Arteriosclerosis & Atherosclerosis: Symptoms, Causes, Diagnosis & Treatment — Complete Guide
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Arteriosclerosis means the arteries — the blood vessels that carry oxygen and nutrients from the heart to the rest of the body — have become thick and stiff, a condition commonly called hardening of the arteries. Atherosclerosis is a specific type of arteriosclerosis: the buildup of fats, cholesterol, and other substances (called plaque) in and on the artery walls. Plaque narrows the arteries, blocks blood flow, and can burst, leading to a blood clot.
Although often considered a heart condition, atherosclerosis can affect arteries anywhere in the body, and its symptoms depend entirely on which arteries are affected — chest pain if it's the heart, stroke-like signs if it's the brain, leg pain when walking if it's the legs, and high blood pressure or kidney failure if it's the kidneys. It can be treated, and healthy lifestyle habits help prevent it.
What the research says
Simple tests can reveal artery disease before symptoms. In a review pooling studies of asymptomatic people, carotid plaque predicted future stroke (pooled HR 1.89; 95% CI 1.04–3.44), coronary artery calcium predicted coronary heart disease events (pooled HR 1.54; 95% CI 1.07–2.07), and an ankle-brachial index below 0.9 predicted cardiovascular death (pooled HR 2.01; 95% CI 1.43–2.81). (Garg et al., Arterioscler Thromb Vasc Biol, 2024) [3]
Medicine can shrink plaque. In 9 studies with 2,290 patients with coronary artery disease already on statins, adding PCSK9 antibody drugs lowered intravascular-ultrasound percent atheroma volume by a mean of 1.26 percentage points (95% CI −1.51 to −1.00; 4 studies, 1,875 participants). (Liu et al., Int J Cardiol, 2023) [4]
What a calcium scan shows goes beyond the score. Across 5 studies of 21,346 people without symptoms (1,309 cardiovascular events), denser coronary calcium was linked to a lower risk of events after adjusting for risk factors and calcium volume (HR 0.80 per standard deviation; 95% CI 0.72–0.89). (Yong et al., JACC Cardiovasc Imaging, 2025) [5]
TL;DR
Arteriosclerosis = thick, stiff artery walls; atherosclerosis = plaque buildup inside the artery — a specific type of arteriosclerosis.
Mild atherosclerosis usually causes no symptoms; problems start when an artery is so narrowed or clogged it can't deliver enough blood.
Symptoms depend on location: angina (heart), TIA/stroke signs (brain), claudication leg pain (legs), high blood pressure or kidney failure (kidneys).
It begins with damage to the inner layer of an artery and builds up over years — possibly starting as early as childhood.
You can't control aging, family history, genes, or inflammatory conditions — but you can control diet, blood pressure, cholesterol, diabetes, exercise, weight, sleep apnea, and smoking.
Complications include coronary artery disease, carotid artery disease, peripheral artery disease, aneurysms, and chronic kidney disease.
Treatment ranges from lifestyle changes alone to medicines (statins, aspirin, blood pressure drugs), angioplasty with stents, endarterectomy, and bypass surgery.
At a Glance
Item | Summary |
Arteriosclerosis | Arteries become thick and stiff — "hardening of the arteries" |
Atherosclerosis | A specific type of arteriosclerosis — plaque buildup in the artery walls |
Plaque | Fats, cholesterol, and other substances in and on artery walls |
Early symptoms | Usually none — mild atherosclerosis is silent |
Location determines symptoms | Heart: angina; brain: TIA/stroke; legs: claudication; kidneys: high BP, kidney failure |
Controllable risk factors | Diet, diabetes, blood pressure, cholesterol, exercise, weight, sleep apnea, smoking (8) |
Uncontrollable risk factors | Aging, family history, genes, inflammatory conditions (4) |
Complications | Coronary artery disease, carotid artery disease, peripheral artery disease, aneurysms, chronic kidney disease |
Main treatments | Lifestyle changes, medicines, angioplasty + stent, endarterectomy, CABG bypass |
Arteriosclerosis vs. Atherosclerosis: The Difference
The terms arteriosclerosis and atherosclerosis are sometimes used to mean the same thing, but there is a real difference between them — and understanding it unlocks the whole topic.
