As we age, cholesterol, calcium, and fatty substances build up in our arteries, creating plaque deposits that narrow the arteries and increase our risk for cardiovascular disease, including carotid artery disease and coronary artery disease (CAD). Carotid artery disease reduces blood flow in the neck arteries that supply blood to the brain, potentially causing a stroke.
While some risk factors for carotid artery disease are determined by heredity, the good news is that others can be controlled through lifestyle changes. With your care team, you can evaluate your risk factors and develop a plan for managing your health.
Controllable risk factors
Talk with your doctor about your risk factors for carotid artery disease and stroke. The following risk factors are all ones that can be managed through lifestyle changes and/or medication:
- Smoking – Blood vessels are equipped with a smooth inner lining that can slow the process of atherosclerosis, or “hardening of the arteries.” Cigarette smoking contributes directly to carotid artery disease by damaging the smooth inner lining of arteries throughout your body. This damage diminishes the ability of your arteries to prevent blockages and contributes to the formation of plaque deposits on damaged areas of your arteries. Smoking also increases blood pressure and lowers levels of "good" cholesterol, thereby increasing other risk factors.
- High blood pressure – A blood pressure over 140/90 mmHg is considered high. If your blood pressure is unmanaged and above this mark, you’re at an increased risk of having carotid arteries prone to damage and blockage from the hardening of the arterial wall. High blood pressure places stress on your artery walls that can cause scarring, rupture, and the formation of plaque deposits over time.
- High LDL (“bad”) cholesterol level – A high level of LDL or “bad” cholesterol in the blood leads directly to cholesterol deposits in the arteries. Exercise, medication, and diet all can contribute to controlling cholesterol levels and reducing the risk of carotid artery disease.
- Diabetes – Patients with diabetes are more likely to have high blood pressure and high cholesterol, which can cause atherosclerosis.
- Obesity – Being overweight contributes to high blood pressure and diabetes, which increase the risk of carotid artery disease. Managing your weight may reduce multiple risk factors.
- Physical inactivity – If you’re diagnosed with carotid artery disease, your doctor may prescribe exercise as part of your wellness plan. Exercise reduces the incidence of many other carotid artery disease risk factors, including diabetes, obesity, high blood pressure, and high cholesterol.
Uncontrollable risk factors
Some risk factors for carotid artery disease and stroke are beyond your control. If you’re at a greater risk based on the factors below, managing the risk factors you can control is imperative.
- Age – Plaque buildup in the arteries is a natural part of aging and increases as we age. But it can also be hastened by a poor diet and other factors. Between the ages of 55–59, about 1.5% of adults have significant plaque buildup in their carotid arteries. By the time adults reach 65–69, 5% will have substantial plaque buildup, and the percentage continues to increase with age.1 Men* (assigned male at birth) are at higher risk under age 75, while women* (assigned female at birth) face the most significant risk after age 75.
- Heredity – A family history of atherosclerosis is a risk factor for carotid artery disease. If you have a family member with carotid artery disease, coronary artery disease (CAD) (heart attack), peripheral artery disease (PAD) (leg and foot complications), and kidney (renal) artery disease (kidney complications, then you’re at risk for these diseases as well.
*The term “men” in the context of “cardiovascular health” applies to individuals assigned male at birth (AMAB) who have a male biological reproductive system, which includes a penis, scrotum, testes, epididymis, vas deferens, prostate, and seminal vesicles.
*The term “women” in the context of “women’s cardiovascular health” applies to individuals assigned female at birth (AFAB) who have a female biological reproductive system, which includes a vagina, uterus, ovaries, Fallopian tubes, accessory glands, and external genital organs.