Plaque buildup, or atherosclerosis, is a gradual process that affects arteries throughout the body. As arterial plaque builds, arteries can become thicker, stiffer, and more narrow — a process commonly called “hardening of the arteries” — limiting blood flow to vital organs and significantly increasing the risk of heart attacks, strokes, and peripheral artery disease.

Understanding how arterial plaque forms, how it affects the body, and how it’s detected can help you take steps to protect your heart health before serious complications occur.

Looking for care or screening related to plaque buildup?

If you’re concerned about plaque buildup or your risk for heart disease, the cardiovascular team at Methodist Le Bonheur Healthcare offers screenings and diagnostic testing to help assess your cardiovascular health. You can use our Find a Provider tool to locate a cardiovascular specialist near you and schedule an appointment online.

What is arterial plaque?

Arterial plaque is a sticky substance made up of fat, cholesterol, calcium, and other materials that accumulate along the endothelium, or inner lining of arteries. Plaque forms when the artery wall becomes damaged — often due to factors like high cholesterol, high blood pressure, smoking, or diabetes — triggering an inflammatory response that allows cholesterol and other substances to build up.

Are there different types of plaque?

Yes. Not all plaque behaves the same way, and the type of plaque matters when assessing cardiovascular risk:

• Calcified (hard) plaque contains more calcium and tends to be more stable. While it can narrow arteries, calcified plaque is less likely to rupture suddenly.
• Non-calcified (soft) plaque contains fatty material and fibrous tissue and is more prone to rupture.
• Low-density non-calcified plaque (vulnerable plaque) has a soft core and thin outer cap, making it especially likely to rupture — even when it causes only mild narrowing.

Plaque rupture can trigger the formation of a blood clot, which may suddenly block blood flow and lead to a heart attack or stroke.

How does plaque cause heart disease?

Plaque contributes to cardiovascular disease in two primary ways:

1. Stenosis (artery narrowing). As plaque builds up, it narrows the lumen, or inside of the artery, limiting the amount of oxygen-rich blood that can reach the heart muscle. This reduced blood flow can cause symptoms such as angina (chest pain) or shortness of breath, especially during physical activity.
2. Plaque rupture and clot formation. Some plaques can rupture unexpectedly. When this happens, the body responds by forming a thrombus, or blood clot. A clot can quickly block the artery, resulting in a heart attack or stroke.

“Plaque doesn’t have to cause severe narrowing to be dangerous. Some heart attacks occur when less severe, softer plaque ruptures and triggers a sudden blockage.”
– Joel Raja, MD Cardiologist at Methodist Le Bonheur Healthcare

What increases the risk of atherosclerosis, or plaque buildup?

Plaque develops gradually over time, and risk is influenced by both non-modifiable and modifiable factors.

• Risk factors for atherosclerosis include:
• High LDL (“bad”) cholesterol
• High blood pressure
• Diabetes or insulin resistance
• Smoking or tobacco use
• Physical inactivity, obesity, or chronic stress
• Chronic kidney disease or other vascular conditions
• Age, with risk increasing for men after age 45 and women after age 55
• Family history of early heart disease or sudden cardiac death

Many of these risk factors can be improved through lifestyle changes and medical care.

How is plaque detected?

Healthcare providers, including the cardiovascular team at Methodist Le Bonheur Healthcare, use a combination of screenings and imaging to detect plaque, based on symptoms and individual risk. Routine evaluations may include:

• • Cholesterol (lipid panel) blood tests
• Blood pressure screening
• Blood glucose or hemoglobin A1C testing
• Electrocardiogram (ECG/EKG)
• Stress testing

When more detailed evaluation is needed, imaging tests can help determine the presence, type, and extent of plaque. Advanced imaging examples include:

• Coronary calcium scan (CAC), which measures calcified plaque in coronary arteries
• Coronary CT angiography (CCTA), which provides detailed images of both hard and soft plaque
• Cardiac catheterization, or angiogram, which identifies blockages and allows for treatment
• Intravascular ultrasound (IVUS), which evaluates plaque from inside the artery

“The goal isn’t just to find plaque — it’s to reduce the chance it causes harm. These tests help us understand what type of plaque is present and how it may impact future risk, which aids in development of the right treatment plan.”
– Joel Raja, MD Cardiologist at Methodist Le Bonheur Healthcare

Can plaque buildup be treated or slowed?

Yes. While plaque cannot always be completely removed, its progression can often be slowed with early detection and appropriate care, reducing long-term risk. Common treatment approaches include:

• Lifestyle changes, such as heart-healthy eating, regular physical activity, stress management, and quitting smoking
• Medications, such as statins to lower cholesterol and stabilize plaque, blood pressure medications, and blood thinners when appropriate
• Procedures like angioplasty, stenting, or bypass surgery for significant blockages

When should you talk to a doctor about plaque?

You should talk to a healthcare provider if you:

• Have symptoms such as chest pain, shortness of breath, or unexplained fatigue
• Have multiple cardiovascular risk factors
• Have a family history of early heart disease
• Want to better understand your heart disease risk, even without symptoms

Working with a cardiologist and primary care provider can help guide screening, prevention, and long-term heart health.

Key takeaways

• Atherosclerosis is a buildup of arterial plaque (cholesterol, fat, calcium, and other substances) inside artery walls.
• Plaque can narrow arteries or rupture suddenly, leading to heart attack or stroke.
• Many people with atherosclerosis have no symptoms until serious complications occur.
• Risk factors include age, family history, high cholesterol, high blood pressure, diabetes, and smoking.
• Early evaluation, lifestyle changes, and medical care can reduce risk and slow disease progression.

Find cardiovascular care and screening options close to home

Heart disease often develops quietly, but guidance from a trained medical provider can make a meaningful difference. At Methodist Le Bonheur Healthcare, our cardiologists and cardiovascular specialists offer heart disease screenings, diagnostic testing, and ongoing care for patients across the Mid-South. Talk with your provider about your heart health risk, or explore screening and care options to take a proactive step toward protecting your heart.

Medical Disclaimer: This content is for informational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider regarding heart disease risk and care. Last medically reviewed on January 21, 2026.