Longevity expert explains whether we can reduce plaque build-up in our arteries and decrease the risk of a heart attack

It is a very common belief that once plaque builds up in the arteries, it is there to stay, a slow, irreversible path towards heart disease. Doctors generally prescribed lifelong medication, stents, or even surgery as the only way forward. But as longevity expert Dr Vass, trained at Cornell, points out, that it might not all be true. Science now shows that arterial plaque can indeed be managed, reduced, and even stabilised if the root causes are targeted.
So, can plaque really be reversed, and can this lower the risk of heart attacks? Here’s all we need to know about it.

Plaque is permanent, and once arteries are clogged, the damage cannot be undone. New research shows that plaque does not have to be static. With precision care, lowering ApoB particles, calming vascular inflammation, and improving nitric oxide function, plaque can shrink or stabilise. This doesn’t mean arteries can be magically “cleaned,” but it does mean outcomes can change without invasive procedures.As per Dr Manoj Kumar Agarwala, Consultant Cardiologist Apollo Hospitals Jubilee Hills Hyderabad, "Plaque build-up in the arteries, known as atherosclerosis, is one of the leading causes of heart attacks. While we cannot completely erase plaque that has already formed, research shows we can certainly slow down its progression and, in some cases, stabilize it to reduce the risk of rupture. Lifestyle choices play a critical role—adopting a balanced diet rich in fruits, vegetables, whole grains, and healthy fats, along with regular physical activity, helps improve cholesterol levels and blood pressure. Avoiding smoking and managing stress further support arterial health. In addition, prescribed medications such as statins can lower harmful cholesterol and reduce inflammation in the blood vessels. Ultimately, it’s about consistency—small, sustained changes make a significant difference over time. By combining preventive care with medical guidance, we can lower the risk of heart attacks and protect our cardiovascular health more effectively."

Plaque forms when cholesterol lodges inside artery walls. The immune system rushes white blood cells to trap it, but this creates foamy cells that worsen inflammation. Over time, a fibrous cap develops, covering softer plaque beneath. The real danger comes when this cap ruptures. A sudden blood pressure spike can tear it open, causing a clot, often the trigger for a heart attack.


It is not always the biggest blockages that cause trouble. A seemingly “mild” 30% blockage of unstable soft plaque can be far more dangerous than a 70% stable blockage.

Completely erasing plaque is not possible. Plaques can shrink and become stable with the right approach. Soft plaques, in particular, can reduce in size when LDL cholesterol, the carrier that deposits fat into artery walls, is aggressively lowered. For example, reducing a 30% soft plaque buildup to 15% is a realistic goal. This makes arteries safer and significantly reduces the risk of rupture.
Lifestyle changes and medication play a crucial role in long-term heart health and plaque management.

Cholesterol gets a bad reputation, but it’s essential for the body. It helps make vitamin D, hormones, and even the protective coating of cells. The problem arises when LDL cholesterol (the so-called “bad” cholesterol) overwhelms the system and deposits fat into the arteries.


On the other hand, HDL cholesterol (the “good” cholesterol) can help remove excess cholesterol from plaques. Studies suggest aiming for an HDL above 60 mg/dL, while high-risk individuals benefit most when LDL levels drop below 70 mg/dL, and some cardiologists now aim for even lower levels, under 55 mg/dL.
Also See: Cardiologist reveals subtle symptoms of heart attack in women to watch out for​

Focus on fruits, vegetables, whole grains, legumes, and foods rich in omega-3s like fatty fish, flaxseeds, and walnuts. Also, limit saturated fats, trans fats, refined carbs, added sugars, and excess salt. Instead, choose healthy fats from olive oil, nuts, and avocados. Following eating patterns like the Mediterranean or DASH diet can help lower cholesterol, reduce inflammation, and support arterial health.

• ​ultra-processed food^​s
• deli meats
  
• sugary drinks

• trans fats

• excessive saturated fats

• high cholesterol foods

• excessive red meat

• excess salt

• refined carbs

Get at least 30 minutes of exercise every day for better cardiovascular health. This could be walking, jogging, running, or swimming. Also see: Longevity expert ranks 7 popular exercises by how well they support long and healthy life​

Exercise helps a lot when it comes to heart health

Sitting is the new smoking. Prolonged sitting can in fact, increase the chances of an early death and heart disease. So try to move more.

According to Harvard experts, while medications like statins remain highly effective in lowering LDL and reducing plaque risk, lifestyle is just as critical. A few evidence-backed approaches include:


Mediterranean diet: Rich in olive oil, nuts, vegetables, fish, and whole grains, it reduces heart disease risk by up to 30%.

Exercise: Aerobic workouts improve blood flow, lower blood pressure, raise HDL, and help regulate weight. About 150 minutes per week is the gold standard.

Quitting smoking: Cigarette smoke damages artery walls, making them more vulnerable to plaque buildup. Quitting improves artery health and raises HDL.

Managing blood pressure and blood sugar: High blood pressure and uncontrolled diabetes accelerate plaque instability.


What sets the newer understanding apart is precision, targeting inflammation, oxidative stress, and metabolic dysfunction rather than just chasing cholesterol numbers.

This article is for informational purposes only and is not a substitute for medical advice. Please consult a qualified healthcare professional before making changes to medications or lifestyle.

With the right lifestyle choices and timely care, it is possible to slow down or even reduce plaque build-up, keeping the heart healthier for longer.

Taking care of your heart with healthy habits and timely treatment can go a long way in keeping plaque under control and lowering future risks. Small, consistent changes in daily life often make the biggest difference. Staying aware and proactive today can help protect your heart for years to come. Start today