How the idea evolved
German pathologist Felix Marchand coined the term in 1904, joining the Greek for "gruel" (athero) and "hardening" (sclerosis). In 1913 Russian scientist Nikolai Anitschkow fed rabbits cholesterol and produced arterial lesions, launching the cholesterol hypothesis. The Framingham Heart Study, begun in 1948, then showed in real populations that high blood pressure, smoking, and high cholesterol raise risk—coining the very phrase "risk factor." In 1999 Russell Ross reframed atherosclerosis as a chronic inflammatory disease, and the 2017 CANTOS trial showed that calming inflammation alone could prevent cardiac events.
How plaque forms—and what it causes
When high blood pressure, smoking, or high blood sugar injures the artery lining, LDL cholesterol seeps into the wall and oxidizes. Immune cells gobble it up, turn into foam cells, and build plaque. It grows silently for decades; once an artery narrows by about 70%, exertion brings on angina. If a plaque's thin cap ruptures, a clot forms on the spot and triggers a heart attack or stroke. In the legs, it causes calf pain when walking.
Testing and prevention
Carotid ultrasound shows wall thickness and plaque, a coronary artery calcium (CAC) scan scores calcified buildup in heart arteries, and the ankle-brachial index checks leg circulation. Lowering LDL is the cornerstone—targets range from under 70 to under 100 mg/dL depending on risk, often with a statin. Not smoking, controlling blood pressure and sugar, a Mediterranean-style diet, 150 minutes of weekly exercise, and a healthy weight slow plaque growth and can stabilize it. If you have high cholesterol, keep tabs on your numbers.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Can atherosclerosis be reversed?
- Not fully, but aggressive LDL lowering can shrink or stabilize plaque.
- Should I get tested without symptoms?
- If you have several risk factors, a calcium score can help decide whether to start a statin.
Sources reviewed: 2026-10-26
References
- Libby, P., et al. (2019). Atherosclerosis. Nature Reviews Disease Primers, 5, 56.
- Ross, R. (1999). Atherosclerosis—an inflammatory disease. NEJM, 340(2), 115–126.
- Anitschkow, N., & Chalatow, S. (1913). Über experimentelle Cholesterinsteatose. Centralblatt für allgemeine Pathologie, 24, 1–9.