for the thickening and hardening of the arteries, which includes atherosclerosis.

Another related cardiovascular condition is coronary heart disease, which occurs when the blood vessels that supply blood to the heart are blocked by atherosclerotic plaque. This is different from conditions such as hypertension (high blood pressure), which can be a cause or a result of atherosclerosis but has a different mechanism and impact.

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Causes of Atherosclerosis

Atherosclerosis does not appear out of nowhere. It develops from a combination of factors that are often interrelated. From daily habits to inherited factors, many things can increase a person’s risk of developing this condition.

Below are the causes of atherosclerosis, including the main risk factors, the role of an unhealthy lifestyle, and the influence of genetics and age.

Main Risk Factors

Some of the main risk factors that can increase a person’s likelihood of developing atherosclerosis include:

• High Cholesterol Levels: High LDL cholesterol (“bad” cholesterol) can build up in the artery walls and form plaque.
• High Blood Pressure (Hypertension): High blood pressure can damage the inner lining of the blood vessels, making them more prone to plaque buildup.
• Diabetes or High Blood Sugar: Uncontrolled blood sugar levels can damage blood vessels and speed up plaque formation.
• Smoking: The chemicals in cigarettes can damage blood vessels and increase the risk of plaque buildup.
• Obesity: Being overweight is often associated with higher cholesterol levels, higher blood pressure, and a higher risk of diabetes, all of which contribute to atherosclerosis.

The Role of an Unhealthy Lifestyle in the Development of Atherosclerosis

A modern lifestyle of instant everything and too little movement contributes to the rise in atherosclerosis cases. Here are some unhealthy habits that can speed up the development of this condition:

• Unhealthy Diet: Eating foods high in saturated fat, sugar, and salt can raise cholesterol levels and blood pressure. Data from Indonesia’s Basic Health Research (Riskesdas) 2018 show that 95.5% of Indonesians over the age of 5 do not eat enough fruits and vegetables, which are important for heart health *. (* Source: Kementerian Kesehatan Republik Indonesia: Potret Kesehatan Indonesia dari Riskesdas 2018)
• Lack of Physical Activity: A sedentary lifestyle, or not moving enough, can lead to obesity and increase the risk of atherosclerosis. The WHO recommends at least 150 minutes of moderate physical activity per week to keep the heart healthy.
• Smoking and Excessive Alcohol Consumption: Smoking and drinking too much alcohol can damage blood vessels and make atherosclerosis worse.

Genetic Factors and Age

In addition to lifestyle factors, genetics and age also play an important role in the development of atherosclerosis:

• Family History: If you have close relatives (parents or siblings) who had heart disease or a stroke at a young age, your risk of developing atherosclerosis is higher. This is because genetic factors can affect cholesterol levels, blood pressure, and the body’s response to inflammation.
• Age: The risk of atherosclerosis increases with age. Blood vessels naturally become less elastic and more prone to damage as we age. According to the National Heart, Lung, and Blood Institute (NHLBI), most cases of atherosclerosis start to appear in people over the age of 40 *. (* National Heart, Lung, and Blood Institute (NHLBI): Atherosclerosis, Causes and Risk Factors)

By understanding the various causes and risk factors of atherosclerosis, we can take the right preventive steps. From changing your diet and increasing physical activity to having regular health checkups, all of these efforts can help reduce the risk of atherosclerosis and its complications.

Read also:

• Optimal Health at 40+: How to Prevent Disease and Stay Active

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Symptoms of Atherosclerosis to Watch Out For

Atherosclerosis often shows no clear symptoms in its early stages, so many people are unaware of their condition until serious complications occur. However, there are actually several signs that can serve as early warnings.

Below are the symptoms of atherosclerosis to pay attention to, from early signs that are often ignored to symptoms based on where the blockage is located.

Early Symptoms That Are Often Ignored

Atherosclerosis is often called a “silent killer” because its symptoms can be very mild or not felt at all in the early stages. However, there are several signs that should not be ignored:

• Excessive Fatigue: Feeling tired even without strenuous activity can be a sign that blood flow to the body’s organs is not optimal.
• Shortness of Breath: Shortness of breath, especially during activity, may indicate that the heart is not getting enough blood supply.
• Mild Chest Pain (Angina): Pain or discomfort in the chest that comes and goes, especially after physical activity or stress, can be an early symptom of atherosclerosis.

