Disease of the Month – Atherosclerosis

Shots:

Characterized by the thickening or hardening of arteries due to plaque buildup, atherosclerosis leads to complications like heart attack or stroke

PharmaShots’ Disease of the Month report aims to familiarize the general population with conditions impacting communities worldwide. The report outlines disease characteristics, types, symptoms, diagnosis, treatments, epidemiology, market size, clinical trial analysis, patient advocacy groups (PAGs), and heart-touching patient stories

For a detailed Atherosclerosis landscape, analysis, and tailored insights, contact our experts at connect@pharmashots.com

Atherosclerosis is often called a silent killer as the condition progresses to complications like heart attack, stroke, and other cardiovascular conditions. It can be attributed to sedentary lifestyles and lack of physical exercise, and poor dietary habits.

The disease progresses gradually as cholesterol, fats, blood cells, and other substances in the bloodstream form plaque along artery walls. Over time, this buildup narrows the arteries, limiting the flow of oxygen-rich blood to organs and tissues throughout the body [1]

Stages of atherosclerosis include: [2]

Endothelial Damage and Immune Response: Endothelial damage triggers chemical signals that attract WBCs to travel to the injury site, causing inflammation in the artery

Fatty Streak Formation: This remains the first visible sign of atherosclerosis, a yellow streak of dead foam cells, resulting from WBCs that absorb cholesterol, at the site of endothelial damage

Plaque Growth: As dead foam cells and debris accumulate, a fatty streak becomes plaque-covered, forming a fibrous cap. This cap helps contain the plaque, but as it grows, it narrows the artery’s opening and restricts blood flow

Plaque Rupture or Erosion: A blood clot forms when plaque ruptures or erodes, damaging the artery lining. With plaque rupture, the fibrous cap breaks, whereas in erosion, surrounding endothelial cells wear away while the fibrous cap stays intact. Both events may cause a blood clot, leading to a heart attack or stroke

Uncontrollable risk factors for atherosclerosis include: [3]

Ageing

A family history of early heart disease or stroke

Changes in genes that make atherosclerosis more likely

Autoimmune conditions such as lupus, inflammatory bowel disease or psoriasis

Controllable risk factors for atherosclerosis include:

Unhealthy diet

Diabetes

High blood pressure

High cholesterol

Lack of exercise

Obesity

Sleep apnea

Smoking and other tobacco use

Atherosclerosis symptoms typically appear when an artery is over 70% blocked and vary based on the blockage’s location, which may include: [2]

Heart

Dyspnea during light physical activity

Angina

Pain in your back, shoulders, neck, arms or belly

Dizziness

Heart palpitations.

Fatigue.

Nausea or vomiting

Digestive system

Pain or cramping in the abdomen after eating

Bloating, nausea or vomiting

Diarrhea

weight loss

Legs and feet

Muscle pain

Burning or aching pain

Changes in skin color like redness

Cool skin on your feet

Frequent skin and soft tissue infections

Sores that don’t heal

Kidneys

Severely high blood pressure resistant to multiple medications

Changes in how often you pee

Edema

Feeling drowsy

Skin that feels dry, itchy or numb

Headaches

weight loss

Nausea, vomiting or loss of appetite

Brain

Dizziness

Drooping on one side of your face

Loss of feeling, muscle strength or weakness on one side of your body

Severe headache

Slurred speech

Vision loss in one eye

To diagnose atherosclerosis, your doctor will examine you and listen to your heart. Some of the tests are: [3]

Blood tests: Blood tests check sugar, cholesterol, and CRP levels—markers linked to a higher risk and inflammation in atherosclerosis

Electrocardiogram (ECG or EKG): An ECG is a quick, painless test that measures the heart’s electrical activity using sensors on the chest, arms, or legs. It can detect reduced blood flow to the heart

Exercise stress tests: Exercise stress tests involve walking on a treadmill or biking while monitoring heart activity to detect conditions not seen during normal activity

Echocardiogram: An echocardiogram uses sound waves to visualize blood flow, heart size, and structure, and may be done during an exercise stress test.

Doppler ultrasound: A healthcare professional may use ultrasound to measure blood flow speed in arteries, helping identify narrowed areas

Ankle-brachial index (ABI): This test compares blood pressure in the ankle and arm to check for atherosclerosis in the legs and feet. A difference may indicate peripheral artery disease

Cardiac catheterization and angiogram: This test checks for narrowed or blocked coronary arteries by inserting a catheter with dye into a blood vessel, usually in the groin or wrist, to make the heart’s arteries visible on images

Coronary calcium scan (heart scan): A coronary calcium scan uses CT imaging to detect calcium deposits in artery walls, potentially revealing coronary artery disease before symptoms appear. A higher score indicates a greater risk of heart attack.

