Atherosclerotic Cardiovascular Disease: What It Is and How It’s Treated

You may often hear the phrase “heart disease” and assume it’s one singular disease. In reality, heart disease (or cardiovascular disease) is an umbrella term. There are many types of heart diseases, and they all have different causes, symptoms, and treatments. One of the most common types is atherosclerotic cardiovascular disease — or ASCVD.

What is atherosclerotic cardiovascular disease?

As the name suggests, ASCVD is a type of heart disease caused by atherosclerosis. This refers to the narrowing of the blood vessels. Having ASCVD increases the risk of heart attack, stroke, and more.

One concerning symptom of ASCVD is angina. This refers to chest pain or pressure caused by a lack of blood flow to the heart. 

Angina pain may be acute, meaning it’s sudden and severe. This may be a sign of a heart attack. However, angina can also be chronic, meaning it’s less severe but longer lasting. Chronic angina may indicate a risk of a future heart attack.

What is atherosclerosis?

Atherosclerosis is when plaque deposits build up on the walls of arteries. Plaque is a sticky, waxy substance. It’s made from cholesterol and some other substances.

First, plaque sticks to the artery walls. As it builds up, it narrows the artery, resulting in reduced blood flow. Next, the plaque starts to harden and become brittle. This makes the artery walls less flexible, so they’re less able to expand and contract when needed (such as during exercise). 

Why is atherosclerosis dangerous?

If plaque completely blocks the artery, it obstructs blood flow. If this blood vessel leads to the heart, the blockage may cause a heart attack. If the blocked blood vessel leads to the brain, it could cause a stroke. 

Pieces of brittle plaque can also break off and rupture. These pieces may travel until they meet more plaque buildup, where more obstruction may form. The blood may then clot behind the blockage. This can also cause a heart attack or stroke.

How is atherosclerotic heart disease treated?

Treatment for ASCVD is a multi-pronged approach. You and your care team will work together to minimize your risks of having a heart attack or stroke. This involves:

• Getting your blood sugar levels under control, especially if you have diabetes

• Lowering your blood pressure

• Improving your cholesterol levels

The above may include a combination of medications and/or lifestyle changes. There are many effective medications available for treating diabetes, high blood pressure, and high cholesterol. 

A healthy lifestyle may help improve your treatment results. Healthy habits that your doctor may recommend include:

• Quitting smoking (or not starting)

• Exercising regularly (based on your doctor’s recommendations for what you can safely do)

• Finding and maintaining a healthy weight

• Eating a heart-healthy diet, which is generally low in saturated fat and salt

How do I know if I have ASCVD?

One of the best ways to know if you have atherosclerotic heart disease is by regular checkups with your doctor. In particular, all adults should have a cholesterol test every four to six years — or more often if you have other risk factors for heart disease. If you have high cholesterol, you can start treatment to help lower your risk of ASCVD.

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Written by:

Lauren Smith, MA

Lauren Smith, MA, has worked in health journalism since 2017. Before joining GoodRx, she was the senior health editor and writer for HealthiNation.

Reviewed by:

Mera Goodman, MD, FAAP

Mera Goodman, MD, FAAP, is a board-certified pediatrician. Prior to practicing medicine, she worked as a management consultant.

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