Symptoms Based on the Location of the Blockage

The symptoms of atherosclerosis can vary depending on which blood vessel is blocked:

• Blockage in the Heart Arteries (Coronary Heart Disease): Symptoms include chest pain (angina), shortness of breath, and an irregular heartbeat. If plaque ruptures and blocks blood flow completely, it can cause a heart attack.
• Blockage in the Brain Arteries: If the blood vessels leading to the brain are blocked, symptoms may include dizziness, difficulty speaking, or weakness on one side of the body. These can be signs of an ischemic stroke.
• Blockage in the Leg Arteries (Peripheral Artery Disease): Symptoms include leg pain when walking, cold feet, or wounds that are slow to heal.

When to Seek Medical Help

If you experience the symptoms mentioned above, especially if your angina is getting worse or comes with other symptoms, it is very important to seek medical help right away. Symptoms such as difficulty breathing, pain in the left arm, jaw, or back, and loss of balance or vision are also signs that you need immediate medical attention. Recognizing and responding to symptoms quickly can make a big difference in the outcome of your heart care.

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Dangerous Complications of Atherosclerosis

Atherosclerosis is not a condition to be taken lightly. If not treated properly, plaque buildup in the blood vessels can cause serious, life-threatening complications. Here are some dangerous complications to watch out for:

1. Heart Attack and Stroke

Heart attack and stroke are the two most fatal complications of atherosclerosis. When plaque in a coronary artery (a blood vessel that supplies blood to the heart) ruptures, a blood clot can form and block blood flow completely. This deprives the heart muscle of oxygen and damages it, which is known as a heart attack.

Meanwhile, a stroke occurs when a blood vessel that supplies blood to the brain is blocked or ruptures. Ischemic stroke, which is caused by a blocked blood vessel, is often linked to atherosclerosis. Data from the Indonesian Ministry of Health (Kemenkes) show that stroke is the leading cause of death in Indonesia, and its prevalence continues to rise.

2. Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD) occurs when the blood vessels in the legs or arms narrow because of plaque buildup. Symptoms include leg pain when walking, cold feet, or wounds that are slow to heal.

If left untreated, PAD can cause tissue death (gangrene) and lead to amputation.

3. Kidney Failure and Other Organ Problems

Atherosclerosis can also affect the blood vessels that supply blood to the kidneys, causing chronic kidney disease or even kidney failure. When the kidneys do not get enough blood, their function gradually declines.

In addition, atherosclerosis can affect other organs, such as the intestines (causing intestinal ischemia) or the eyes (causing vision problems).

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Diagnosing Atherosclerosis

Diagnosing atherosclerosis is an important step to detect plaque buildup in the blood vessels before it causes serious complications such as a heart attack or stroke. The diagnostic process usually involves several methods, from blood tests to imaging scans and a physical examination. Here is a complete explanation of the steps in diagnosing atherosclerosis:

1. Blood Tests to Check Cholesterol and Blood Sugar

Blood tests are a common first step in diagnosing atherosclerosis. These tests measure cholesterol, blood sugar, and markers of inflammation in the body, which can give a picture of the risk of atherosclerosis.

• Cholesterol: High levels of LDL cholesterol (bad cholesterol) and low levels of HDL cholesterol (good cholesterol) can increase the risk of plaque buildup in the blood vessels. An LDL level above 130 mg/dL is considered high and should be watched.
• Blood Sugar: High blood sugar levels, especially in people with diabetes, can damage the blood vessel walls and speed up plaque formation. The HbA1c test is often used to monitor long-term blood sugar levels.
• Inflammatory Markers: Tests such as CRP (C-Reactive Protein) can help identify inflammation in the body, which is often associated with atherosclerosis.

The results of these blood tests will help the doctor determine whether the patient is at high risk of atherosclerosis and needs further tests.

2. Imaging Scans Such as Angiography, CT Scan, or MRI

If blood tests show a risk of atherosclerosis, the doctor may recommend imaging scans to look directly at the condition of the blood vessels. Some commonly used types of scans are:

• Angiography: This procedure uses a catheter and contrast dye to visualize blood flow in the arteries. Coronary angiography is often used to detect blockages in the heart arteries. Although it is accurate, this procedure is invasive and is usually done when symptoms are already severe.
• CT Scan: CT angiography (CTA) is a non-invasive method that uses X-rays and contrast dye to produce detailed images of the blood vessels. A CT scan can help detect plaque in the coronary arteries.
• MRI: Magnetic Resonance Imaging (MRI) uses a magnetic field and radio waves to produce images of the blood vessels without radiation exposure. MRI is very useful for detecting plaque in large blood vessels such as the aorta.

These scans help the doctor see the location and severity of the blockage, so the right treatment can be planned.

