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Cholesterol and Artery Plaque Buildup

Cholesterol plaques are the culprits of heart disease. Plaques begin in artery walls and grow over years. The growth of cholesterol plaques slowly blocks blood flow in the arteries. Worse, a cholesterol plaque can suddenly rupture. The sudden blood clot that forms over the rupture then causes a heart attack or stroke.

Blocked arteries caused by plaque buildup and blood clots are the leading cause of death in the U.S. Reducing cholesterol and other risk factors can help prevent cholesterol plaques from forming. Occasionally, it can even reverse some plaque buildup.

Recommended Related to Cholesterol Management

HDL Cholesterol: The Good Cholesterol

Good cholesterol, bad cholesterol: what's the difference? Is there a "naughty and nice" list for cholesterol? HDL cholesterol is the well-behaved "good cholesterol." This friendly scavenger cruises the bloodstream. As it does, it removes harmful bad cholesterol from where it doesn't belong. High HDL levels reduce the risk for heart disease -- but low levels increase the risk.

Read the HDL Cholesterol: The Good Cholesterol article > >

Cholesterol Plaques and Atherosclerosis

Cholesterol plaques form by a process called atherosclerosis. Another name for atherosclerosis is "hardening of the arteries." LDL or "bad cholesterol" is the raw material of cholesterol plaques. Progressive and painless, atherosclerosis grows cholesterol plaques silently and slowly. The eventual result is blocked arteries, which places blood flow at risk.

The cholesterol plaques of atherosclerosis are the usual cause of heart attacks, strokes, and peripheral arterial disease. These conditions together are called cardiovascular disease. Cardiovascular disease is the No. 1 killer in America, causing more than 900,000 deaths each year.

Understanding Cholesterol Plaque

Cholesterol plaques start developing in the walls of arteries. Long before they can be called plaques, hints of atherosclerosis can be found in the arteries. Even some adolescents have these "fatty streaks" of cholesterol in their artery walls. These streaks are early precursors of cholesterol plaques. They can't be detected by tests. But researchers have found them during autopsies of young victims of accidents and violence.

Atherosclerosis develops over years. It happens through a complicated process of cholesterol plaque formation that involves:

  • Damaged endothelium. The smooth, delicate lining of blood vessels is called the endothelium. High cholesterol, smoking, high blood pressure, or diabetes can damage the endothelium, creating a place for cholesterol to enter the artery's wall.
  • Cholesterol invasion. "Bad" cholesterol (LDL cholesterol) circulating in the blood crosses the damaged endothelium. LDL cholesterol starts to accumulate in the wall of the artery.
  • Plaque formation. White blood cells stream in to digest the LDL cholesterol. Over years, the toxic mess of cholesterol and cells becomes a cholesterol plaque in the wall of the artery.

 

How Cholesterol Plaque Attacks

Once established, cholesterol plaques can behave in different ways.

  • They can stay within the artery wall. The cholesterol plaque may stop growing, or may grow into the wall, out of the path of blood.
  • Plaques can grow in a slow, controlled way into the path of blood flow. Slow-growing cholesterol plaques may or may not ever cause any symptoms -- even with severely blocked arteries.
  • Cholesterol plaques can suddenly rupture -- the worst case scenario. This will allow blood to clot inside an artery. In the heart, this causes a heart attack. In the brain, it causes a stroke.

Cholesterol plaques of atherosclerosis cause the three main kinds of cardiovascular disease:

  • Coronary artery disease -- Stable cholesterol plaques in the heart's arteries can cause no symptoms or can cause chest pain called angina. Sudden cholesterol plaque rupture and clotting causes blocked arteries. When that happens, heart muscle dies. This is a heart attack, also called myocardial infarction.
  • Cerebrovascular disease -- Cholesterol plaque ruptures in one of the brain's arteries. This causes a stroke, leading to permanent brain damage. Blockages can also cause transient ischemic attacks, or TIAs. A TIA has symptoms like those of stroke. But they are temporary and there is no permanent brain damage.  However, patients who experience a TIA are at a much higher risk of a subsequent stroke, so medical attention and care is essential.
  • Peripheral arterial disease -- Blocked arteries in the legs can cause pain on walking and poor wound healing due to poor circulation. Severe disease may lead to amputations.

WebMD Medical Reference

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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