Other imaging tests: Magnetic resonance angiography (MRA) and positron emission tomography (PET) can detect hardening, narrowing of large arteries, and aneurysms.

Atherosclerosis treatment may involve lifestyle modifications, medications, and surgical procedures are: [4]

Lifestyle changes

Managing risk factors such as smoking, blood sugar and cholesterol levels, inactivity, unhealthy eating habits, and high blood pressure can help prevent atherosclerosis.

Medicines

Medications that may be prescribed to treat atherosclerosis include:

Antiplatelet medicines: Antiplatelet medicines, such as aspirin, clopidogrel, ticlopidine, and dipyridamole, reduce platelet clumping to prevent clots

Anticoagulants: Anticoagulants, or blood thinners like warfarin and heparin, reduce blood clotting differently from antiplatelet drugs

Cholesterol-lowering medicines: Cholesterol-lowering medicines, such as statins (e.g., simvastatin, atorvastatin, pravastatin), bile acid sequestrants, nicotinic acid, and fibrates, help reduce LDL cholesterol and triglyceride levels.

Blood pressure medicines: Various types of medications lower blood pressure through different mechanisms

Coronary angioplasty

In PCI, a catheter is inserted through a blood vessel to the heart, where a balloon is inflated to widen the artery and improve blood flow. This procedure, typically used in coronary arteries, includes various types of angioplasties:

Balloon angioplasty: A small balloon is inflated within the blocked artery to clear the obstruction

Atherectomy: A small device at the tip of a catheter removes the blockage inside the artery by shaving it away

Laser angioplasty: A laser is employed to vaporize the blockage in the artery

Coronary artery stent: A small mesh coil is expanded within the blocked artery to clear the obstruction and remains in place to keep the artery open

Atherosclerosis is responsible for one in every four deaths in the United States. Being asymptomatic, it is rather difficult to determine its incidence accurately [5]

Sex: Atherosclerosis is more prevalent in men, as compared to women, attributed to the protective function of female sex hormones

Age: In 2020, among people aged 30–79 worldwide, increased carotid intima-media thickness affected 27.6% (1.07 billion), carotid plaque 21.1% (816 million), and carotid stenosis 1.5% (58 million)

In 2024, the global Atherosclerosis treatment market was valued at $46.43B and is projected to reach $62.18B by 2035, growing at a CAGR of 2.7% from 2025 to 2035 [6]

Lipitor (atorvastatin calcium) is indicated to treat atherosclerosis in adults [7]

Approved therapies include Lipitor (Viatris) and Crestor (AstraZeneca)

Active & Inactive Trials of P-II & P-III are concentrated in the US, followed by Spain, Australia, and Italy. Data were extracted on May 08, 2025

Several patient advocacy groups are dedicated to supporting individuals with MI and improving their quality of life

Douglas’ Story [9]

My remarkable GP, Dr. Belknap, called one Friday evening to deliver the results of my heart scan. The news was devastating. My total score exceeded 1250., Dr. Belknap recommended that I look into Dr. Fuhrman’s theories on managing atherosclerosis. Saturday morning, I was online visiting Dr. Fuhrman’s website. Twenty minutes later I enrolled in his Diamond member program. Since then, for the past two years, I have followed Dr. Fuhrman’s recommendations. Dr. Fuhrman called me at my home to review my situation, offer some focused direction and just the right amount of encouragement. Well worth the funds paid. I also purchased every book written by Dr. Fuhrman, and read them all; most helpful. Being intelligent about how the body works adds to my devotion to the program. I need reasons behind my actions. Dr. Fuhrman’s books do that, page after page.

I continue to work closely with my doctor. I speak with an associate of Dr. Fuhrman each year to ensure that I’m traveling down the right path. I also stay in touch with my cardiologist. A recent treadmill test indicated that I’m doing very well. After the cardiologist reviewed page after page of readouts subsequent to that treadmill test, he said, “I got nothin’ you’re good to go.” Now I have a resting heart rate of 50 and excellent recovery rate during aerobic sessions. My blood pressure stays around 116 / 60.

