Your cardiovascular system is only as healthy as the arteries that carry oxygen-rich blood to and from your heart. Ideally, your arteries should be clear and flexible, with a smooth, undamaged endothelium, the single layer of cells that line the inner surface of your arteries. But as you age, the effects of unhealthy habits can damage your arteries. When arteries become damaged, a condition called aortic atherosclerosis, blood flow can be obstructed or even completely blocked. (17)
Did you know? Atherosclerosis is the underlying cause of about half of all deaths in the Western world. In the United States alone, it’s the leading cause of death, responsible for one in every four deaths annually. (24)
What is atherosclerosis?
Atherosclerosis is a chronic condition, developing silently over many years. It starts when the endothelium becomes compromised. This, in turn, triggers the formation of plaque at the site of the damage. Plaque is a fatty substance made up of cholesterol, calcium, cellular waste, and a blood-clotting material called fibrin. Over time, this plaque builds up inside your arteries, further damaging the endothelium. This causes your arteries to become narrow and stiff. It also causes your heart to work harder to push blood throughout the body.
As plaque accumulates, it can reduce the amount of blood that flows to your heart, brain, and other vital organs. Worse yet, if the plaque becomes unstable, it can rupture and cause a blood clot to form. This clot can then block the artery and trigger a heart attack or stroke. (17)
Risk factors for atherosclerosis
Many things contribute to endothelial damage and plaque buildup. Some factors aren’t within our control, while others are preventable risks. Understanding and addressing the risks you can control can help you reduce your risk of aortic atherosclerosis and related problems. Risk factors include:
- Age (33)
- Diabetes (Type 2) (28)
- Family history (21)
- High blood pressure
- High cholesterol (11)
- High triglycerides (9)
- Lack of exercise (1)
- Obesity or overweight (16)
- Smoking (34)
- Unhealthy eating habits (15)(31)
Did you know? The early stages of atherosclerosis can begin in early childhood. (10)
There typically aren’t any symptoms associated with mild to moderate atherosclerosis. Once an artery is severely damaged, you may experience the following symptoms, depending on which arteries are affected.
The arteries leading to your heart:
- Chest pain
- Pressure in the chest
The arteries leading to your brain:
- Numbness or weakness in your arms or legs
- Difficulty speaking or slurred speech
- Temporary loss of vision in one eye
- Drooping facial muscles
The arteries in your arms and legs:
- Leg pain while walking
The arteries leading to your kidneys:
Best diet to prevent atherosclerosis
According to a study that appeared in the journal Advances in Nutrition, a beneficial diet for reducing atherosclerosis is the Mediterranean diet. (27) A Mediterranean diet, which includes lots of vegetables, as well as whole grains, high-quality protein, fruits, and nuts, not only supports healthy blood pressure and cholesterol levels, it also helps reduce artery-damaging inflammation. (5)(7)(19) The best foods in the Mediterranean diet shown to support healthy arteries are omega-3 rich fish like salmon, beans, oats, olives, avocados, mushrooms, walnuts, tea, and dark chocolate. (3)
5 supplements for healthy arteries
Combined with a healthy diet, research suggests that these supplements may help prevent the progression of aortic atherosclerosis.