3. Physical Examination and Medical History

In addition to laboratory tests and imaging scans, the doctor will also perform a physical examination and review the patient’s medical history. This step is important to identify risk factors and symptoms that may be related to atherosclerosis.

• Physical Examination: The doctor will check for signs such as a weak pulse, high blood pressure, or an arterial bruit (an abnormal sound heard through a stethoscope).
• Medical History: The doctor will ask about your family history, smoking habits, diet, physical activity, and medical conditions such as diabetes or hypertension. These factors can increase the risk of atherosclerosis.

The combination of a physical examination, medical history, and the results of laboratory tests or imaging scans will give a complete picture of the patient’s condition and help the doctor determine the most suitable treatment.

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Treatment Options for Atherosclerosis

Atherosclerosis is a serious condition that requires proper treatment to prevent complications such as a heart attack or stroke. Treatment for atherosclerosis usually involves a combination of medication, medical procedures, and lifestyle changes. Here is a complete explanation of the treatment options available:

Medications

Medication is the first step in managing atherosclerosis. The goal is to control risk factors, reduce symptoms, and prevent plaque from developing in the blood vessels. Some commonly prescribed types of medication include:

1. Cholesterol-Lowering Drugs: Statins are the most commonly used drugs to lower LDL (bad) cholesterol and reduce inflammation in the blood vessels. Statins may help lower the risk of a heart attack.
2. Antiplatelet Drugs: Aspirin or clopidogrel is often given to prevent blood clots that can block blood vessels. These drugs are especially recommended for patients who already have symptoms such as chest pain or a history of stroke.
3. Blood Pressure-Lowering Drugs: Hypertension is a major risk factor for atherosclerosis. Drugs such as ACE inhibitors or beta-blockers help control blood pressure and reduce the heart’s workload.
4. Blood Sugar-Controlling Drugs: For people with diabetes, keeping blood sugar levels stable is very important to prevent damage to the blood vessels. Drugs such as metformin or insulin are often used for this purpose.

The doctor will adjust the type and dose of medication based on the patient’s condition and test results.

Medical Procedures

If atherosclerosis has already caused a severe blockage in a blood vessel, a medical procedure may be needed to restore blood flow. Some commonly performed procedures are:

1. Angioplasty and Stenting: This procedure involves inflating a small balloon to open a narrowed blood vessel, followed by placing a stent (a small metal mesh tube) to keep the vessel open. Angioplasty may help reduce angina (chest pain) symptoms in many patients.
2. Bypass Surgery: In more severe cases, the doctor may recommend bypass surgery (CABG). This procedure uses a blood vessel from another part of the body to create a new route around the blocked blood vessel. This surgery is often performed in patients with blockages in the coronary arteries.
3. Endarterectomy: This procedure is done to remove plaque that is blocking a blood vessel, especially in the carotid arteries (the blood vessels in the neck that supply blood to the brain).

These medical procedures are usually recommended for patients with severe symptoms or a high risk of complications.

Lifestyle Changes as Part of Long-Term Therapy

Lifestyle changes are the main foundation of atherosclerosis treatment. Without these changes, medication or procedures will not give optimal results in the long term. Here are some steps you can take:

1. Healthy Diet: Eating foods low in saturated fat, cholesterol, and salt can help control cholesterol levels and blood pressure. Prioritize fiber-rich foods such as fruits, vegetables, whole grains, and fish that contain omega-3s.
2. Regular Exercise: Physical activity such as brisk walking, cycling, or swimming for 30 minutes a day can improve heart health and blood circulation. According to the World Health Organization (WHO), regular exercise can help reduce the risk of heart disease.
3. Quit Smoking: Smoking damages blood vessels and speeds up plaque formation. Quitting smoking is the most important step to prevent atherosclerosis from progressing.
4. Stress Management: Chronic stress can raise blood pressure and the risk of atherosclerosis. Relaxation techniques such as yoga, meditation, or breathing therapy can help manage stress.
5. Enough Sleep: Lack of sleep can affect blood pressure and overall heart health. Try to sleep 7 to 8 hours every night.

Lifestyle changes not only help control atherosclerosis but also improve overall quality of life.

