Atherosclerosis is the process of narrowing and hardening of the arteries due to plaque buildup in the inner lining of arteries. It's the key cause of heart attacks and strokes and the No. 1 killer in the U.S.
When it comes to developing health risks from atherosclerosis, some people are at higher risk than others. But because atherosclerosis is silent until it's advanced, estimating one's health risk takes some educated guesswork.
Did You Know?
Under the Affordable Care Act, many health insurance plans will cover preventive care services, including blood pressure and cholesterol screenings, at no cost to you. Learn more.
How can you determine your risk? The risk factors are easy to identify. You can use the same tools your doctor uses to learn where you stand.
Risk Factors for Atherosclerosis
To get started, first consider your medical history. If you've had one of these medical conditions, you most likely have atherosclerosis:
Angina pectoris (heart-related chest pain)
History of a stroke or heart attack
Blockages in the carotid arteries (in the neck)
Peripheral artery disease
These conditions are considered evidence of atherosclerosis. People with diabetes are also at high risk of developing the health risks associated with atherosclerosis. Guidelines for treating cholesterol in people with diabetes assume that atherosclerosis is already present.
Next, tally your risk factors for atherosclerosis:
Family history of heart attacks in your immediate family
High "bad" cholesterol (LDL level)
Low "good" cholesterol (HDL level)
High blood pressure (140/90 or greater)
Be sure to share the information with your doctor.
The best estimates of atherosclerosis risk come from the Framingham Heart Study. Researchers have followed thousands of men and women and their children for more than 40 years.
Doctors sometimes use a risk calculator to calculate atherosclerosis risk, based on the Framingham study. The American Heart Association has a similar tool.
You'll need some information, including your blood pressure and cholesterol levels. The Framingham calculator provides your 10-year risk of having a heart attack or dying from heart disease.
Based on your Framingham risk, you'll fit in one of three categories:
Low risk: Less than a 10% risk of having a heart attack in the next 10 years. No further testing or treatment is needed, if you have no symptoms. You should reduce your risk even further with diet, exercise, blood pressure control, and smoking abstinence.
Moderate risk: A 10% to 20% risk of having a heart attack in the next 10 years. Here's the gray area. In addition to the healthy lifestyle improvements listed above, you may need additional treatment to lower cholesterol. Your doctor may recommend further testing to look for possible blockages in your heart.
Higher risk: Greater than 20% risk of having a heart attack in the next 10 years. Watch out: it's time to take atherosclerosis very seriously. You and your doctor should have an aggressive plan to reduce your risk factors.
Wilson, P., Circulation, 1998.
Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Circulation, 2002.
American Heart Association.
Richard Stein, MD, national spokesman, American Heart Association; professor of medicine and director of urban community cardiology program, New York University School of Medicine, New York.