1. Aged garlic extract
Aged garlic extract works in multiple ways to prevent atherosclerosis and improve overall heart health. One double-blind, randomized clinical trial of 88 patients with uncontrolled hypertension found that aged garlic extract lowered systolic blood pressure as much as 11.5 mmHg and diastolic pressure by 6.3 mm Hg compared to a placebo. (26)
Another clinical trial involving 65 firefighters found that a combination of aged garlic extract and coenzyme Q10 (CoQ10) halted the progression of dangerous coronary artery calcification (CAC). After 12 months, researchers at the University of California, Los Angeles found that those taking 1,200 mg of aged garlic extract and 120 mg of coenzyme Q10 had significant reductions in CAC progression, as well as decreases in the markers for inflammation and oxidative stress that can further damage the endothelial lining of blood vessels. (35)
Recent findings also show that aged garlic extract may reduce the amount of unstable plaque in arteries. This is critical since this type of plaque is more likely to rupture. (29)
2. Coenzyme Q10
With its anti-inflammatory and antioxidant properties, CoQ10 provides energy to heart cells and protects the cardiovascular system from free radical damage. Research involving 51 patients with coronary artery disease showed that taking supplemental CoQ10 reduced a marker of free radical-induced oxidation by as much as 29%. (14)
As we age, our body’s ability to make CoQ10 declines. Statin medications, commonly prescribed to lower cholesterol levels, may also deplete CoQ10 levels in the body. (6) Making matters worse, CoQ10 supplements are poorly absorbed by the body. Fortunately, studies show that a more bioavailable form of CoQ10 called ubiquinol provides 60% better absorption than standard CoQ10 supplements. (36) Over the past decade, studies have demonstrated that ubiquinol also may inhibit low-density lipoprotein (LDL) oxidation and may have a direct effect on the progression of atherosclerotic lesions. (18)
This mineral is essential for a healthy heart, yet many people don’t get enough. In fact, about three-quarters of the total population doesn’t get enough dietary magnesium to support good health. (32) Clinical studies show a strong correlation between low magnesium levels and the formation of arterial calcium deposits that contribute to atherosclerosis. (20) Research in the Journal of Hypertension shows that magnesium helps to lower blood pressure, enhances blood flow, and improves endothelial function in people with mild atherosclerosis. (4) Plus, recent findings in the International Journal of Hypertension note that adequate magnesium levels protect the lining of arteries and prevent the accumulation of platelets and debris along arterial walls. (13)
4. Vitamin K
Vitamin K is a fat-soluble vitamin that escorts calcium out of the blood so it can be used to build strong bones and teeth. However, if you’re low on vitamin K, calcium is picked up by soft tissue throughout the body. This can be especially dangerous when it occurs in the delicate endothelial tissue that lines the walls of your arteries. (30) A study in the journal Atherosclerosis reported that vitamin K reverses the buildup of calcium deposits in post-menopausal women. (2) Another trial involving more than 4,800 men and women confirmed that getting enough vitamin K may contribute to prevention of aortic calcification and coronary heart disease (CHD). (8)
Zinc is a critical antioxidant and anti-inflammatory mineral that may lower your risk for atherosclerosis. One way it does this is by reducing total cholesterol, LDL, and triglycerides that contribute to plaque buildup. (25) Supplementation has also been shown to protect against cholesterol oxidation. (12) In addition, zinc lowers inflammation and vascular cell adhesion molecules that bind to cholesterol and cellular debris in arteries. (37)
Did you know? Taking more than 15 mg of zinc on a long-term basis may lead to copper deficiency. If you do take a zinc supplement, make sure you also take 2 mg of copper to ensure you have enough of both minerals. (23)
The bottom line
Atherosclerosis is the leading cause of heart attack and stroke. (22) Unfortunately, since aortic atherosclerosis takes so many years to develop, it can be difficult to identify. Instead of waiting until you’re diagnosed with atherosclerosis, consume a healthy diet, such as the Mediterranean diet, and nutrients to support healthy arteries. If you already have one or more risk factors for atherosclerosis, work with your integrative healthcare provider to develop a plan that supports your overall cardiovascular health.
- Ahmadi-Abhari, S., Sabia, S., Shipley, M. J., Kivimäki, M., Singh-Manoux, A., Tabak, A., McEniery, C., … & Brunner, E. J. (2017). Physical activity, sedentary behavior, and long-term changes in aortic stiffness: The Whitehall II Study. Journal of the American Heart Association, 6(8).
- Beulens, J. W. J., Bots, M. L., Atsma, F., Bartelink, M.-L. E. L., Prokop, M., Geleijnse, J. M., Witteman, J. C. M., … & van der Schouw, Y. T. (2009). High dietary menaquinone intake is associated with reduced coronary calcification. Atherosclerosis, 203(2), 489–493.
- Cheng, Y.-C., Sheen, J.-M., Hu, W. L., & Hung, Y.-C. (2017). Polyphenols and oxidative stress in atherosclerosis-related ischemic heart disease and stroke. Oxidative Medicine and Cellular Longevity, 2017, 8526438.
