Atherosclerosis Treatment

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If you have a diagnosis of atherosclerosis, work with your healthcare team to set up a treatment plan that works for you. Your plan will be based on your lifestyle, home and neighborhood environment, and culture. Your 10-year or lifetime risk assessment is a good way to start the conversation.

Sometimes atherosclerosis can be reversed over time by following a heart-healthy lifestyle and taking medicines.

Procedures and surgery may help people who have dangerous levels of  plaque  buildup in the  arteries  of the heart or elsewhere in the body.

Heart-healthy living is very important for preventing and treating atherosclerotic plaque buildup throughout your lifetime.

Steps you can take for a healthy lifestyle include:

• Choose heart-healthy foods, such as the DASH (Dietary Approaches to Stop Hypertension) eating plan. A heart-healthy eating plan includes fruits, vegetables, and whole grains and limits saturated fats, sodium (salt), and added sugars.
• Be physically active. Regular physical activity can help manage risk factors, such as unhealthy cholesterol levels, high blood pressure, overweight, and obesity. Adults should engage in a total of 150 minutes or more per week of moderate physical activity or 75 minutes per week of vigorous physical activity. Before starting any exercise program, ask your provider what level of physical activity is right for you.
• Quit smoking and avoid secondhand smoke. Research shows that nicotine and flavorings found in vaping products can damage your heart and lungs. Visit Smoking and Your Heart and Your Guide to a Healthy Heart. These resources include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute's Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848). Talk to your healthcare provider if you vape.
• Get healthy sleep. The recommended amount for adults is 7 to 9 hours of sleep a day.
• Aim for a healthy weight. Losing just 3% to 5% of your current weight can help you manage some coronary heart disease risk factors, such as high blood cholesterol and diabetes. Weight loss can also improve blood pressure readings.
• Manage your health factors. Work with your provider to control your blood cholesterol level, blood pressure, and blood sugar. These are all important risk factors for atherosclerosis, but you can work with your provider to treat them with heart-healthy lifestyle changes and medicines.
• Limit how much alcohol you drink. Men should limit their intake to two drinks or less in a day. Women should drink one drink or less per day.
• Manage stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

Medicines can help manage risk factors and treat atherosclerosis or its complications. Your provider may also prescribe medicines to treat other medical conditions, such as high blood pressure, that can trigger plaque buildup or make it get worse.

Medicines often used to treat atherosclerosis or related conditions are listed below.

• ACE inhibitors and beta blockers help lower blood pressure and lower the heart's workload.
• Anti-platelet or anti-clotting medicines may help reduce risk of complications for some people who have atherosclerosis.
• Aspirin (low dose) is not recommended for most people unless they already have disease caused by atherosclerosis, or they have had a heart attack or stroke. Side effects may include bleeding and anemia, especially for those age 60 and older. Discuss aspirin use with your provider before you start taking it to make sure the benefit will outweigh the risk.
• Calcium channel blockers lower blood pressure by relaxing blood vessels.
• Medicines to control blood sugar may help lower your risk for complications of atherosclerosis if you have diabetes.
• Nitrates, such as nitroglycerin, dilate your coronary arteries and relieve or prevent chest pain from angina.
• Ranolazine treats coronary microvascular disease and the chest pain it may cause.
• Statins  and other cholesterol medicines treat unhealthy blood cholesterol Your provider may recommend a statin if you have a higher risk for coronary heart disease or stroke or if you have diabetes and are between ages 40 and 75. Your provider may prescribe another type of medicine if you are unable to take statins or if statins have not worked well enough to manage your blood cholesterol and  triglyceride  levels. Some non-statin medicines are given as injections or as IV infusions.
• Thrombolytic medicines, sometimes called clot busters, may be used to treat blood clots resulting from atherosclerosis. These medicines can dissolve  blood clots  that block arteries, causing a stroke, heart attack, mesenteric  ischemia  or other problems. Ideally, the medicine should be given as soon as possible after a clot is discovered.
• Weight-loss medicines, along with a healthy diet and exercise, may help some people with obesity lose weight. Obesity and overweight are risk factors for atherosclerosis. Some medicines are given as injections. Your provider may prescribe a medicine for short-term use, but other medicines may be needed long term. Weight-loss medicines are not safe to use during pregnancy. Learn more about approved weight-loss medicines.

