Clogged Arteries (Arterial Plaque)

Arteries are blood vessels that carry blood rich in oxygen throughout your body. They go to your brain as well as to the tips of your toes. Healthy arteries have smooth inner walls and blood flows through them easily. Some people, however, develop clogged arteries. Clogged arteries result from a buildup of a substance called plaque on the inner walls of the arteries. Arterial plaque can reduce blood flow or, in some instances, block it altogether.

Video Transcript

American Heart Association: "Atherosclerosis."<br>National Heart, Lung, and Blood Institute: "What Is Atherosclerosis?"<br>Nucleus Medical Media.

SPEAKER: When you have atherosclerosis, a fatty material called plaque builds up inside the walls of your arteries. It's a problem because it can reduce or completely block blood flow and lead to a heart attack or a stroke. No one knows exactly why it happens, but scientists think it begins with damage to the inner wall of an artery. It can start as early as childhood. It starts when things traveling in the blood, like cholesterol, fats, calcium, and waste products, collect in the damaged part of the artery wall. With all of it bunched together, chemical reactions start to happen with your body's bad, LDL cholesterol. This triggers inflammation and cells at the site release chemicals that call for help. Your immune system sends white blood cells to the damaged site. They begin to eat the cholesterol. This sounds good, but it isn't. The cells change into foam and those foam cells form plaque. As the plaque increases, the artery wall thickens and hardens. At the same time, muscle cells in the artery wall start multiplying. And they move to the surface of the plaque. They contribute to the problem by forming a hard cover or cap over the plaque. Eventually, the artery narrows enough to reduce blood flow, which reduces the amount of oxygen nearby organs can receive. Over time, the cap may break open and release all this plaque into the bloodstream. It can flow downstream in the artery and form a blood clot, which can stop blood flow all together. When that happens, blood supply becomes limited to the areas around the clot. If it happens in your heart, it causes a heart attack. If it happens in your brain, it causes a stroke.

Clogged arteries greatly increase the likelihood of heart attack, stroke, and even death. Because of these dangers, it is important to be aware, no matter how old you are, of the causes of artery plaque and treatment strategies to prevent serious consequences.

What causes arterial plaque?

Plaque that accumulates on the inner walls of your arteries is made from various substances that circulate in your blood. These include calcium, fat, cholesterol, cellular waste, and fibrin, a material involved in blood clotting. In response to plaque buildup, cells in your artery walls multiply and secrete additional substances that can worsen the state of clogged arteries.

As plaque deposits grow, a condition called atherosclerosis results. This condition causes the arteries to narrow and harden.

Although experts don’t know for sure what starts atherosclerosis, the process seems to stem from damage to the lining of the arterial wall. This damage, which enables the deposition of plaque, may result from:

  • High ''bad'' cholesterol and low ''good'' cholesterol. High levels of ''bad'' cholesterol, or low-density lipoprotein (LDL), are major contributors to arterial plaque formation. But that doesn’t tell the whole story. Everyone also has ''good'' cholesterol, or high-density lipoprotein (HDL), circulating in the blood. HDL is believed to remove some of the bad cholesterol from plaque in clogged arteries and transport it back to the liver, where it is eliminated.
  • High blood pressure . Having high blood pressure increases the rate at which arterial plaque builds up. It also hastens the hardening of clogged arteries.
  • Cigarette smoke. Cigarette smoke seems to increase the rate of atherosclerosis in the arteries of the heart, legs, and the aorta -- the largest artery in the body.
  • Diabetes, or elevated circulating blood sugar, is also a major culprit. Even people who have elevated sugars not yet at the level of diabetes, such as seen in metabolic syndrome, also have increased risk of plaque formation.
  • Other risk factors include family history, stress, sedentary lifestyle and obesity. Knowing your family history is critical.

Plaque often starts to develop during the childhood or teenage years. Then clogged arteries develop in middle age or later.