- Cunha, A. R., D’El-Rei, J., Medeiros, F., Umbelino, B., Oigman, W., Touyz, R. M., & Neves, M. F. (2017). Oral magnesium supplementation improves endothelial function and attenuates subclinical atherosclerosis in thiazide-treated hypertensive women. Journal of Hypertension, 35(1), 89–97.
- Davis, C. R., Hodgson, J. M., Woodman, R., Bryan, J., Wilson, C., & Murphy, K. J. (2017). A Mediterranean diet lowers blood pressure and improves endothelial function: Results from the MedLey randomized intervention trial. The American Journal of Clinical Nutrition, 105(6), 1305–1313.
- Deichmann, R., Lavie, C., & Andrews, S. (2010). Coenzyme Q10 and statin-induced mitochondrial dysfunction. The Ochsner Journal, 10(1), 16–21.
- Estruch, R., Martínez-González, M. A., Corella, D., Salas-Salvadó, J., Ruiz-Gutiérrez, V., Covas, M. I., Fiol, M., … & PREDIMED Study Investigators. (2006). Effects of a Mediterranean-style diet on cardiovascular risk factors: A randomized trial. Annals of Internal Medicine, 145(1), 1–11.
- Geleijnse, J. M., Vermeer, C., Grobbee, D. E., Schurgers, L. J., Knapen, M. H. J., van der Meer, I. M., Hofman, A., & Witteman, J. C. M. (2004). Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: The Rotterdam Study. The Journal of Nutrition, 134(11), 3100–3105.
- Handelsman, Y., & Shapiro, M. D. (2017). Triglycerides, atherosclerosis, and cardiovascular outcome studies: Focus on Omega-3 fatty acids. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 23(1), 100–112.
- Hong, Y. M. (2010). Atherosclerotic cardiovascular disease beginning in childhood. Korean Circulation Journal, 40(1), 1–9.
- Hurtubise, J., McLellan, K., Durr, K., Onasanya, O., Nwabuko, D., & Ndisang, J. F. (2016). The different facets of dyslipidemia and hypertension in atherosclerosis. Current Atherosclerosis Reports, 18(12), 82.
- Jenner, A., Ren, M., Rajendran, R., Ning, P., Huat, B. T. K., Watt, F., & Halliwell, B. (2007). Zinc supplementation inhibits lipid peroxidation and the development of atherosclerosis in rabbits fed a high cholesterol diet. Free Radical Biology & Medicine, 42(4), 559–566.
- Kostov, K., & Halacheva, L. (2018). Role of magnesium deficiency in promoting atherosclerosis, endothelial dysfunction, and arterial stiffening as risk factors for hypertension. International Journal of Molecular Sciences, 19(6).
- Lee, B.-J., Tseng, Y.-F., Yen, C.-H., & Lin, P.-T. (2013). Effects of coenzyme Q10 supplementation (300 mg/day) on antioxidation and anti-inflammation in coronary artery disease patients during statins therapy: A randomized, placebo-controlled trial. Nutrition Journal, 12(1), 142.
- Liu, B., Zhang, Y., Wang, R., An, Y., Gao, W., Bai, L., Li, Y., … & Liu, E. (2018). Western diet feeding influences gut microbiota profiles in apoE knockout mice. Lipids in Health and Disease, 17(1), 159.
- Lovren, F., Teoh, H., & Verma, S. (2015). Obesity and atherosclerosis: Mechanistic insights. The Canadian Journal of Cardiology, 31(2), 177–183.
- Lusis, A. J. (2000). Atherosclerosis. Nature, 407(6801), 233–241.
- Malekmohammad, K., Sewell, R. D. E., & Rafieian-Kopaei, M. (2019). Antioxidants and atherosclerosis: Mechanistic aspects. Biomolecules, 9(8).
- Martínez-González, M. A., Gea, A., & Ruiz-Canela, M. (2019). The Mediterranean diet and cardiovascular health. Circulation Research, 124(5), 779–798.
- Massy, Z. A., & Drüeke, T. B. (2012). Magnesium and outcomes in patients with chronic kidney disease: Focus on vascular calcification, atherosclerosis and survival. Clinical Kidney Journal, 5(Suppl 1), i52–i61.