Arteriosclerosis happens when the blood vessels that carry oxygen and nutrients from the heart to the rest of the body become thick and stiff. These blood vessels are called arteries. Healthy arteries are flexible and elastic. But over time, the walls in the arteries can harden — a condition commonly called hardening of the arteries.
Atherosclerosis is a specific type of arteriosclerosis. It is the buildup of fats, cholesterol, and other substances in and on the artery walls. This buildup is called plaque. Plaque can cause arteries to narrow, blocking blood flow, and it can also burst, leading to a blood clot.
Although atherosclerosis is often considered a heart condition, it can affect arteries anywhere in the body. The good news: atherosclerosis can be treated, and healthy lifestyle habits can help prevent it.
How Atherosclerosis Develops
Atherosclerosis is a disease that slowly gets worse. It may begin as early as childhood, and the exact cause is not known. What is known is how it progresses:
The inner artery wall gets damaged. Injury to the inner layer of an artery may be caused by high blood pressure, high cholesterol, high triglycerides (a type of fat in the blood), smoking or other tobacco use, diabetes, insulin resistance, obesity, or inflammation from an unknown cause or from diseases such as arthritis, lupus, psoriasis, or inflammatory bowel disease.
Substances collect at the injury site. Once the inner wall is damaged, blood cells and other substances gather there and build up in the inner lining of the artery.
Plaque forms. Over time, fats, cholesterol, and other substances collect on and in the walls of the heart arteries. This buildup is plaque.
The artery narrows — and the plaque can burst. Narrowed arteries can block blood flow. The plaque can also burst, leading to a blood clot.
Symptoms of Atherosclerosis
Mild atherosclerosis usually doesn't cause symptoms. Symptoms usually don't happen until an artery is so narrowed or clogged that it can't send enough blood to organs and tissues. Sometimes a blood clot completely blocks blood flow. The clot may break apart — and if that happens, it may cause a heart attack or stroke.
Symptoms of moderate to severe atherosclerosis depend on which arteries are affected:
Arteries affected | Symptoms | What it's called |
Heart arteries | Chest pain or pressure | Angina |
Arteries to the brain | Sudden numbness or weakness in arms or legs, trouble speaking, slurred speech, sudden or temporary loss of vision in one eye, drooping face muscles | Transient ischemic attack (TIA) — untreated, it can lead to a stroke |
Arteries in arms and legs | Leg pain when walking; lower blood pressure in the affected arm or leg | Claudication — a symptom of peripheral artery disease (PAD) |
Arteries to the kidneys | High blood pressure or kidney failure | Chronic kidney disease |
When to See a Doctor
If you think you have atherosclerosis, make an appointment for a health checkup. Early diagnosis and treatment can stop atherosclerosis from getting worse, and treatment may prevent a heart attack, stroke, or another medical emergency.
Get emergency medical help if you have chest pain or symptoms of a transient ischemic attack or stroke — sudden numbness or weakness in the arms or legs, trouble speaking, slurred speech, sudden or temporary loss of vision in one eye, or drooping face muscles.
Causes and Risk Factors
Causes
As explained above, atherosclerosis likely starts with damage or injury to the inner layer of an artery, caused by high blood pressure, high cholesterol, high triglycerides, smoking, diabetes, insulin resistance, obesity, or inflammation. Blood cells and other substances then collect at the injury site, plaque builds up over years, the artery narrows, and the plaque may burst into a blood clot.
Risk Factors You Can't Control
Aging.
Family history of early heart disease or stroke.
Gene changes that make atherosclerosis more likely.
Inflammatory conditions such as lupus, inflammatory bowel disease, or psoriasis.
Risk Factors You Can Control
An unhealthy diet.
Diabetes.
High blood pressure.
High cholesterol.
Lack of exercise.
Obesity.
Sleep apnea.
Smoking and other tobacco use.
