Atherosclerosis (hardening of the arteries) is the most common form of arteriosclerosis, a class of diseases in which the walls of a person's artery become thicker and less elastic through deposits along the arteries that often contain calcium. Fatty material (atheromas or plaque) accumulates under the inner lining of arterial walls, resulting in narrowing and eventual impairment of blood flow. It can affect medium and large arteries in the brain, heart, kidneys, other vital organs, and arms and legs. When it develops in the carotid arteries, atherosclerosis can lead to stroke. In the coronary arteries, it can result in heart attack.

Risk Factors
Male gender, menopause in women, hypertension, elevated levels of low-density lipoprotein (LDL), decreased levels of high-density lipoprotein (HDL), quitting smoking, diabetes, obesity, having a personal or family history of heart disease, sedentary lifestyle, increasing age, high fat or sucrose intake, hyperhomocysteinemia, elevated fibrinogen, CRP and Lp(a) levels, deficiency of Coenzyme Q10 and L-carnitine, air pollution, stress, sleep deficiency, social isolation, high degrees of negative attitudes (such as hostility and cynical distrust), excessive experience of negative emotions (such as depression, anger, and anxiety), and high ratio of free radical markers to antioxidants.

Signs and symptoms
Pain and cramps at the site of the narrowed artery, such as chest pain or leg cramps when walking; a hardened feel, like small, hard pipes, of arteries in forearms or carotid arteries in the neck. Clinical signs and symptoms include aneurysm, thrombosis, embolus, and stenosis; lowered or absent pulses; vascular (blood vessel) bruit (whooshing or blowing sound heard over the artery with a stethoscope); (in more severe cases) muscle atrophy, ulceration, or gangrene.

The disease develops slowly. It shows few symptoms until the arteries have narrowed severely or have actually become obstructed. Nevertheless, atherosclerosis is the leading cause of illness and death in the United States and most other Western countries. It causes about one million deaths per year in the United States alone, double the number of deaths from cancer.

Tests that indicate atherosclerosis (or complications thereof) include:
   - an ultrasound of affected area
   - a CT scan of affected area
   - an arteriography of affected area.

Treatment
To some extent, the body will protect itself by forming new blood vessels (collateral circulation) around the affected area. Follow your health care provider's recommendations for treatment and control of hypertension, diabetes, and other diseases.

Nutritional supplements can be very effective and counseling strategies and behavioral techniques help patients to manage stress, move toward more positive attitudes, and establish broader, supportive social relationships. There is increasing evidence that elevated levels of homocysteine may be important in the genesis of atherosclerosis and cardio-vascular disease, and that nutrition can be helpful at modifying those levels.

See below for detailed recommendations.

Prognosis
The final outcome varies, but atherosclerosis is usually progressive and frequently leads to complications that include:

   - coronary artery disease (atherosclerosis of the coronary arteries)
   - deficiency of blood supply due to obstruction (ischemia/angina)
   - cardiac arrhythmias and congestive heart failure
   - pre-gangrene of the lower limbs
   - acute myocardial infarction (heart attack)
   - transient ischemic attack (TIA) or stroke
   - premature renal failure
   - damage to blood vessels, muscles, or body organs.