Plaque

Arterial plaque is a slow-building deposit that forms inside the walls of your blood vessels over years or decades. It starts when LDL cholesterol — sometimes called "bad" cholesterol — seeps into the inner lining of an artery and becomes oxidized. The immune system responds by sending white blood cells to the site, and over time, those cells, along with more cholesterol, calcium, and cellular debris, accumulate into a plaque deposit.

As plaque grows, it narrows the inside of the artery, reducing the amount of blood that can flow through. This is the process known as atherosclerosis, and it can affect arteries throughout the body — in the heart (leading to coronary artery disease), in the arteries supplying the brain (raising stroke risk), and in the legs (causing peripheral artery disease).

The danger increases if a plaque deposit becomes unstable and ruptures. When that happens, a blood clot forms at the rupture site very quickly, and that clot can block the artery entirely — causing a heart attack or stroke, depending on where it occurs. This is why plaque management is a cornerstone of cardiovascular prevention, even when a person doesn't yet have symptoms.

Plaque buildup is the underlying cause of most heart attacks and many strokes, making it one of the most important cardiovascular health concepts to understand. The tricky thing about atherosclerosis is that it progresses silently for years — plaque accumulates without symptoms until a significant portion of an artery is narrowed or a clot forms.

Many of the lifestyle changes and medications used in cardiovascular prevention — controlling LDL cholesterol, managing blood pressure, not smoking, staying physically active — are specifically aimed at slowing plaque development and stabilizing existing plaques. Imaging tests like carotid ultrasound or coronary calcium scoring can help doctors detect plaque burden early, providing a clearer picture of risk and guiding preventive decisions.