Atherosclerosis vs Arteriosclerosis: What's the Difference

The terms atherosclerosis and arteriosclerosis are often used interchangeably, even though they describe different processes affecting the arteries. Both involve changes to the artery walls over time and are linked to ageing and heart disease, which adds to the confusion. However, while they may sound similar, they do not mean the same thing and can have different causes, risks, and implications for treatment.

Understanding the difference matters because plaque buildup and artery stiffening affect blood flow in different ways and require different approaches to prevention and management. Knowing which process is involved can help explain your symptoms, clarify test results, and guide more targeted steps to protect your heart and blood vessels over the long term.

Arteriosclerosis: When Arteries Become Stiff Over Time

Arteriosclerosis is a general term used to describe the hardening and stiffening of arteries over time. It refers to structural changes in the artery walls that make them less flexible, rather than a specific buildup of fatty plaque. This process develops gradually and is commonly associated with ageing, but it can begin earlier depending on underlying health factors.

As arteries become stiffer, the heart has to work harder to push blood through the circulatory system. This increased resistance can contribute to persistently high blood pressure and place added strain on the heart and blood vessels, raising the risk of cardiovascular complications such as heart disease and stroke. Even when arteries are not significantly narrowed, reduced elasticity alone can impair healthy blood flow.

Several factors can contribute to the development of arteriosclerosis, including:

• Advancing age
• Long-standing high blood pressure
• Diabetes and other metabolic conditions
• Calcium deposits within the artery walls
• Chronic inflammation and prolonged exposure to cardiovascular risk factors

While arteriosclerosis is common, its severity and progression vary from person to person, making early awareness and risk management important for long-term vascular health.

Atherosclerosis: When Plaque Builds Up and Narrows Arteries

Atherosclerosis is a specific type of arteriosclerosis and one of the most common causes of heart disease and stroke. It occurs when fatty deposits, known as plaque, build up inside the arteries. Unlike general artery stiffening, this buildup narrows the space for blood to flow, reducing oxygen delivery to vital organs such as the heart and brain. The condition often develops slowly and may not cause noticeable symptoms until it becomes severe.

The process usually begins when the inner lining of the artery is damaged. Factors such as high cholesterol, smoking, high blood pressure, diabetes, and ongoing inflammation can weaken this protective layer. Once damaged, cholesterol can slip into the artery wall, triggering a chain reaction that leads to plaque formation.

Over time, plaque continues to grow and harden. This can gradually restrict blood flow or, in some cases, become unstable and rupture. When that happens, a blood clot can form suddenly, blocking the artery and causing a heart attack or stroke.

How the Difference Shapes Diagnosis and Treatment

Although arteriosclerosis and atherosclerosis are closely related, they affect the arteries in different ways, and that difference has real implications for your health.

How This Difference Affects Diagnosis

Understanding which process is at play helps with more accurate risk assessment and earlier detection. Arteriosclerosis may raise blood pressure over time, while atherosclerosis can remain hidden until it causes symptoms such as chest pain (angina) or triggers sudden events like a heart attack or stroke. Different tests are used to assess arterial stiffness and plaque-related narrowing, ranging from blood pressure-based assessments to imaging tests that show plaque buildup and reduced blood flow.

How Treatment Approaches Differ

Treatment is tailored to the underlying process. Arteriosclerosis is typically managed by controlling blood pressure and improving overall vascular health through lifestyle changes and long-term medication. Atherosclerosis focuses more on lowering cholesterol, reducing inflammation, and slowing plaque progression with medications. When blockages are severe, procedures like angioplasty or bypass surgery may be used to restore blood flow and reduce future cardiovascular risk.

Get the Right Care for Your Arteries From EH Heart Specialist

Not all artery problems are treated the same way. Some people mainly develop stiff arteries that drive up blood pressure over time, while others develop plaque that can suddenly block blood flow and cause a heart attack or stroke. Telling these apart helps doctors decide what to prioritise, whether that is tighter blood pressure control, cholesterol lowering, lifestyle changes, or procedures to restore circulation. When the underlying problem is correctly identified, care becomes more focused, risks are addressed earlier, and long-term outcomes are more likely to improve.

At EH Heart Specialist Clinic, we focus on identifying the specific changes affecting your arteries so care can be tailored to what your heart and blood vessels actually need. Through comprehensive assessment and appropriate testing, Dr Eric Hong can help clarify your cardiovascular risk and recommend a personalised plan to manage it effectively. If you have concerns about your heart health or want a clearer understanding of your risk, book an appointment with us to take a proactive step towards protecting your heart health.