Arteriosclerosis/Atherosclerosis – Diagnosis and Treatment

Diagnosis

Healthcare providers use a range of tests to check for atherosclerosis, arteriosclerosis, and related vascular diseases. These tests reveal plaque buildup, artery narrowing, and the effects of high cholesterol or high blood sugar.

Doctors use these tests to find issues like peripheral artery disease, renal artery stenosis, aortic aneurysm, and other complications related to atherosclerotic vascular disease.

Blood Tests

Doctors check cholesterol (including LDL cholesterol) and blood sugar levels with blood tests. They may also measure C-reactive protein (CRP), which signals inflammation in arteries. High CRP raises the risk for artery problems.

Electrocardiogram (ECG or EKG)

Doctors record the heart’s electrical signals with this test. Abnormal results can point to reduced blood flow or past heart damage.

Exercise Stress Test

Doctors ask patients to walk on a treadmill or use a stationary bike. They track the heart’s response to exercise to uncover problems that resting tests might miss.

This can reveal symptoms like chest pain or leg pain that only happen during activity.

Imaging Tests

Doctors use several imaging techniques:

• Echocardiogram: Shows how blood moves through the heart and checks the heart’s structure.
• Doppler Ultrasound: Measures blood flow speed and strength in arteries.
• Magnetic Resonance Angiography (MRA) and Positron Emission Tomography (PET): Give detailed views of artery walls, plaque, aneurysms, and blockages.
• Coronary Calcium Scan (Heart Scan): A CT scan that detects calcium deposits in coronary arteries. Higher scores mean more risk for heart problems.

Ankle-Brachial Index (ABI)

Doctors compare blood pressure at the ankle and arm. If the ankle pressure is lower, this may mean peripheral artery disease or atherosclerosis in the legs.

Cardiac Catheterization and Angiography

Doctors insert a thin tube into a blood vessel and guide it to the heart. They inject dye to show blockages or narrow areas on X-rays. This test helps doctors see plaque, ruptures, or changes in artery walls.

Test	What it Detects
Blood Tests	High cholesterol, blood sugar, inflammatory markers
ECG/EKG	Heart electrical issues, ischemia
Stress Test	Heart problems during activity
Echocardiogram	Blood flow, heart structure
Doppler Ultrasound	Blockages, narrowed arteries, PAD
ABI	Leg artery perfusion, PAD
Angiography	Precise narrowing/blockage, atheromatous changes
CT Calcium Scan	Coronary calcium, risk of events
MRA/PET	Vessel structure and function

Doctors may order other tests, such as lipoprotein(a) or extra blood markers, if standard tests are unclear or symptoms continue.

Treatment

Medicines Used to Manage Atherosclerosis

Doctors use medications to control atherosclerosis and lower the risk of complications. The type of medicine depends on each person’s needs:

Type of Medicine	Main Purpose
Statins & cholesterol meds	Lower cholesterol, slow/reverse artery plaque
Antiplatelet drugs	Lower blood clot risk
Blood pressure drugs	Control hypertension, prevent complications
Blood sugar drugs	Manage diabetes to reduce risks
Clot-busters (fibrinolytics)	Break up acute blood clots

• Cholesterol-Lowering Medicines: Doctors often prescribe statins to lower LDL (“bad”) cholesterol and slow or reduce plaque buildup. Other options include niacin, fibrates, and bile acid sequestrants. Sometimes, more than one type is needed.

• Drugs to Help Prevent Blood Clots: Doctors may use antiplatelet drugs, such as aspirin, to reduce the chance of blood clots. This lowers the risk of heart attack or stroke. Only take these medicines if your doctor recommends them.

• Blood Pressure Medicines: Doctors prescribe these to lower blood pressure and help prevent heart attacks or strokes. Lowering blood pressure reduces strain on the heart and vessels.

• Medicines for Other Health Problems: People with diabetes or other conditions may get medicines to keep these under control. Doctors may also prescribe drugs to relieve symptoms like leg pain during exercise.

• Medicines to Dissolve Clots: In emergencies, doctors may use fibrinolytic drugs to break up sudden blood clots blocking an artery.

Surgical and Other Interventions for Severe Blockages

If medicine and lifestyle changes are not enough, or if the blockage is severe, doctors may use procedures or surgery to restore blood flow.

• Balloon Widening and Stent Insertion: In angioplasty and stenting, doctors guide a thin tube to the blocked area. They inflate a small balloon to push plaque aside and open the artery. They often leave a mesh tube (stent) in place to keep the artery open. Some stents release medicine to help prevent re-narrowing.