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What are the dangers of arterial plaque and clogged arteries?

It depends on where arterial plaque accumulates. Clogged arteries in different parts of the body can lead to multiple medical conditions, including:

  • Coronary artery disease. When plaque accumulates in the arteries carrying blood to the heart, it results in coronary artery disease, or heart disease. Coronary artery disease can cause chest pain or shortness of breath. This condition can lead to heart attacks and is the leading cause of death in the United States.
  • Carotid artery disease . The carotid arteries run up either side of your neck. They supply oxygen to your brain. The accumulation of arterial plaque in the carotid arteries can lead to stroke.
  • Peripheral artery disease. If plaque builds up in the blood vessels that carry blood to your legs, it can reduce the amount of oxygen delivered. The reduced blood flow can cause you to experience pain, numbness, or serious infection in your legs and feet.

Do clogged arteries cause any symptoms?

In many instances, clogged arteries do not cause any symptoms until a major event, such as a heart attack or stroke, occurs.

At other times, especially when the artery is blocked by 70% or more, the buildup of arterial plaque may cause symptoms that include:

The first symptom, chest pain, is also called angina. It may result from reduced blood flow to the heart. That reduced blood flow is caused by plaque in the arteries leading to the heart.

Clogged arteries in carotid artery disease may cause stroke precursors known as transient ischemic attacks, or TIAs. TIAs may produce the following symptoms:

  • Sensation of weakness or numbness on one side of your body
  • Inability to move an arm or a leg
  • Loss of vision on one side only
  • Slurring of words

Clogged arteries in peripheral artery disease may cause:

Are there tests for clogged arteries?

Yes. There are several tests for clogged arteries. Your doctor will determine which tests to prescribe based on your symptoms and medical history. The tests may include:

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How are clogged arteries or arterial plaque treated?

There are a variety of prevention and treatment options for clogged arteries. What your doctor prescribes to reduce arterial plaque and prevent clogged arteries will depend on the severity of your condition and your medical history. Your doctor may prescribe one or more of the following:

1. Lifestyle changes. A healthy lifestyle is essential for the management of arterial plaque and treatment of clogged arteries. This includes:

  • Eating a diet low in saturated fats and cholesterol, with less sugars and simple carbohydrates, and rich in fruits and vegetables
  • Maintaining a healthy body weight
  • Not smoking
  • Exercising regularly
  • Managing stress levels
  • Keeping blood pressure and cholesterol down
  • Maintaining low blood sugars

2. Surgical or interventional procedures. In some instances, surgery may be necessary to treat clogged arteries and prevent additional arterial plaque accumulation. These procedures may include:

  • Stent placement. A small tube called a stent, which may contain medication, can be placed in an artery to maintain adequate blood flow. A catheter is used through the artery of the leg to reach the heart, and a stent is put in place through the catheter in the area of the blockage.
  • Bypass surgery. In this operation, arteries from other parts of the body are moved to bypass clogged arteries and help oxygen-rich blood reach its target destination.
  • Balloon angioplasty. This procedure helps open clogged arteries that have become partially or fully blocked by opening up the blockage with a device that pushes the plaque to the side walls of the arteries.

3. Medications. A number of medications may help control some of the factors that contribute to the accumulation of arterial plaque. These include:

  • Cholesterol-lowering drugs
  • Blood pressure-lowering drugs
  • Aspirin and other blood-thinning drugs, which reduce the likelihood of dangerous blood clot formation
WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on November 5, 2018

Sources

SOURCES:

American Heart Association: ''Atherosclerosis.''

U.S. Food and Drug Administration: ''Atherosclerosis.''

American Heart Association: ''Peripheral Heart Disease.''

National Heart Lung and Blood Institute: ''Atherosclerosis.''

WebMD Medical Reference: ''Coronary Artery Disease.''

Society for Vascular Surgery, VascularWeb: ''Carotid Artery Disease, Stroke, Transient Ischemic Attacks.''

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