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Preventing Atherosclerosis

Preventing atherosclerosis is an important step in keeping your heart and blood vessels healthy. By adopting a healthy lifestyle, you can reduce the risk of plaque buildup in your blood vessels and avoid serious complications such as a heart attack or stroke. Here are some effective prevention steps:

1. Healthy Diet

A healthy diet is a key part of preventing atherosclerosis. The food you eat every day can affect your cholesterol levels, blood pressure, and blood vessel health. Here are tips for eating a healthy diet:

• Reduce Saturated and Trans Fats: Avoid foods high in saturated fat, such as red meat, butter, and high-fat dairy products. Trans fats, which are often found in fast food and packaged foods, can also raise bad (LDL) cholesterol levels.
• Eat More Fiber: Eat fiber-rich foods such as fruits, vegetables, whole grains, and nuts. Fiber helps lower LDL cholesterol and keeps your digestion healthy.
• Choose Healthy Fats: Use sources of unsaturated fat such as olive oil, avocado, and fatty fish (salmon, mackerel) that are rich in omega-3s. Omega-3s are known to help reduce inflammation and prevent plaque from forming in the blood vessels.
• Limit Salt and Sugar: Too much salt can raise blood pressure, while too much sugar can lead to diabetes. Both are major risk factors for atherosclerosis.

Keep in mind that eating a healthy diet can help reduce the risk of heart disease.

2. Regular Exercise and Maintaining an Ideal Body Weight

Regular physical activity not only helps maintain an ideal body weight but also improves the health of your heart and blood vessels. Here are the benefits of exercise in preventing atherosclerosis:

• Improves Blood Circulation: Exercise helps blood flow smoothly and reduces pressure on the blood vessels.
• Lowers Cholesterol and Blood Pressure: Physical activity such as brisk walking, cycling, or swimming can lower bad (LDL) cholesterol and raise good (HDL) cholesterol.
• Controls Body Weight: Being overweight or obese is a major risk factor for atherosclerosis. Regular exercise helps burn calories and keep your body weight ideal.

It is recommended to do at least 150 minutes of moderate-intensity exercise per week, such as brisk walking or cycling, to keep your heart healthy.

3. Quit Smoking and Reduce Alcohol Consumption

Smoking and excessive alcohol consumption are bad habits that can damage blood vessels and increase the risk of atherosclerosis.

Smoking damages the lining of the blood vessels, triggers inflammation, and speeds up plaque formation. Quitting smoking can help reduce the risk of heart disease.

Excessive alcohol consumption can raise blood pressure and triglyceride levels in the blood.

Stopping these bad habits not only prevents atherosclerosis but also improves your overall health.

4. Stress Management and Enough Sleep

Chronic stress and lack of sleep can affect the health of your heart and blood vessels. Here are ways to manage stress and improve sleep quality:

• Stress Management: Stress can raise blood pressure and trigger unhealthy habits such as smoking or overeating. Relaxation techniques such as yoga, meditation, or breathing exercises can help reduce stress.
• Enough Sleep: Lack of sleep can disrupt hormone balance and increase the risk of high blood pressure and obesity. Try to sleep 7 to 8 hours every night.

According to the National Sleep Foundation, getting enough good-quality sleep can help reduce the risk of heart disease.

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Conclusion

Atherosclerosis is a serious condition in which plaque builds up in the walls of the blood vessels, narrowing blood flow and increasing the risk of cardiovascular disease.

Its main causes include an unhealthy lifestyle, such as a high-fat diet, lack of physical activity, and smoking, as well as genetic factors and age.

Its symptoms are often not felt at first, but it can develop into dangerous complications such as a heart attack, stroke, or peripheral artery disease.

Diagnosing atherosclerosis involves blood tests, imaging scans, and a physical examination, while treatment includes medication, medical procedures, and lifestyle changes.

Prevention remains the key, with a focus on a healthy diet, regular exercise, and avoiding bad habits such as smoking.

Keeping your heart and blood vessels healthy is an important step in preventing atherosclerosis and its complications. Start by adopting a healthy diet, exercising regularly, quitting smoking, and managing stress. In addition, have regular health checkups to monitor your cholesterol, blood pressure, and blood sugar levels. According to the World Health Organization (WHO), 80% of premature heart disease and stroke cases can be prevented with positive lifestyle changes.

Do not wait until symptoms appear to take action. Start today with small steps to protect yourself and your family from the risk of cardiovascular disease. If you or your family have a history of heart disease, diabetes, or high blood pressure, consult a doctor promptly for proper advice and treatment. Remember, heart health is a long-term investment in a better quality of life.

Remember that the information in this article is educational and is not a substitute for professional medical advice. If you experience the symptoms of atherosclerosis mentioned above, consult a specialist promptly or visit Heartology Cardiovascular Hospital for proper evaluation and care.

At Heartology Cardiovascular Hospital, cardiologists can explain your condition, your testing and treatment options, and their risks and benefits, as well as answer your questions about heart and blood vessel health.