Complications
The complications of atherosclerosis depend on which arteries are narrowed or blocked:
Complication | Where it happens | What can result |
Coronary artery disease | Arteries close to the heart | Chest pain, heart attack, or heart failure |
Carotid artery disease | Arteries close to the brain | Transient ischemic attack (TIA) or stroke |
Peripheral artery disease | Arteries in the arms or legs | Blocked or changed blood flow; rarely, tissue death called gangrene |
Aneurysms | Anywhere in the body — a bulge forms in the artery wall | Most have no symptoms; if an aneurysm bursts, it can cause life-threatening bleeding inside the body |
Chronic kidney disease | Arteries leading to the kidneys | The kidneys don't get enough oxygen-rich blood to remove fluids and waste |
How Atherosclerosis Is Diagnosed
To diagnose atherosclerosis, your healthcare professional examines you and listens to your heart. You're asked about your symptoms and family health history, and you may be referred to a cardiologist — a doctor trained in heart diseases. During the exam, your healthcare professional may hear a whooshing sound when listening with a stethoscope.
The Ten Main Tests
Test | What it does |
Blood tests | Check blood sugar and cholesterol levels — high levels raise atherosclerosis risk. A C-reactive protein (CRP) test checks for a protein linked to inflammation of the arteries. |
Electrocardiogram (ECG or EKG) | A quick, painless test with sticky sensor patches on the chest and sometimes arms or legs; measures the heart's electrical activity and can show reduced blood flow to the heart. |
Exercise stress tests | Walking on a treadmill or riding a stationary bike while the heart's activity is watched. Exercise makes the heart pump harder and faster than usual, revealing conditions that might otherwise be missed. Medicine substitutes if you can't exercise. |
Echocardiogram | Sound waves show blood flow through the heart plus the size and shape of heart structures. Sometimes done during a stress test. |
Doppler ultrasound | A special ultrasound device checks blood flow at different points in the body, showing the speed of blood flow in the arteries and revealing narrowed areas. |
Ankle-brachial index (ABI) | Compares blood pressure in the ankle with that in the arm to check for atherosclerosis in the legs and feet — a difference may mean peripheral artery disease. |
Cardiac catheterization and angiogram | A long, thin, flexible tube is guided through a blood vessel (usually in the groin or wrist) to the heart; dye flows through the catheter so the coronary arteries show clearly on images, revealing narrowing or blockages. |
Coronary calcium scan (heart scan) | CT imaging looks for calcium deposits in the artery walls. It can show coronary artery disease before symptoms appear. Results are given as a score — the higher the calcium score, the higher the heart attack risk. |
Other imaging tests | Magnetic resonance angiography (MRA) or positron emission tomography (PET) can show hardening and narrowing of large arteries, as well as aneurysms. |
Treatment of Atherosclerosis
Treatment may include lifestyle changes, medicines, a heart procedure, or heart surgery. For some people, lifestyle changes may be the only treatment needed.
Medications
Many different medicines can slow — or even reverse — the effects of atherosclerosis:
Statins and other cholesterol medicines lower low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol — and can reduce plaque buildup. Some cholesterol medicines can even reverse the buildup of fatty deposits in the arteries. Statins are the most common type; others include niacin, fibrates, and bile acid sequestrants. You may need more than one type.
Aspirin thins the blood and prevents clots. Daily low-dose aspirin therapy may be recommended for primary prevention of heart attack or stroke in certain people — those who have never had a heart attack, stroke, bypass, or angioplasty with stent, and no blocked arteries elsewhere. The benefit for this use has been debated, so don't start daily aspirin without talking to a healthcare professional.
Blood pressure medicine doesn't reverse atherosclerosis but prevents or treats complications — some blood pressure medicines reduce heart attack risk.
Other medicines control conditions that raise atherosclerosis risk (such as diabetes) and treat specific symptoms (such as leg pain during exercise).
Fibrinolytic therapy uses a clot-dissolving medicine when a clot blocks blood flow — generally used in emergency situations.
Surgery and Procedures
If atherosclerosis causes a severe blockage in an artery, a procedure or surgery may be needed:
Procedure | What happens |
Angioplasty and stent placement (percutaneous coronary intervention) | A thin, flexible catheter is guided to the narrowed part of the artery; a tiny balloon is inflated to widen the blocked artery and improve blood flow. A small wire-mesh tube (stent) may be used to keep the artery open — some stents slowly release medicine. |
Endarterectomy | Surgery removes fatty buildup from the walls of a narrowed artery. When done on the neck arteries, it's called a carotid endarterectomy. |
Coronary artery bypass graft (CABG) surgery | Open-heart surgery where a healthy blood vessel from another part of the body creates a new path for blood around the blocked or narrowed coronary artery. Usually done only in people with many narrowed heart arteries. |
Lifestyle Changes and Home Remedies
The American Heart Association recommends these eight heart-healthy tips:
Don't smoke, vape, or use tobacco — and stay away from cigarette smoke. Smoking damages the arteries and is a major risk factor for coronary artery disease. Nicotine tightens blood vessels and forces the heart to work harder. Not smoking is one of the best ways to lower the risk of complications such as a heart attack.