• Removal of Plaque From Arteries: In endarterectomy, doctors remove fatty buildup from inside an artery. If done in the neck, it is called carotid endarterectomy and helps lower stroke risk.

• Bypass surgery: In coronary artery bypass grafting (CABG), doctors attach a healthy vessel from another body part to route blood around a blocked heart artery. This allows blood to reach the heart muscle by a different path. CABG is major surgery and is usually for people with several blocked arteries.

Angioplasty with or without a stent is less invasive. Endarterectomy physically removes blockage. Bypass surgery is more complex and is for more severe cases.

Doctors decide on these treatments based on the location, severity, and symptoms of atherosclerosis.

Everyday Habits and Home Approaches

Making changes to daily routines can help support artery health and slow plaque buildup. People can take several steps at home to lower risk and manage atherosclerosis.

Avoid all tobacco products, including cigarettes and vaping. Tobacco smoke harms blood vessels. Quitting smoking is one of the best ways to lower heart risk.

Stay physically active each day. Adults should aim for about 30 minutes of exercise on most days. Walking, cycling, and swimming are good choices. People with health concerns should ask their doctor about safe activities.

Maintaining a healthy weight is important. Even small weight loss can improve heart health for those who are overweight.

Choose a nutritious diet. The table below lists recommended foods:

Food Group	Examples	Advice
Fruits & Vegetables	Apples, spinach, tomatoes	Eat daily, vary choices
Whole Grains	Oats, brown rice, whole wheat	Pick whole over refined
Lean Proteins	Fish, chicken, beans	Limit red meats
Healthy Fats	Olive oil, nuts, avocado	Avoid trans fat

Check nutrition labels to limit salt and saturated fats.

Lower stress with relaxation techniques like deep breathing, mindfulness, or yoga. Connecting with friends or support groups can also help.

Manage key health numbers. Check blood pressure, blood sugar, and cholesterol regularly. Follow medical advice and take medicine if needed.

Drink less alcohol. For women, moderation means one drink daily; for men, up to two. Get enough good-quality sleep. Adults should aim for 7 to 9 hours each night to support heart health.

Complementary Health Approaches

Some people use foods and supplements to help lower cholesterol or blood pressure. Examples include fish oil, garlic, green tea, oat bran, cocoa, barley, alpha-linolenic acid, blond psyllium, beta-sitosterol, and sitostanol.

These are found in certain foods, supplements, or added to products like margarine.

Supplement/Food	Potential Effect
Fish oil	Supports heart health.
Oat bran	May reduce cholesterol.
Garlic	Helps blood pressure.
Green tea	May improve cholesterol levels.

Always consult a healthcare provider before using supplements, as some can interact with medicines or cause side effects.

Getting Ready for Your Visit

Steps You Can Take Before Your Appointment

Before your visit, you can take several steps to make the most of your time with your healthcare provider:

• Ask About Pre-Visit Rules: When scheduling, ask if you need to fast or follow any special steps, especially before a cholesterol test.
• Keep a Record of Symptoms: Write down any signs, such as chest pain or shortness of breath, even if they seem unrelated.
• Note Important Personal Details: Include family history of heart disease, high cholesterol, stroke, high blood pressure, diabetes, or recent life changes.
• List All Medications and Supplements: Bring an up-to-date list showing everything you take, including prescriptions, over-the-counter items, vitamins, and dosages.
• Bring a Companion: A friend or family member can help remember details and information from the appointment.
• Prepare to Discuss Lifestyle: Be ready to talk about eating habits and exercise. This helps your doctor give advice suited to your needs.
• Write Down Questions: Make a list of anything you want to ask, such as:

Question Examples
What tests will be done?
Which treatment is best for me?
What foods should I avoid or include?
What physical activities are suitable for me?
How often do I need cholesterol checks?
Are there alternatives or generic options for medicine?
How do I manage other health issues together?
Should I see a specialist about my condition?

Ask about anything else you do not understand or want to know more about.

Questions Your Healthcare Provider May Have

During your appointment, your healthcare team will likely ask questions to better understand your risk and symptoms.

If you are ready with honest answers, you can get the best advice and care.

• Do you have relatives with high cholesterol, heart disease, high blood pressure, or stroke?
• What are your usual eating and exercise habits?
• Have you ever smoked or used any tobacco products, now or in the past?
• Do you get chest pain, discomfort, or pain in your legs when you walk or rest?
• Have you experienced a stroke, numbness, tingling, weakness on one side of your body, or trouble speaking?

When you share details openly, your healthcare team can create a care plan that fits your needs.