Atherosclerosis & Plaque

What is Atherosclerosis?

Atherosclerosis is a chronic and progressive condition driven by damage of the endothelium (the delicate inner lining of our arteries) due to injury and inflammation followed by plaque formation. (1, 2)

This lining is sensitive to many forms of irritants such as high blood pressure, smoking, elevated blood sugar, chronic inflammation, etc. Once damaged, cholesterol has the potential to sneak into the arterial wall, initiating the cascade we know as plaque build up. LDL, or our “bad cholesterol”, has the ability to become oxidized (ie. changes in structure to become more sticky and unidentifiable) which can activate our immune system. Once activated, the immune system synthesizes macrophages or white blood cells to clear the oxidized LDL. In the process, the macrophages become foam cells, which lays the “fatty streak” foundation for further plaque to form. 

Over time, plaque accumulation narrows and hardens the arteries, restricting blood flow and increasing the risk of serious cardiovascular events such as heart attacks, strokes, and peripheral artery disease. (2)

To learn more about cholesterol, see my article here!

What are the risk factors and consequences of atherosclerosis?

Several factors contribute to the development and progression of atherosclerosis, including:

• Uncontrolled hypertension

• High LDL and low HDL cholesterol

• Chronic inflammation

• Diabetes and insulin resistance

• Smoking

• Sedentary lifestyle

• Poor dietary habits

• Genetic predisposition

• Exposure to heavy metals or organic toxins (ie. Mold, etc.)

• Infections

If left unaddressed, atherosclerosis can result in conditions such as:

• Coronary artery disease

• Heart attack

• Stroke

• Peripheral artery disease

• Thrombosis (ie. Blood clots)

• Exercise Intolerance

• Erectile Dysfunction

Conventional Approaches to Atherosclerosis

Conventional treatments often focus on reducing cardiovascular risk factors and preventing complications, such as high blood pressure, cholesterol and blood clots. 

Common interventions include:

• Statins: Lower LDL cholesterol and reduce inflammation

• Antiplatelet medications: Reduce the risk of clot formation

• Antihypertensives: Manage blood pressure

• Surgical interventions: In severe cases, angioplasty, stenting, or bypass surgery may be necessary.

Naturopathic Approaches to Atherosclerosis

Naturopathic medicine emphasizes prevention and whole-person care to support cardiovascular health. When working with someone to prevent atherosclerosis, lifestyle modifications, dietary changes, and the use of specific nutrients and botanicals are key!

Lifestyle Strategies

• Regular physical activity: Aerobic and strength-training exercises improve cardiovascular function, reduce inflammation, and promote healthy weight. 

• Stress management: Chronic stress contributes to endothelial dysfunction; techniques like mindfulness, yoga, and breathing exercises can be beneficial.

• Smoking cessation: Quitting smoking significantly lowers cardiovascular risk.

Using Food as Medicine

If there is one key principle I share with my patients in the prevention of atherosclerosis, it’s eat more antioxidants! A heart-healthy diet rich in whole, plant-based foods is foundational. 

Some of the diets that have been shown most protective against atherosclerosis include the Mediterranean Diet, Vegetarian, DASH, and anti-inflammatory.

All of these diets emphasize the following:

• Rich in fibers

• Rich in healthy fats

• Rich in antioxidants 

• Low in processed foods and sugars

• Low in sodium 

Antioxidants neutralize oxidative stress, a key driver of plaque formation in the arteries. Oxidative stress occurs when free radicals (aka: unstable molecules that can damage cells) accumulate and cause injury to the inner lining of blood vessels. This damage makes it easier for LDL cholesterol to accumulate at the arterial walls and promotes plaque buildup.

Nutritional Supplements for Atherosclerosis

Key nutrients and antioxidants for cardiovascular health include:

• Vitamin C 

• Vitamin E

• CoQ10

• Polyphenols

• Vitamin K2

• Magnesium 

• Omega-3 

• Vitamin B6 (P5P), Vitamin B12, & Folate 

Vitamin C

We think of Vitamin C as primarily an immune booster, but it also supports the production of collagen. Collagen is essential for maintaining the integrity and elasticity of blood vessels so that they a re less likely to harden. Vitamin C also enhances nitric oxide availability, promoting vasodilation and better blood flow. Some research suggests that vitamin C may reduce inflammatory markers like C-reactive protein (CRP), further supporting cardiovascular health.

Including vitamin C-rich foods like citrus fruits, bell peppers, strawberries, and broccoli in your diet is a simple and effective way to support arterial health naturally.

Botanicals

• Garlic (Allium sativum): Lowers blood pressure and cholesterol and has antiplatelet effects.

• Hawthorn (Crataegus spp.): Improves arterial elasticity and supports heart function.

• Turmeric (Curcuma longa): Curcumin has potent anti-inflammatory and antioxidant properties.

• Guggul (Commiphora mukul): Supports healthy lipid metabolism.

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References:

1. https://www.nhlbi.nih.gov/health/atherosclerosis

2. Houston, MC. Personalized and precision integrative cardiovascular medicine. Wolters Kluwer. 2020.