Atherosclerosis: Your Arteries Age by Age

Atherosclerosis takes place over a lifetime. Complications from atherosclerosis tend to happen later in life. But the process of narrowing and hardening of the arteries starts early, progressing over decades.

Developing some atherosclerosis is often unavoidable. It's the result of aging and our own genetic tendencies. A much larger part, though, is determined by our behavior and lifestyle choices as we move through life.

How old are your arteries? Are they the ones you had in college? Or are they hitting their golden years early? Making sure your arteries act their age -- or even young at heart -- is partly up to you.

Atherosclerosis: The Early Days

Heart attacks and strokes are the late effects of atherosclerosis that begins when we're young. The early forms of atherosclerosis are all asymptomatic, but they lay the foundation for future blockages.

Fatty streaks. The earliest form of atherosclerosis, these are cholesterol deposits in the walls of arteries. Virtually everyone develops fatty streaks early in life. Risk factors, lifestyle choices, and genetics cause fatty streaks to grow, becoming atherosclerotic plaques.

Endothelial dysfunction. The inner lining of your arteries is the endothelium. The endothelium actively works to keep arteries free from plaques or clots. Healthy endothelium means healthy arteries capable of meeting the demand of any activity level.

Risk factors like high cholesterol or blood pressure, smoking, and diabetes all damage the endothelium. This damage can't be detected with commonly used tests. But impaired endothelium is a "canary in the coal mine," signaling atherosclerosis is likely to develop.

Plaques. As cholesterol continues to deposit in artery walls, fatty streaks turn into plaques. These bumps on the artery wall are made of cholesterol, cells, and debris. The presence of risk factors accelerates the growth of plaques.

Plaques represent "true" atherosclerosis. They can grow into the flow of blood slowly, causing progressive symptoms. Far worse, plaques can become unstable, triggering a sudden blood clot in the artery. This causes heart attacks and most strokes.

Atherosclerosis in Your Childhood

Believe it or not, the process of atherosclerosis may begin as early as infancy. Studies of premature babies show that fatty streaks develop even before birth. Babies whose mothers had high cholesterol had more prominent fatty streaks.

Similar studies in children younger than 13 showed the same thing. Fatty streaks began to look more like atherosclerosis in older children, especially kids with obesity or higher cholesterol.

For many of us, these fatty streaks have progressed to mild atherosclerosis even before we turn 20. In a study that looked inside young people's arteries with ultrasound, the arteries of 17% of teenagershad small plaques of atherosclerosis.