Some dietary supplements and foods have shown signs in studies that they may help manage atherosclerosis risk factors. Talk with your provider about possible benefits and risks of nutritional supplements and particular foods. Be sure to discuss any nutritional supplements or medicines you're already taking. Some may interfere with other treatments or cause side effects.

The Food and Drug Administration has issued a warning about some red yeast rice products. Read more about use of dietary supplements in cholesterol management.

GUIDE

Dietary Approaches to Stop Hypertension (DASH) eating plan

The DASH eating plan is flexible and easy to follow, with many resources to help you create healthy habits for a lifetime.

View the DASH eating plan.

You may need a procedure, heart surgery, or another type of surgery to treat disease resulting from plaque buildup or to lower your risk of complications of atherosclerosis.

• Percutaneous coronary intervention (PCI) opens coronary arteries that are narrowed or blocked by the buildup of plaque. A small mesh tube called a stent is usually implanted after PCI to prevent the artery from narrowing again.
• Coronary artery bypass grafting (CABG) improves blood flow to the heart by using sections of normal arteries from the chest wall or veins from the legs to bypass the blocked arteries. Surgeons typically use CABG to treat people who have severe plaque buildup in arteries in the heart. Bypass grafting can also treat arteries in other parts of the body, such as the arteries leading to the intestines.
• Transmyocardial laser revascularization or coronary endarterectomy treats severe angina associated with coronary heart disease when other treatments are too risky or do not work.
• Carotid endarterectomy treats carotid artery disease. Other treatment options for this disease may include angioplasty and carotid artery stenting.
• Weight-loss (bariatric) surgery helps people with severe obesity lower their risk for atherosclerosis and its complications by reducing  inflammation  that can trigger or worsen plaque buildup.
• Lipoprotein  apheresis may help some people who have very high cholesterol levels due to a  genetic  disease called familial hypercholesterolemia. Lipoprotein apheresis uses a filtering machine to remove "bad" LDL cholesterol from the blood, then returns the remainder of the blood to your body.
• Angioplasty opens narrowed or blocked arteries. Healthcare providers may use angioplasty to treat peripheral artery disease affecting the legs, to treat coronary heart disease in the arteries of the heart, or to treat carotid artery disease in the neck. Your provider may inflate a small balloon in the artery to help flatten the plaque. Sometimes the balloon is coated with medicine to help the artery heal. A small mesh tube called a stent may be inserted to reduce the chances of the artery narrowing again.

• To help relieve symptoms of peripheral artery disease, your provider will recommend a supervised exercise program in a clinic or a home-based exercise program. Most home programs include health coaching, activity monitors, or regular check-ins with a coach by telephone. Talk with your provider regularly about your progress.
• If you have had a complication from atherosclerosis, your provider may recommend a cardiac rehabilitationprogram.
• Behavioral therapy or coaching support helps many people stick with their heart-healthy lifestyle changes. Counseling may also improve people's quality of life after they've had a complication.

Studies suggest that it is possible to reverse or cure atherosclerosis, especially in its early stages. Normal function and structure of blood vessels can be restored in some people by controlling the main risk factors for atherosclerosis (smoking, high blood pressure, diabetes, and high blood cholesterol) and taking medicines to achieve very low levels of "bad" LDL cholesterol. For example, in people with stable angina, scientists showed that following a heart-healthy lifestyle and taking medicines to achieve much lower LDL cholesterol levels could stabilize plaques within 30 days of beginning medicines. Within a year or two, the plaques began to disappear. Severe atherosclerosis may not be fully reversible with currently available treatments.