artery risks and benefits for patients

Overview

Artery disease, also called atherosclerosis (say: ath-er-o-skle-RO-sis), is a condition where the arteries – the blood vessels that carry oxygen-rich blood from your heart to the rest of your body – become narrowed or blocked. This happens when fatty deposits called plaque build up inside the artery walls. Over time, the plaque can harden, making it harder for blood to flow. This can lead to serious problems like chest pain, heart attack, or stroke. The 'risks and benefits' for patients often refer to understanding how to manage artery disease: the risks of leaving it untreated versus the benefits of lifestyle changes and medical care.

Yes, artery disease is very common, especially as people age. It is the leading cause of heart attacks and strokes worldwide.

It can affect anyone, but it is more common in people over 50, those with a family history of heart disease, smokers, people with high blood pressure, high cholesterol, or diabetes, and those who are overweight or inactive.

Symptoms

Common symptoms

• Chest pain or discomfort (angina) – often feels like pressure, squeezing, or fullness in the chest, especially with activity
• Shortness of breath
• Pain, cramping, or numbness in your legs when walking (claudication) that goes away with rest
• Fatigue
• Dizziness or feeling faint

Symptoms in children

• Artery disease is rare in children, but when it occurs it may be due to genetic conditions. Symptoms can include chest pain, fainting during exercise, or abnormal heart rhythms.

Symptoms in older adults

• Older adults may have fewer typical symptoms and more general ones like tiredness, confusion, or reduced activity. They may also have leg pain at rest or wounds that heal slowly on the feet or legs.

Causes

Main causes

• Atherosclerosis – the buildup of fatty plaque inside artery walls

Risk factors

• Smoking or using tobacco
• High blood pressure (hypertension)
• High levels of LDL cholesterol (the 'bad' cholesterol)
• Low levels of HDL cholesterol (the 'good' cholesterol)
• Diabetes or prediabetes
• Obesity or being overweight
• Unhealthy diet high in saturated fats, trans fats, and salt
• Lack of physical activity
• Heavy alcohol use
• Family history of heart disease or stroke
• Age (over 45 for men, over 55 for women)
• Chronic stress

When to see a doctor

See a doctor urgently if:

• If you have new or worsening chest pain, shortness of breath, or leg pain while walking – see a doctor or go to urgent care the same day.
• If you have any of the emergency symptoms listed above, call your local emergency number immediately.

Book a routine appointment if:

• If you have risk factors like high blood pressure, high cholesterol, diabetes, or a family history of artery disease, visit your doctor regularly for check-ups.
• If you are over 40 and have not had a cardiovascular risk assessment, talk to your doctor about having one.

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and risk factors. They will listen to your heart and lungs, check your blood pressure, and may order tests to look at your arteries and heart function.

Tests that may be done

• Blood tests – to check cholesterol, blood sugar, and other markers
• Electrocardiogram (ECG or EKG) – records electrical activity of the heart
• Exercise stress test – heart monitoring while you walk on a treadmill
• Ankle-brachial index (ABI) – compares blood pressure in your ankle and arm to check for leg artery blockages
• Ultrasound (carotid or peripheral) – uses sound waves to see blood flow in arteries
• Coronary angiogram – a dye and X-ray to see blockages in heart arteries
• CT scan or MRI – special imaging to view arteries

What to expect at your appointment

Most tests are painless and done in a clinic or hospital. Your doctor will explain each test and what it shows. You may need to fast for some blood tests. The results will help your doctor decide the best treatment plan for you.

Treatment

Treatment for artery disease focuses on slowing the buildup of plaque, preventing complications, and improving blood flow. It involves a combination of lifestyle changes, medications (if prescribed), and sometimes procedures to open or bypass blocked arteries. The goals are to relieve symptoms, reduce the risk of heart attack and stroke, and help you stay active and healthy.

Self-care at home

• Quit smoking – this is the single most important step you can take for your arteries
• Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins, and low in saturated fats, trans fats, salt, and added sugars
• Aim for at least 150 minutes of moderate aerobic activity (like brisk walking) each week, or as advised by your doctor
• Manage your weight – even a small loss can help
• Limit alcohol to no more than one drink per day for women and two for men (or as your doctor advises)
• Find healthy ways to cope with stress, such as relaxation techniques or talking to a friend

Medical treatments

If lifestyle changes are not enough, your doctor may prescribe medications to lower blood pressure, reduce cholesterol, prevent blood clots, or control blood sugar. These are taken long-term and should be taken exactly as prescribed. Do not stop any medication without talking to your doctor. Always ask your pharmacist or doctor for details about side effects and interactions.

When is surgery considered?

Surgery or procedures may be recommended if arteries are severely narrowed or blocked and symptoms are not controlled with medication. Options include angioplasty (inserting a small balloon to open the artery, often with a stent) or bypass surgery (using a healthy blood vessel from another part of the body to create a detour around the blockage). Your surgeon will discuss the risks and benefits of these options with you.

Living with this condition

Living with artery disease means making heart-healthy choices a part of your daily routine. Take your medications as directed, keep your risk factors under control, and pay attention to any new or worsening symptoms. Regular check-ups are important. Learn to listen to your body – if you feel chest discomfort, leg pain, or shortness of breath, rest and let your doctor know.

Lifestyle tips

• Follow a balanced diet – try the Mediterranean diet as a guide
• Stay active in ways you enjoy, like walking, swimming, or cycling
• Get at least 7–8 hours of sleep each night
• Avoid smoking and secondhand smoke
• Limit stress with mindfulness, hobbies, or talking to someone you trust

Diet and exercise

Eat plenty of colorful vegetables, fruits, whole grains, nuts, seeds, fish, and lean poultry. Cook with healthy oils like olive oil. Cut back on red meat, processed foods, and sugary drinks. For exercise, start slowly and gradually increase. If you have leg pain when walking, rest until it goes away, then continue – this can actually help improve circulation over time. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Living with a chronic condition like artery disease can be stressful and sometimes scary. You may feel anxious about your health or about having a heart attack or stroke. It is normal to feel this way. Talk to your doctor or a mental health professional if you feel overwhelmed. Joining a support group can also help. Taking care of your emotional health is just as important as managing your physical health.

Prevention

Yes, many cases of artery disease can be prevented or delayed with a healthy lifestyle. Even if you have a family history, taking steps to eat well, stay active, avoid tobacco, and manage stress can make a big difference. Controlling blood pressure, cholesterol, and diabetes is also key.

Screening programmes

Routine screening for high blood pressure and high cholesterol is recommended for most adults starting at age 20. Your doctor may also check your blood sugar and do a risk assessment based on your age, sex, and other factors. If you have risk factors, earlier or more frequent screening may be advised.

Complications

If left untreated

• Heart attack (myocardial infarction)
• Stroke (when a blood clot blocks an artery in the brain)
• Heart failure – when the heart cannot pump enough blood
• Peripheral artery disease complications – open sores, infections, and even amputation of a limb
• Aneurysm – a bulge in a weakened artery wall that can burst

Long-term outlook

While artery disease is a serious condition, the outlook can be very good with proper management. Many people with artery disease live full, active lives for many years. Treatment and lifestyle changes can slow the disease, relieve symptoms, and greatly lower the risk of a heart attack or stroke. The key is to work closely with your healthcare team and stick with your plan.

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