Can clogged blood vessels be cleaned up again?
Early atherosclerosis can partially reverse, particularly with strong LDL lowering through statins or newer agents. The earlier you intervene, the more benefit you can expect, so discuss your cholesterol and blood pressure levels with your doctor.
Atherosclerosis (fatty build-up in artery walls) is not a one-way street. In the PESA study, in which more than 3,400 participants were followed for six years, plaque shrank in 8% of people with early atherosclerosis. That percentage may seem small, but it proves that shrinkage is genuinely possible in humans, not just in animal research.
The strongest drivers of plaque growth are excessively high LDL cholesterol (the 'bad' cholesterol) and high blood pressure. Notably, this effect was greatest in the youngest participants, aged 40 to 55. Intervening early therefore yields more benefit. It is also striking that nearly half of the people without classic risk factors already turned out to have atherosclerosis, and that LDL contributed to more extensive plaques even within officially 'normal' ranges. Current threshold values may be too lenient.
Statins, particularly at high doses, measurably reduce the fat content of plaques. They also make plaques less dangerous in terms of their composition. Newer agents called PCSK9 inhibitors have a comparable or stronger LDL-lowering effect and also show plaque shrinkage in imaging studies. There is, however, an important caveat: the direct link between plaque shrinkage on a scan and fewer heart attacks or strokes in practice has not yet been well established.
How plaques shrink is partly understood. Immune cells in the vessel wall store fat when LDL is high, but when LDL is sufficiently lowered they can also export fat and leave the plaque. HDL cholesterol ('the good kind') assists in this process by removing fat from those immune cells. Larger, long-established plaques respond less well to these changes than early plaques do. Anti-inflammatory agents can also reduce plaque, but the evidence for this is thinner than for statins and PCSK9 inhibitors.
Based on the PESA study (3,471 participants, observational), the YELLOW trial (statins, imaging study), multiple clinical imaging studies with statins/PCSK9 inhibitors, and a mathematical model for LDL/HDL combinations. The link between plaque shrinkage on a scan and clinical outcomes (heart attacks, mortality) has not yet been sufficiently established.
Can you remove microplastics from your blood vessels?
No method exists to selectively remove microplastics from your blood vessels, and research into this has not been conducted either. What you can do is limit daily exposure, for example by using less plastic packaging and not heating food in plastic.
How healthy are my blood vessels / what is my vascular age?
For a first impression of your vascular health, an ApoB blood test is the simplest and most accessible step; a CAC scan adds the most value when your risk remains unclear after blood testing.
Which foods or supplements keep your blood vessels healthy?
The Mediterranean diet most demonstrably lowers your risk of cardiovascular disease. Individual supplements do not help.
Does treating inflammation in the coronary arteries through medication actually make a difference for your long-term heart health?
Targeted anti-inflammatory treatment, particularly with low-dose colchicine, measurably reduces the risk of serious cardiac events in people with coronary artery disease. Discuss with your cardiologist whether this is relevant for you, because not every drug works and there are safety considerations that require careful weighing.
Does climbing stairs actually do anything for my heart?
Yes, climbing stairs genuinely does something for your heart. Climbing roughly 50 to 100 steps a day is associated with fewer heart attacks, strokes and irregular heart rhythms, though this is based on observational studies, not experiments.
What does a vascular age measurement (stiffness of your blood vessels) tell you about your health?
A high vascular age on the measurement is a serious signal: your risk of cardiovascular disease, dementia, and premature death is considerably elevated. Discuss it with your doctor, as there are lifestyle and medication options to slow arterial stiffness.