Get regular exercise — at least 30 minutes a day on most days of the week. Ask your healthcare team about the amount and type of exercise that's best for you.
Keep a healthy weight — being overweight increases coronary artery disease risk. Even losing a small amount of weight helps.
Eat healthy foods — fruits, vegetables, and whole grains; limit salt and saturated fats; read nutrition labels.
Manage stress — exercise, mindfulness, support groups, yoga, or deep breathing. These relaxation practices can temporarily lower blood pressure.
Control blood pressure, blood sugar, and cholesterol — through lifestyle changes and medicines taken as directed, plus regular health checkups.
Limit alcohol — up to one drink a day for women and up to two a day for men.
Get good sleep — poor sleep may increase heart disease risk. Adults should aim for 7 to 9 hours daily.
Prevention
The same lifestyle changes that treat atherosclerosis also prevent it. Keep the arteries healthy by not smoking or using tobacco, eating nutritious foods, getting regular exercise and staying active, keeping a healthy weight, and controlling blood pressure, blood sugar, and cholesterol.
Alternative Medicine — What to Know First
Some foods and herbal supplements may help lower cholesterol and blood pressure, the two major risk factors for atherosclerosis. Possible options include alpha-linolenic acid, barley, beta-sitosterol (found in supplements and some margarines), blond psyllium, cocoa, fish oil, garlic, green tea, oat bran, and sitostanol.
Talk to your healthcare professional before adding any supplement to your treatment. Some supplements change the way atherosclerosis medicines work, which could cause harmful side effects.
Coping and Support
Living with atherosclerosis often means long-term medication, regular checkups, and real lifestyle changes — a combination that can feel overwhelming at first. Remember that this condition is treatable, and in many cases even reversible in its early stages. Connect with others through heart and blood health support communities, keep every appointment, and take your medicines exactly as directed. Small consistent changes add up to real protection for your heart and every artery in your body.
Preparing for Your Appointment
If you think you may have atherosclerosis or have a family history of heart disease, make an appointment for a health checkup and ask whether you need a cholesterol test.
What You Can Do
Check pre-appointment restrictions — for example, you may be told not to eat or drink for a few hours before a cholesterol test.
Write down any symptoms, including ones that may not seem related. Always mention chest pain or shortness of breath.
Write down key personal information — family history of high cholesterol, heart disease, stroke, high blood pressure, or diabetes, plus major stresses or recent life changes.
List all medicines, vitamins, and supplements with dosages.
Take someone along if possible — a companion may remember something you miss.
Be ready to discuss your food and exercise habits. If you don't already eat healthy or exercise, your healthcare team can give you tips on getting started.
Write down your questions, from most to least important.
Questions to Ask Your Healthcare Professional
What tests will I need?
What's the best treatment?
What foods should I eat or not eat?
What's an appropriate level of exercise?
How often do I need a cholesterol test?
What are the options to the primary treatment you're suggesting?
Is there a generic option to the medicine you're prescribing?
I have other health conditions — how can I best manage them together?
Should I see a specialist?
Are there brochures or other printed material I can take with me, and what websites do you recommend?
Questions Your Doctor Will Likely Ask
Do you have a family history of high cholesterol, high blood pressure, or heart disease?
What are your diet and exercise habits like?
Do you or did you smoke or use tobacco in any form?
Do you have chest pain or discomfort, or pain in your legs with walking or at rest?
Have you had a stroke, or unexplained numbness, tingling, or weakness on one side of your body, or difficulty speaking?
What You Can Do in the Meantime
It's never too early to make healthy lifestyle changes. Eat healthy, be active, get more exercise, and don't smoke or vape. These simple steps protect you against atherosclerosis and its complications, including heart attack and stroke.
