Addiction Nicotine Use Smoking-Related Diseases The Link Between Smoking and Atherosclerosis By Terry Martin Terry Martin Facebook Twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial process Updated on November 10, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Armeen Poor, MD Medically reviewed by Armeen Poor, MD Armeen Poor, MD, is a board-certified pulmonologist and intensivist. He specializes in pulmonary health, critical care, and sleep medicine. Learn about our Medical Review Board Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Karen Cilli Fact checked by Karen Cilli Karen Cilli is a fact-checker for Verywell Mind. She has an extensive background in research, with 33 years of experience as a reference librarian and educator. Learn about our editorial process Print Science Picture Co / Getty Images Table of Contents View All Table of Contents What Is Atherosclerosis? Effects Causes and Risk Factors How Smoking Affects Risk It's Never Too Late to Quit Atherosclerosis is a life-threatening disease in which cholesterol, cellular waste, calcium, and other fatty substances are deposited along the lining of artery walls in your body. These sticky, yellowish deposits, known as plaque, build up over time, hindering your blood flow. If you smoke, you face an increased risk of atherosclerosis, heart attack, and stroke. What Is Atherosclerosis? Atherosclerosis, also known as hardening of the arteries or arteriosclerosis, often starts early in life and progresses slowly as you age. Atherosclerosis typically affects medium and large arteries in the body. Many scientists believe that damage to the endothelium, the innermost layer of the artery, is where atherosclerosis begins. Damage to the endothelium allows plaque to build up along the lining of your arterial walls. As it does, it constricts blood flow and decreases the supply of oxygen to your body. Effects of Atherosclerosis Plaque can rupture and cause blood clots (thrombus). These blood clots can break away and enter your bloodstream, lodging in another part of your body, sometimes completely blocking blood flow, called an embolus. Fatty embolisms that block blood flow to your heart cause a heart attack. If they block blood flow to your brain, they cause a stroke. If blood flow to your arms and legs is reduced, it can cause you to have difficulty walking and eventually lead to gangrene, which is when tissue dies due to lack of blood supply. Causes and Risk Factors Though the precise cause of atherosclerosis is unknown, there are some known risk factors. Because high cholesterol and high blood pressure can cause damage to the innermost layer of the artery where atherosclerosis begins, they are considered two of the potential causes of the condition. Elevated Cholesterol and Triglyceride Levels Elevated levels of cholesterol and triglycerides in your blood cause damage to your endothelium. The body needs cholesterol (mainly high-density lipoprotein or HDL), but too much comes with health risks. Your body usually produces most of the cholesterol it needs in your liver. The rest comes from animal fat in your diet. While our bodies also need some low-density lipoprotein (LDL) cholesterol, too much can raise your cholesterol levels dangerously and put you at risk for atherosclerosis and heart attack. Foods that come from animals, such as chicken, eggs, dairy products, beef, and pork, contain cholesterol. Foods from plants do not contain cholesterol. High Blood Pressure Blood pressure is the result of two forces. One is the pressure created by your heart pumping blood through your circulatory system. The other is the force of the resistance of the arteries as your blood flows through them. When your heart pumps, it pushes blood through the larger arteries and on into the smaller blood vessels, called arterioles. The arterioles can constrict or expand, and when they do, the resistance of the blood flow is affected. The more difficult it is for the blood to flow, the higher your blood pressure will be. When high blood pressure goes untreated for a long time and your heart is forced to pump harder to get the blood to flow, your heart muscle may become enlarged and weakened. High blood pressure hurts your arteries and arterioles over time as well. Arteries become scarred and hardened, putting you at risk for atherosclerosis. Health Risks From Smoking How Smoking Affects Atherosclerosis Risk Smoking is considered one of the biggest risk factors for atherosclerosis. Cigarette smoke increases the risk of atherosclerosis in the following ways: Cholesterol: The toxins in tobacco smoke lower your HDL ("good" cholesterol) levels while raising levels of LDL ("bad" cholesterol). Nicotine and carbon monoxide: The nicotine and carbon monoxide in cigarette smoke damage your endothelium, setting the stage for the build-up of plaque. High blood pressure: While cigarette smoking won't cause high blood pressure, if you smoke and you also have hypertension, smoking can increase the risk of malignant hypertension, a dangerous form of high blood pressure. It's Never Too Late to Quit If you smoke and you're thinking about quitting, know that it's never too late to quit. Regardless of your age or how many years you've smoked, research has shown that your body will begin the healing process within 20 minutes of your last cigarette. Within one year of quitting smoking, your risk for coronary artery disease drops to half that of someone who smokes. Between 5 and 15 years of quitting, your risk of coronary disease and stroke drops to that of nonsmokers. Trying to quit smoking isn't easy, but it's worth it. The encouraging news is that according to statistics from the Centers for Disease Control and Prevention (CDC), more than three out of every five people who have ever smoked cigarettes in the United States have quit. You can, too. There are many strategies that may help manage the stress associated with quitting and help you deal with cravings, such as: Getting some exercise Doing deep breathing exercises Reaching out to your support system Speaking with a counselor or joining a support group Healthy coping mechanisms for dealing with stress are also good for heart health, so it's a win-win. There are also medications that can help you quit. Consult with your healthcare provider about your desire to quit. They can help you find what works best for you. Best Non-Medical Ways to Quit Smoking Was this page helpful? Thanks for your feedback! So you're ready to finally quit smoking? Our free guide can help you get on the right track. Sign up and get yours today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 15 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Siasos G, Tsigkou V, Kokkou E, et al. Smoking and atherosclerosis: Mechanisms of disease and new therapeutic approaches. Curr Med Chem. 2014;21(34):3936–3948. doi:10.2174/092986732134141015161539 Atherosclerosis. National Heart, Lung, and Blood Institute. Gimbrone MA Jr, García-Cardeña G. Endothelial cell dysfunction and the pathobiology of atherosclerosis. Circ Res. 2016;118(4):620–636. doi:10.1161/CIRCRESAHA.115.306301 Musani MH, Musani MA, Verardi MA. Venous gangrene a rare but dreadful complication of deep venous thrombosis. Clin Appl Thromb Hemost. 2011;17(6):E1–E3. doi:10.1177/1076029610376629 MedlinePlus. Gangrene. Kim JA, Montagnani M, Chandrasekran S, Quon MJ. 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