Do I waver from the Fuhrman regiment? Yes, I do. But those occasions are rare, very rare. Month after month I stay the course, and it is delicious. And I exercise at only a moderate pace most every day for around 45 to 60 minutes. My cardiologist said that extreme workouts (heart rate over 75 percent) do nothing but stress the heart and build up the unwanted cortisol in the body. I believe that contributes to inflammation. Steady and moderate is all that’s necessary. Every day my aerobic exercise raises my heart rate to 65 percent to 70 percent. That is my own decision and not that of Dr. Fuhrman. I do some light weightlifting as well.

And my lipid panel scores continue to improve. My goal is to weigh no more than 165 pounds, eight more pounds to go…slow and steady. My A1C score is 5.1: that’s excellent! Thanks, in part, to Dr. Fuhrman’s program, I have lost 45 pounds over about 30 months. From a snug pair of 40″ Levi’s to a very comfortable pair of 35″ jeans. The 34’s are ready and waiting. I feel great!

A Body Spec scan in August 2018 indicated exactly what kind of fat lived where in my body. I plan to go in for a second scan before my next general physical in October. It is quite likely that I will avoid having to take compensatory medications (Repatha) to control my cholesterol and related lipid numbers. When I first discovered the condition, I felt like I was getting up and going to bed with the Grim Reaper. My physician, cardiologist and I know that I’m on the right path. I’ve banished that thought from my mind. I’m feel good and expect to live a very long and healthy life.

Ben’s Story [10]

When 47-year-old Ben Beale headed out for a run during a family holiday, his wife Sarah had no idea it was the last time she would see her beloved husband – a father of five.

While Ben was out, Sarah received the call every partner fears: “Your husband is receiving CPR, you need to make your way to emergency as fast as you can.”

Ben would never return from his run.

After passing away from a heart attack, Ben’s family and friends were left grief-stricken and confused. How could a man at the peak of physical fitness be gone so suddenly?

Just a year earlier, after visiting his doctor several times to express concern about symptoms he was experiencing, Ben had been advised that he was at low risk of experiencing a coronary event in the next two to three years. A week before his death, Ben had been medically cleared for a charity boxing match.

Though Sarah was told it was a ‘one-off catastrophic event’, an autopsy revealed that Ben had a buildup of fat and cholesterol in his arteries – a condition known as atherosclerosis, which is the main cause of heart attack. Atherosclerosis is often referred to as a ‘silent killer’, as it can occur without symptoms.

The autopsy also showed that the father of five had suffered two or three heart attacks previously and that a portion of his heart was already dead.

Sarah says: “Ben was at the peak of his fitness and health and had no idea he was suffering from a disease which takes far too many lives.”

The Institute’s Executive Director Professor Jason Kovacic, a world-leading atherosclerosis expert, looked into Ben’s medical history and identified the possibility that he had an increase in a cholesterol-related particle known as Lipoprotein(a), or ‘Lp(a)’, which raises the risk of heart attack and stroke.

Unlike LDL (‘bad’) cholesterol, which is often linked to lifestyle factors, levels of Lp(a) are determined by genetic factors.

“We have long wondered why healthy people with low cholesterol levels and seemingly no other major risk factors like smoking or diabetes can suffer heart attacks. But we now understand that high levels of Lp(a) could be responsible for many of these events.” Prof Kovacic says.

Professor Kovacic, along with other cardiologists, is now calling for Lp(a) levels to be more widely tested across the population and for more awareness of the condition.

Three of Ben’s family members have since been identified with elevated Lp(a) and Ben’s older children have been tested and cleared.

While there is currently no cure for atherosclerosis, as well as Lp(a) scientists at the Institute have identified critical pathways that are key in driving this build-up of plaque that leads to the hardening of the arteries.

This world-first research has the potential to pave the way for new treatments that would effectively ‘deactivate’ these pathways before they can cause devastating damage like a heart attack, saving families like the Beale’s from experiencing the heartache of losing a loved one so young.

Ben’s memory lives on through the establishment of the Ben Beale Laboratory in Cardiovascular Research at the Institute’s hub based at the University of Western Australia.

The Ben Beale Laboratory opened on 24 April 2022, marking the five-year anniversary of Ben’s passing.

Sarah says: “Partnering with Victor Chang Cardiac Research Institute gives life to Ben and gives meaning to him losing his life so young. Every person we can save through greater research makes Ben’s life count that much more. It means we can save another child from losing their father and we can give another father the ability to watch his children grow.”

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