How Is Atherosclerosis Treated?

Treatments for atherosclerosis may include lifestyle changes, medicines, and medical procedures or surgery.

Goals of Treatment

The goals of treatment are to:

• Relieve symptoms
• Reduce risk factors in an effort to slow, stop, or reverse the buildup of plaque
• Lower the risk of blood clots forming
• Widen or bypass clogged arteries
• Prevent diseases related to atherosclerosis

Lifestyle Changes

Making lifestyle changes can often help prevent or treat atherosclerosis. For some people, these changes may be the only treatment needed.

• Follow a healthy eating plan to prevent or reduce high blood pressure and high blood cholesterol and to maintain a healthy weight.
• Increase your physical activity. Check with your doctor first to find out how much and what kinds of activity are safe for you.
• Lose weight, if you're overweight or obese.
• Quit smoking, if you smoke. Avoid exposure to secondhand smoke.
• Reduce stress.

Follow a Healthy Eating Plan

For a healthy eating plan, go to the National Heart, Lung, and Blood Institute’s (NHLBI’s) Aim for a Healthy Weight Web site. This site provides practical tips on healthy eating, physical activity, and controlling your weight.

Therapeutic Lifestyle Changes (TLC). Your doctor may recommend TLC if you have high cholesterol. TLC is a three-part program that includes a healthy diet, physical activity, and weight management.

With the TLC diet, less than 7 percent of your daily calories should come from saturated fat. This kind of fat is mainly found in meat and poultry, including dairy products. No more than 25 to 35 percent of your daily calories should come from all fats, including saturated, trans, monounsaturated, and polyunsaturated fats.

You also should have less than 200 mg a day of cholesterol. The amounts of cholesterol and the different kinds of fat in prepared foods can be found on the Nutrition Facts label.

Foods high in soluble fiber also are part of a healthy eating plan. They help block the digestive track from absorbing cholesterol. These foods include:

• Whole grain cereals such as oatmeal and oat bran
• Fruits such as apples, bananas, oranges, pears, and prunes
• Legumes such as kidney beans, lentils, chick peas, black-eyed peas, and lima beans

A diet high in fruits and vegetables can increase important cholesterol-lowering compounds in your diet. These compounds, called plant stanols or sterols, work like soluble fiber.

Fish are an important part of a heart healthy diet. They're a good source of omega-3 fatty acids, which may help protect the heart from blood clots and inflammation and reduce the risk for heart attack. Try to have about two fish meals every week. Fish high in omega-3 fats are salmon, tuna (canned or fresh), and mackerel.

You also should try to limit the amount of sodium (salt) that you eat. This means choosing low-sodium and low-salt foods and "no added salt" foods and seasonings at the table or when cooking. The Nutrition Facts label on food packaging shows the amount of sodium in the item.

Try to limit drinks with alcohol. Too much alcohol will raise your blood pressure and triglyceride level. (Triglycerides are a type of fat found in the blood.) Alcohol also adds extra calories, which will cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day.

See the NHLBI’s "Your Guide to Lowering Your Cholesterol With TLC" for more information.

Dietary Approaches to Stop Hypertension (DASH) eating plan. Your doctor may recommend the DASH eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in salt/sodium.

This eating plan is low in fat and cholesterol. It also focuses on fat-free or low-fat milk and dairy products, fish, poultry, and nuts. The DASH eating plan is reduced in red meats (including lean red meat), sweets, added sugars, and sugar-containing beverages. It's rich in nutrients, protein, and fiber.

The DASH eating plan is a good heart healthy eating plan, even for those who don’t have high blood pressure. See the NHLBI’s "Your Guide to Lowering Your Blood Pressure With DASH" for more information.

Increase Physical Activity

Regular physical activity can lower many atherosclerosis risk factors, including LDL ("bad") cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your levels of HDL cholesterol (the "good" cholesterol that helps prevent atherosclerosis).

Check with your doctor about how much and what kinds of physical activity are safe for you. Unless your doctor tells you otherwise, try to get at least 30 minutes of moderate-intensity activity on most or all days of the week. You can do the activity all at once or break it up into shorter periods of at least 10 minutes each.

Moderate-intensity activities include brisk walking, dancing, bowling, bicycling, gardening, and housecleaning.

More intense activities, such as jogging, swimming, and various sports, also may be appropriate for shorter periods. See the NHLBI’s "Your Guide to Physical Activity and Your Heart" for more information.

Maintain a Healthy Weight

Maintaining a healthy weight can decrease your risk factors for atherosclerosis. A general goal to aim for is a body mass index (BMI) of less than 25.

BMI measures your weight in relation to your height and gives an estimate of your total body fat. You can calculate your BMI using the NHLBI's online calculator, or your health care provider can calculate your BMI.

A BMI between 25 and 29 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for preventing and treating atherosclerosis. Your doctor or other health care provider can help you determine an appropriate goal for you.

For more information on losing weight and maintaining your weight, see the Diseases and Conditions Index Overweight and Obesity article.

Quit Smoking

If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis.

The U.S. Department of Health and Human Services has information on how to quit smoking.

Reduce Stress

Research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event—particularly one involving anger. Also, some of the ways people cope with stress, such as drinking, smoking, or overeating, aren't heart healthy.

Physical activity can help relieve stress and reduce other atherosclerosis risk factors. Many people also find that meditation or relaxation therapy helps them reduce stress.

Medicines

To help slow or reverse atherosclerosis, your doctor may prescribe medicines to help lower your cholesterol or blood pressure or prevent blood clots from forming.

For successful treatment, take all medicines as your doctor prescribes.

Medical Procedures and Surgery

If you have severe atherosclerosis, your doctor may recommend one of several procedures or surgeries.

Angioplasty is a procedure to open blocked or narrowed coronary (heart) arteries. Angioplasty can improve blood flow to the heart, relieve chest pain, and possibly prevent a heart attack. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure.

Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass (that is, go around) your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.

Bypass grafting also can be used for leg arteries. In this surgery, a healthy blood vessel is used to bypass a narrowed or blocked blood vessel in one of your legs. The healthy blood vessel redirects blood around the artery, improving blood flow to the leg.

Carotid artery surgery removes plaque buildup from the carotid arteries in the neck. This opens the arteries and improves blood flow to the brain. Carotid artery surgery can help prevent a stroke.