What Causes Clogged Arteries & How They’re Treated
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What are clogged arteries?
Clogged arteries, also called atherosclerosis, is when there’s a build-up of plaque inside the arteries.
Your arteries are blood vessels that carry oxygen-rich blood and nutrients from the heart to various parts of the body. The plaque that forms there—arterial plaque—is made up of cholesterol, fat, inflammatory cells, calcium, and other materials.
If an arterial plaque becomes large enough, it can decrease the amount of blood that normally flows through the artery. Then areas of the body that the artery normally supplies don’t get enough oxygen and nutrients.
The parts of the body most commonly affected include the heart, brain, and legs. A clogged artery in the heart is sometimes referred to as a “heart blockage.”
Clogged arteries are treated with lifestyle changes, medication, and procedures. Your treatment will depend on what part of your body is affected, the severity of the plaque build-up, and the risk factors that caused the plaque build-up.
Sometimes, arterial plaques burst and form a blood clot. This can cause serious conditions such as a heart attack or stroke.
If you think you may be having a heart attack or stroke, go to the ER immediately.
Most common symptoms
The warning signs of clogged arteries of the heart are chest tightness, chest pain, or trouble breathing, especially with physical exertion. If the leg arteries are clogged, you may feel cramping in your calves, thighs, or butt when walking or climbing stairs. If the arteries of the neck or head are clogged, you may have vision issues, feel like the room is spinning, or have difficulty with walking or balance. —Dr. Sunny Varshney
Most people have no symptoms during the early stages of plaque build-up. But as the build-up grows larger, you may start to notice symptoms. The symptoms you experience depend on where the clogged arteries are located.
- Squeezing chest pain or tightness with physical exertion or emotional stress that lasts anywhere from 30 seconds to a few minutes.
- Difficulty breathing when you exert yourself.
- Vertigo (the sensation that the room is spinning)
- Difficulty speaking or slurred speech
- Difficulty keeping your balance
- Blurry vision or vision loss
- Drooping face muscles
- Other neurologic problems, like reduced sensation or strength in a specific part of the body (the location varies based on which part of the brain isn’t getting enough blood flow)
- Cramping pain in the calves, thighs, or buttocks in one or both legs when you exert yourself (the pain usually feels better with rest)
- Ulcers (open sores that don’t heal) and reduced sensation in one or both feet (if leg artery disease is severe)
- Similar cramping pain with exertion can occur in the arms if those arteries are clogged.
- Arteries that supply blood to your intestines can also become clogged, though this is rare. If this happens, you may have crampy abdominal pain after eating. In severe cases, people may start to avoid eating so they don’t experience pain. This can cause weight loss.
If you think you may have clogged arteries, get medical attention. The type of medical attention you need depends on the symptoms you’re experiencing.
Go to the ER if you have:
- Sudden, severe chest pain
- Neurologic symptoms (like reduced sensation in an area of the body)
- Severe leg pain, especially if your leg turns pale or blue-ish or is cold
If your symptoms are less severe, make an appointment with your doctor. Ideally, the appointment should take place within a few days. Or go to an urgent care center.
Causes of arterial plaque
Plaque build-up and clogged arteries typically develop over many years. Many factors contribute to it.
The first stage of clogged arteries involves damage to the inner layer of cells in the artery. This can be caused by high blood pressure, high cholesterol levels, smoking, diabetes, obesity, and other causes of inflammation.
Once the damage has occurred, inflammatory cells, cholesterol, and other materials begin to collect in the artery. These form a plaque. Over time, the plaque can grow until it severely narrows the artery and reduces blood flow.
Sometimes, the plaque can burst open (rupture) or the top of the plaque can get worn down (erosion), which causes a blood clot.
Risk factors for clogged arteries include:
- Older age (over 45 years for men and over 55 years for women)
- Being overweight or obese
- A sedentary lifestyle
- High blood pressure
- High levels of bad (LDL) cholesterol
- Diabetes, especially if it’s poorly controlled
- Frequent exposure to environmental and air pollution
- Tobacco use, including e-cigarettes and exposure to secondhand smoke
- Eating a diet high in saturated fats or trans fats
- A strong family history of clogged arteries (especially if the problem developed at a young age)
At any given time, there are numerous clinical trials evaluating new drugs and devices to improve how people with clogged arteries feel and help them live longer. Remain open to the idea of trying new, improved treatments for plaque buildup in the future. —Dr. Varshney
Treatments for clogged arteries include a combination of lifestyle changes, medication, and sometimes procedures. The goal is to slow plaque build-up, prevent significant artery narrowing, and prevent complications like heart attack or stroke.
