Atherosclerosis: A Man’s Worst Enemy

Atherosclerosis: A Man’s Worst Enemy

What Is Atherosclerosis?

Atherosclerosis is a major risk factor for cardiovascular disease (CVD), which, according to the World Health Organisation is the leading cause of death on a global scale.

Atherosclerosis is more common in men than women, and men tend to develop the condition at an earlier age. Atherosclerosis is a condition where the arteries harden and become narrow as a result of a build-up of fatty substances known as plaques. This is a potentially dangerous situation because a restricted supply of blood can damage organs and disrupt their ability to function properly.

All arteries are susceptible to atherosclerosis, and exactly the type of CVD it precipitates depends on which arteries are affected. The arteries most commonly affected by atherosclerosis are:

  • The coronary arteries – atherosclerosis in these arteries, which supply blood to your heart, can lead to coronary heart disease.
  • The carotid arteries – atherosclerosis in these arteries, which supply blood to your brain, can lead to a stroke.
  • The peripheral arteries – atherosclerosis in these arteries, which supply blood to your legs, can lead to peripheral artery disease

Symptoms of Atherosclerosis

Atherosclerosis itself has no obvious symptoms, and from a young age, an unwanted build up in the lining of the artery walls can develop without any overt indication of its occurrence. Very often it is not until the narrowing effect of atherosclerosis is sufficient to restrict the flow of blood, that awareness is triggered.

Commonly, the first signs of atherosclerosis are pains and cramps, when blood flow to tissues is not adequate to meet their demand for oxygen. An unfortunate reality of atherosclerosis is that, because of its silent progression, people sometimes don't realise that they have the condition until they experience a heart attack or stroke.

Risk Factors for Atherosclerosis

The exact mechanism by which your arteries become clogged is still not fully understood, but just as atherosclerosis is a risk factor for cardiovascular disease, atherosclerosis itself has a range of associated risk factors. These risk factors are broadly classified into two categories referred to as non-modifiable risk and modifiable factors.

Non-modifiable risk factors for atherosclerosis are factors that we cannot do anything about and include:


As a person ages, the hardening and narrowing of the arteries is a natural process, and so atherosclerosis is more prevalent in members of the population who are over the age of 40. According to the NHS, it is thought every adult has the condition at least to some extent.


Men are more likely to develop atherosclerosis at an earlier age than women. This disparity can be possibly attributed to a protective effect of female hormones such as progesterone, but other factors such as the way men deal with stress might also be of significance. However, as women get older their risk of developing atherosclerosis soon catches up with that of their male counterparts, especially after the menopause.


Certain ethnic groups have a different level of risk of developing atherosclerosis. High blood pressure and diabetes are risk factors for atherosclerosis, and rates of these risk factors are higher among people of African and African-Caribbean descent. In the UK diabetes is five times more common among people of South Asian descent than it is in the majority population.

Family History

An individual with a brother or father who develops atherosclerosis before the age of 55 or a sister or mother who develops the condition before the age of 65 is at a higher risk than the rest of the population. A person's risk of developing atherosclerosis can be as much as double if they have a first degree relative with the condition.

Modifiable risk factors are factors that are within our control and include:

Body Weight

Sometimes being overweight or obese can indirectly predispose a person to atherosclerosis by increasing their chance of developing associated risk factors, such as type 2 diabetes, high blood pressure and high cholesterol. This is especially true if the excess weight is primarily distributed around the midsection.


Both type 1 and type 2 diabetes can lead to damage to the walls of the arteries, which increases the risk of developing atherosclerosis.


Smoking damages artery walls, and as part of the body's subsequent repair response blood cells known as platelets clump together at the site of the damage, eventually leading to a narrowing of the arteries.


Cholesterol has a range of essential functions in the body and contributes to cell structure and hormone production. However, there are two major types of cholesterol, one good and one bad.

The bad type of cholesterol is known as low-density lipoprotein (LDL), and an excess of LDL cholesterol in the blood can contribute to atherosclerosis. As a risk factor, high cholesterol is of greater importance for men than it is for women.

High Blood Pressure

Over 25% of adults in the UK have high blood pressure. If the blood inside the arteries is pumped at an excessive pressure, the internal lining of their walls becomes damaged, contributing to the development of atherosclerosis in the same way as smoking.


Excessive alcohol consumption can result in both high blood pressure and high cholesterol, which are important risk factors for atherosclerosis.

Physical Activity

Being physically inactive can result in high blood pressure, and so a low level of physical activity is a risk factor for atherosclerosis.

What Can a Man Do?

In any effort to support heart health, a man cannot typically control being male any more than he can abate the ageing process, or alter his ethnicity or family history. However, there are certain lifestyle measures that he can implement in order to gain governance over the risk factors for atherosclerosis that are responsive to manipulation.

  • Achieving and maintaining a healthy body weight confers a range of health benefits, in addition reducing the risk of developing atherosclerosis. Consuming an amount of calories that is appropriate to your size and level of physical activity is fundamental to controlling body weight. On average a man needs approximately 2500 Kcals a day, although the exact figure depends on the individual, and will often be lower if weight loss is the goal.
  • If a man has either type 1 or type 2 diabetes, carefully following the advice of his doctor or dietician, and effectively controlling his blood glucose levels can have a positive impact on his degree of risk of developing atherosclerosis
  • According to the British Heart Foundation, giving up smoking is the single most important thing a man can do for the health of his heart. A GP will be able to provide information on local stop smoking services.
  • Maintaining healthy cholesterol levels through a properly balanced diet forms the basis of any strategy geared toward reducing the risk of atherosclerosis. Switching out fatty foods for fruit, vegetables and whole grain cereal can help a man lower his cholesterol levels, and according to the NHS, a 2000mg daily intake a of plant sterols can also have a role.
  • High blood pressure results in an increased risk of atherosclerosis, but as there are rarely any symptoms, a man might not even realise that he has it. A GP will be able to check blood pressure and give advice on how to control it.
  • Moderating alcohol intake can support a man in reducing his risk of atherosclerosis. The government recommends a weekly alcohol intake of no more than 14 units and that drinking alcohol should be spread out over three or more days.
  • Being active and exercising regularly can help a man maintain the health of his arteries, by keeping his blood pressure in the acceptable range. The British Heart Foundation recommends gradually building up exercise to a target total of 150 minutes a week.


Atherosclerosis Your Quick Guide. British Heart Foundation 2014
Cardiovascular diseases Fact sheet No. 317. World Health Organization 2015
Type 2 Diabetes in the UK South Asian Population. South Asian Health Foundation 2014
Jeanine E Roeters van Lennep, H.Tineke Westerveld, D.Willem Erkelens, Ernst E van der Wall. Risk factors for coronary heart disease: implications of gender. Cardiovascular research. 2002
Weidner G. Why do men get more heart disease than women? An international perspective. Journal of American college health. 2000 May; 48(6);291-4
Vitale C, Miceli M, Rosano GM. Gender-specific characteristics of atherosclerosis in menopausal women: risk factors, clinical course and strategies for prevention. Climacteric: the Journal of the International Menopause Society. 2007 Oct; 10 Suppl; 16-20.