Frequently Asked Questions
What is the difference between arteriosclerosis and atherosclerosis?
Arteriosclerosis means the arteries have become thick and stiff — commonly called hardening of the arteries. Atherosclerosis is a specific type of arteriosclerosis in which fats, cholesterol, and other substances build up in and on the artery walls, forming plaque that narrows the arteries and can burst into a blood clot.
Can you have atherosclerosis with no symptoms?
Yes. Mild atherosclerosis usually causes no symptoms at all. Symptoms typically appear only when an artery is so narrowed or clogged that it can't deliver enough blood to organs and tissues — which is why early checkups matter.
What does atherosclerosis feel like?
It depends on which arteries are affected. In the heart arteries, it feels like chest pain or pressure (angina). In the leg arteries, it causes leg pain when walking (claudication). In the brain arteries, it causes stroke-like symptoms such as sudden weakness, slurred speech, or temporary vision loss in one eye.
What causes plaque to form in arteries?
The process likely begins with damage to the inner layer of an artery from high blood pressure, high cholesterol, high triglycerides, smoking, diabetes, insulin resistance, obesity, or inflammation. Blood cells and other substances collect at the injury site, and over time plaque builds up, narrowing the artery.
Which risk factors can I control?
You can control your diet, diabetes, blood pressure, cholesterol, exercise habits, weight, sleep apnea, and tobacco use. You cannot control aging, family history, gene changes, or inflammatory conditions such as lupus or psoriasis — but managing the controllable factors significantly lowers your overall risk.
What tests diagnose atherosclerosis?
Diagnosis may include blood tests (cholesterol, blood sugar, and CRP for inflammation), an ECG, exercise stress tests, an echocardiogram, Doppler ultrasound, the ankle-brachial index, cardiac catheterization with angiogram, and a coronary calcium scan — a CT scan that can detect artery disease before symptoms appear, with results given as a calcium score.
How is atherosclerosis treated?
For some people, lifestyle changes are the only treatment needed. Otherwise, treatment includes medicines (statins and other cholesterol drugs, aspirin, blood pressure medicine, and emergency clot-dissolving therapy) and procedures or surgery (angioplasty with stent placement, endarterectomy to remove plaque, and coronary artery bypass graft surgery).
Conclusion
Arteriosclerosis and atherosclerosis describe the slow stiffening and narrowing of the body's arteries — a process that can start as early as childhood but rarely shows symptoms until blood flow is seriously compromised. This guide has walked through how plaque forms and bursts, why symptoms depend on which arteries are affected, which risk factors you can and can't control, the five major complications, the full set of diagnostic tests, and the complete range of treatments from lifestyle changes to bypass surgery. The most encouraging fact: this condition can be treated, slowed, and in some cases even reversed — and the eight heart-healthy habits start working the day you adopt them. If you suspect your arteries may be at risk, the best first step is simple: schedule a checkup and ask about a cholesterol test.
This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
References
Mayo Clinic. Arteriosclerosis / atherosclerosis — Symptoms & causes. Accessed October 12, 2026. https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569
Mayo Clinic. Arteriosclerosis / atherosclerosis — Diagnosis & treatment. Accessed October 12, 2026. https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/diagnosis-treatment/drc-20350575
Garg PK, Bhatia HS, Allen TS, et al. Assessment of subclinical atherosclerosis in asymptomatic people in vivo: measurements suitable for biomarker and Mendelian randomization studies. Arterioscler Thromb Vasc Biol. 2024;44(1):24-47. PMID 38150519. https://doi.org/10.1161/ATVBAHA.123.320138
Liu S, Wang P, Liu C, et al. Effect of PCSK9 antibodies on coronary plaque regression and stabilization derived from intravascular imaging in patients with coronary artery disease: a meta-analysis. Int J Cardiol. 2023;392:131330. PMID 37666281. https://doi.org/10.1016/j.ijcard.2023.131330
Yong Y, Giovannucci J, Pang SN, et al. Coronary artery calcium density and risk of cardiovascular events: a systematic review and meta-analysis. JACC Cardiovasc Imaging. 2025;18(3):294-304. PMID 39243235. https://doi.org/10.1016/j.jcmg.2024.07.024
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