- Quitting smoking
- Eating smaller portions
- Eating a heart-healthy diet that’s high in vegetables, fruits, whole grains, legumes, and lean proteins
- Limiting sweets, processed foods, sodium, and refined sugars
- Getting at least 150 minutes of moderate physical activity (or 75 minutes of intense physical activity) per week
- Maintaining a healthy weight and body mass index
- Anti-hypertensive medications to control high blood pressure if you have it. These include hydrochlorothiazide, carvedilol, amlodipine, lisinopril, and others. Typically, the goal is to maintain blood pressure that is less than 130/80.
- Medications to control diabetes if you have it. Diabetes medications include metformin, insulin, dapagliflozin (Farxiga), liraglutide (Victoza), and others.
- Statin medications, which lower bad (LDL) cholesterol levels and make plaques less likely to rupture. They are taken daily over many years. Statins include atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor).
- Low-dose aspirin, which can prevent the formation of blood clots. Since aspirin slightly thins the blood, it can cause excess bleeding (like blood in the stool or urine, or excess bleeding after small injuries like cuts or scrapes). If you have a history of certain bleeding problems, your doctor may tell you to not take aspirin.
- If you already have moderate or severe arterial plaque, you will be prescribed medication based on the location of the clogged arteries. For example, cilostazol is for people with blockages in the arteries of the legs to help lessen leg pain with physical exertion.
If you have severe plaque build-up or complications (such as a heart attack), you may need to have procedures or surgery to unclog arteries or bypass clogged arteries. These include:
- Percutaneous coronary intervention. This involves inserting a stent (a mesh tube) into blocked arteries that supply blood to the heart muscle. It is used when you’ve had a heart attack. It may also be recommended if the artery is severely narrowed and causing significant chest pain even when taking medications. It is minimally invasive— a catheter is inserted into the artery through the wrist or groin. If you haven’t had a heart attack, you usually can go home the same day of the procedure.
- Bypass grafting surgery. This surgery takes a vein or artery from another part of the body to create a bypass, or alternative route, around a severe blockage in an artery. Bypass grafting is usually done in the heart, but it can also treat severe blockages in the legs, abdomen, or neck. Recovery can take several days to a few weeks.
- Carotid endarterectomy. This surgery involves removing plaque build-up in the carotid artery. This artery is located in the neck and supplies blood to the brain. Recovery typically takes several days to a week.
Plaque build-up and clogged arteries require long-term management with lifestyle changes, medications, and regular follow-up visits with your doctor.
If you had a procedure or surgery for plaque build-up, you will need short-term follow-up visits with your doctor. They will make sure there are no complications from your surgery and that the surgical wounds (cuts) are healing well.
You will continue to be monitored by your doctor. You may need lab tests and imaging studies from time to time to check plaque build-up in the arteries. Depending on how you are feeling, you may eventually be prescribed stronger medications to treat risk factors.
The best ways to prevent plaque build-up and clogged arteries are:
- Quitting smoking.
- Getting at least 150 minutes of moderate physical activity (or 75 minutes of intense physical activity) per week.
- Eating a heart-healthy diet that’s high in vegetables, fruits, whole grains, legumes, and lean proteins.
- Limiting sweets, processed foods, sodium, and refined sugars.
- Maintaining a normal body weight and body mass index.
- Taking any medications your doctor has prescribed, such as those for high blood pressure and diabetes.
Adopting and maintaining a healthy lifestyle, including a heart-healthy diet and regular exercise, is more important than all the medications used to treat clogged arteries combined. Study after study has shown that people who maintain a healthy weight, eat a varied diet, avoid smoking, and get regular aerobic exercise have much lower rates of plaque build-up. —Dr. Varshney
Dr. Varshney is a board-certified Internist and current Cardiovascular Medicine Fellow at Brigham and Women's Hospital / Harvard Medical School. He earned his undergraduate degree in Biomedical Engineering from Washington University in St. Louis (2010) and graduated first in his class from the University of Texas Southwestern Medical School (2014). He then completed an internal medicine residency at Brigham and Women's Hospital / Harvard Medical School. Following this, he worked as a hospitalist at Brigham and Women's Hospital for 1 year while completing multiple projects spanning translational, clinical, and implementation research. He then began Cardiovascular Medicine Fellowship at Brigham and Women's Hospital in 2018.
Dr. Varshney is interested in the evidence-based design, development, evaluation, and implementation of technologies to improve outcomes for patients with cardiovascular disease. He has a particular interest in remote monitoring and mechanical circulatory support devices and is pursuing multiple academic endeavors in these areas. He plans to complete additional clinical training in the care of patients with advanced heart failure, cardiac transplantation, or need for mechanical circulatory support after completing Cardiovascular Medicine Fellowship. He has published multiple articles in the peer-reviewed medical literature and has written for other outlets including U.S. News & World Report and Doximity.