- Nasir, K., Michos, E. D., Rumberger, J. A., Braunstein, J. B., Post, W. S., Budoff, M. J., & Blumenthal, R. S. (2004). Coronary artery calcification and family history of premature coronary heart disease: Sibling history is more strongly associated than parental history. Circulation, 110(15), 2150–2156.
- National Heart, Lung, and Blood Institute. (n.d.). Atherosclerosis. https://www.nhlbi.nih.gov/health-topics/atherosclerosis
- National Institutes of Health. (2021). Zinc – health professional fact sheet. https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/
- Pahwa, R., & Jialal, I. (2021). Atherosclerosis. In StatPearls. StatPearls Publishing.
- Ranasinghe, P., Wathurapatha, W. S., Ishara, M. H., Jayawardana, R., Galappatthy, P., Katulanda, P., & Constantine, G. R. (2015). Effects of Zinc supplementation on serum lipids: A systematic review and meta-analysis. Nutrition & Metabolism, 12, 26.
- Ried, K., Travica, N., & Sali, A. (2016). The effect of aged garlic extract on blood pressure and other cardiovascular risk factors in uncontrolled hypertensives: The AGE at Heart trial. Integrated Blood Pressure Control, 9, 9–21.
- Ros, E., Martínez-González, M. A., Estruch, R., Salas-Salvadó, J., Fitó, M., Martínez, J. A., & Corella, D. (2014). Mediterranean diet and cardiovascular health: Teachings of the PREDIMED study. Advances in Nutrition , 5(3), 330S – 6S.
- Selvin, E., Coresh, J., Golden, S. H., Boland, L. L., Brancati, F. L., Steffes, M. W., & Atherosclerosis risk in communities study. (2005). Glycemic control, atherosclerosis, and risk factors for cardiovascular disease in individuals with diabetes: The atherosclerosis risk in communities study. Diabetes Care, 28(8), 1965–1973.
- Shaikh, K., Kinninger, A., Cherukuri, L., Birudaraju, D., Nakanishi, R., Almeida, S., Jayawardena, E., … & Budoff, M. J. (2020). Aged garlic extract reduces low attenuation plaque in coronary arteries of patients with diabetes: A randomized, double-blind, placebo-controlled study. Experimental and Therapeutic Medicine, 19(2), 1457–1461.
- Shioi, A., Morioka, T., Shoji, T., & Emoto, M. (2020). The inhibitory roles of vitamin K in progression of vascular calcification. Nutrients, 12(2).
- Torres, N., Guevara-Cruz, M., Velázquez-Villegas, L. A., & Tovar, A. R. (2015). Nutrition and atherosclerosis. Archives of Medical Research, 46(5), 408–426.
- Uwitonze, A. M., & Razzaque, M. S. (2018). Role of magnesium in vitamin D activation and function. The Journal of the American Osteopathic Association, 118(3), 181–189.
- Wang, J. C., & Bennett, M. (2012). Aging and atherosclerosis: Mechanisms, functional consequences, and potential therapeutics for cellular senescence. Circulation Research, 111(2), 245–259.
- Wang, Z., Wang, D., & Wang, Y. (2017). Cigarette smoking and adipose tissue: The emerging role in progression of atherosclerosis. Mediators of Inflammation, 2017, 3102737.
- Zeb, I., Ahmadi, N., Nasir, K., Kadakia, J., Larijani, V. N., Flores, F., Li, D., & Budoff, M. J. (2012). Aged garlic extract and coenzyme Q10 have favorable effect on inflammatory markers and coronary atherosclerosis progression: A randomized clinical trial. Journal of Cardiovascular Disease Research, 3(3), 185–190.
- Zhang, Y., Liu, J., Chen, X.-Q., & Oliver Chen, C.-Y. (2018). Ubiquinol is superior to ubiquinone to enhance coenzyme Q10 status in older men. Food & Function, 9(11), 5653–5659.
- Zhu, D., Su, Y., Zheng, Y., Fu, B., Tang, L., & Qin, Y.-X. (2018). Zinc regulates vascular endothelial cell activity through zinc-sensing receptor ZnR/GPR39. American Journal of Physiology. Cell Physiology, 314(4), C404–C414.