What Is Atherosclerosis and How You Can Prevent It

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

“Atherosclerosis.” It’s part and parcel of having diagnosed cardiovascular disease, but most people have trouble pronouncing it, let alone explaining it.

Let’s take a closer look at what this mouthful is, and what you can do to prevent it.

What Is Atherosclerosis?

Atherosclerosis (pronounced ath-uh-roh-skler-o-sis) is the clinical name for the progressive narrowing of arteries due to plaque buildup. You may also hear it called “hardening of the arteries.”

Technically, atherosclerosis is a process rather than a condition. It is the primary cause of cardiovascular disease, and most everyone develops some degree of atherosclerosis over their lifetime. When and how much depends on your heredity and lifestyle.

Here’s how the atherosclerotic process works. There’s a thin layer of cells that line the inside of all arteries, called the endothelium (en-do-thee-lee-um). The endothelium regulates how the artery functions. For example, when more blood is needed, endothelial cells release nitric oxide, causing the artery to dilate temporarily, increasing blood flow.

The endothelium can be damaged by free radicals, oxidized LDL cholesterol, toxins, and other harmful elements in your blood stream. When this happens, the body initiates its repair process. The injured area becomes inflamed, and cholesterol and calcium combine to form a “patch” over it. Atherosclerosis is what occurs when arteries are chronically damaged and the patching process happens over and over again. The layers of patches eventually narrow the artery and make it stiff and less responsive.

What Causes Atherosclerosis?

For decades we’ve been sold the myth that arterial plaque buildup occurs because cholesterol levels are too high. This is not true!

Cholesterol is found in plaque buildup because it is the primary material the body uses to create the patch. But it does not cause atherosclerosis or cardiovascular disease. The true problem is what’s damaging the artery—and causing the inflammation—in the first place.

What Are the Symptoms of Atherosclerosis?

Unfortunately, people who have atherosclerosis don’t tend to experience symptoms until their disease is significantly progressed—so it’s possible for the process to be active for years without your knowing it. Still, there are signs that you have a problem. Atherosclerosis symptoms  include:


Sometimes called a “heart cramp,” angina is pain, pressure, or discomfort in the chest, typically felt during physical exertion or when you are unusually angry, excited, or anxious. Patients may also experience shortness of breath and fatigue.

Angina is not a heart attack, but it is caused by the same problem—a lack of oxygen to the heart. The difference is that with a heart attack, a clot prevents oxygen-rich blood from reaching the heart. During an angina attack, blood is still flowing; however, the arteries cannot dilate enough to match the demand for oxygen. Usually this is because arteries have narrowed and lost their elasticity.

If you have angina, atherosclerosis is—and has been—occurring in your coronary arteries. Be sure to monitor your symptoms with your doctor. And if you haven’t seen a doctor, by all means, do so at once.

Leg pain and numbness

One of the things people tend to overlook about cardiovascular disease is that it’s a systemic problem. The most dramatic events occur in the heart and brain, but atherosclerosis affects arteries in the entire body.

Pain and numbness in the lower legs, particularly during exertion, can be a symptom that the arteries in the legs, your femoral arteries, are narrowing due to atherosclerosis. Smokers—active and former—are especially prone to this problem, which is called peripheral artery disease (PAD).  If you suffer from PAD, your doctor will probably ask that you have a more thorough workup to see how much narrowing has affected the arteries that supply your heart and brain (your coronary and carotid arteries) as well.

Erectile dysfunction (ED)

Though it can be caused by many factors (e.g., low testosterone, depression, injury, nerve problems, and some medications), ED, like leg pain, can be a symptom of atherosclerosis. Research suggests that ED “shares atherogenic risk factors with coronary heart disease, including active and passive smoking, overweight, hypertension, and diet.” It has also been found that in patients with coronary heart disease, ED preceded CAD in the majority, by an average of two to three years.

Any man who sees a doctor with complaints of ED also should get a full cardiovascular workup.

Transient ischemic attack, or TIA

The symptoms of TIAs are similar to the symptoms of a full-blown stroke, but usually subside after a few minutes, when the body’s natural clot-busting agents dissolve the blockage. Like angina, TIAs should be considered a warning that blood flow is compromised. Seek treatment immediately.

Heart attack or stroke

The most obvious and urgent atherosclerosis symptom is a heart attack or stroke.  Blockages in the arteries going to your heart and brain can result from slow, chronic plaque buildup, or from blood clots that form when plaque ruptures in a hardened, narrowed artery.

Treating and Preventing Atherosclerosis

The best way to prevent atherosclerosis is to make heart-healthy lifestyle choices that minimize the amount of damage and inflammation in your arteries. Here are some of my top recommendations:

Manage your blood pressure

Many people consider blood pressure to be a relatively minor problem, but it is incredibly destructive when left untreated. I like to compare high blood pressure to a flooding river. As the high water races around bends, it erodes the banks. Similarly, chronically high pressure cuts into the arterial lining, which sets the atherosclerotic process in motion. Preventing atherosclerosis involves keeping your blood pressure in a healthy range with these eight natural steps.

Stop smoking

Smoking is a top risk factor for heart disease and for atherosclerosis. It’s a surefire way to raise blood pressure and flood your blood stream with chemicals that wreak havoc in your arteries. While I have no doubt that you should quit if you’re still smoking, I do realize it probably won’t be easy, and that quitting is a major life change. Here are some tips that can help.

Limit sugar intake as much as possible

We’ve known for decades that people with type 2 diabetes are at higher risk of cardiovascular disease. Why?  Excess glucose (sugar) in the blood combines with proteins to form advanced glycation end products, or AGEs—another element that can damage the endothelium. Worse, too much insulin can be inflammatory, as well. Since higher blood glucose means the body releases more insulin, a high-sugar diet is a double whammy when it comes to atherosclerosis and heart disease. Avoid eating sugar as much as you can. Stick with a low-glycemic, anti-inflammatory diet instead.

Reduce stress

When you’re stressed, the sympathetic branch of your nervous system pumps cortisol and other hormones into your blood stream to ready your body for a seemingly imminent challenge. While occasional cortisol spikes pose no cardiovascular risk, chronic exposure is inflammatory. Protect yourself by finding ways to manage and reduce your day-to-day stress level through meditation, yoga, massage, or similar techniques.


Tobacco and nicotine aren’t the only toxins that do a number on your arteries. So do pesticides, heavy metals, pollution, and industrial chemicals found in food and personal care products. Since it’s virtually impossible to escape exposure, I recommend focusing most on what you can control—eating organic food and using products that contain natural ingredients, to start. Eating lots of fresh fruits and vegetables daily is also one of the best ways to detox.

Practice Earthing

Earthing (also called grounding) floods your body with free electrons. These electrons help neutralize positively charged free radicals that can damage artery walls. Grounding has also been shown to have a balancing effect on the nervous system. The easiest way to get reap the benefits of getting grounded  is to walk barefoot on grass or sand. Check out these Q&As on additional ways to implement grounding in your life.

Take nutritional supplements

Turmeric and fish oil both have anti-inflammatory properties that can help keep arteries healthy. I also like a generous dose of CoQ10, for both its energy support and its antioxidant power.

Can Atherosclerosis Be Reversed?

This is one of the most common questions I hear, and my answer is yes. To some degree, you can stop and reverse plaque buildup; however, it’s a long process. Plaque buildup doesn’t go from 0 to 85 percent overnight, and it doesn’t undo itself that quickly, either. It takes time and serious commitment to a heart-healthy lifestyle—including a diet and nutritional supplement plan. Read my full plan for reversing plaque buildup.


© Stephen Sinatra, MD. All rights reserved.


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