Many vitally important parts of your body are hidden deep inside you. Many more are too tiny to see without sophisticated imaging technology.

Today’s two subjects are as easy to see as the nose on your face.

In fact, they’re on both sides of your nose—running right up the outside of your neck.

Your carotid arteries supply oxygenated blood to the part of the brain that houses your ability to think, talk, have a personality, functioning senses, and move your body.

They’re the blood-to-brain superhighway. And like a superhighway, when lanes get blocked, there can be trouble.

In the case of your carotid arteries, it’s in the form of a heart attack or stroke.

Are your carotids at risk?

The risk factors are similar to those for heart disease—and pretty much every other disease:

• Age
• Smoking
• Hypertension—the most important treatable risk factor for stroke
• Abnormal lipids or high cholesterol
• Insulin resistance
• Diabetes
• Obesity and sedentary lifestyle
• Family or personal history of atherosclerosis (hardening of the arteries), coronary artery disease, or carotid artery disease

What causes carotid artery disease?

Like your coronary arteries, your carotid arteries can develop atherosclerosis on the inside of the vessels. It’s the outcome of bad diet, stress, cholesterol, and other unhealthy behaviors coming together over the years—leaving their marks in the form of plaque-narrowed, slow-moving blood to the brain.

And that plaque is a multiple threat. It doesn’t just narrow your carotids—bits of it can break off, travel up into your brain, and land on a smaller artery, likely disabling it (and you).

These ingredients are the perfect recipe for a stroke.

What are the symptoms?

There may be no symptoms at all. One minute, you’re fine, next minute, you’re down, possibly dead, possibly disabled.

It might be a stroke if there’s:

• Sudden loss of vision, blurred vision, or difficulty in seeing out of one or both eyes
• Weakness, tingling, or numbness on one side of the face, one side of the body, or in one arm or leg
• Sudden difficulty in walking, loss of balance, lack of coordination
• Sudden dizziness or confusion
• Difficulty speaking (aphasia)
• Confusion
• Sudden severe headache
• Problems with memory
• Difficulty swallowing (dysphagia)

If you have any of the same symptoms as a stroke, it might also be a transient ischemic attack (TIA). This happens when blood flow to the brain is slow or a clot briefly blocks an artery. But with a TIA, the symptoms last a few minutes or few hours and then go away.

But you must treat a TIA as an emergency—no one can know if it’s the beginning of a major stroke. Seek urgent help if you or someone you know experiences any of the above symptoms. It could be lifesaving.

How do I know if I’m at risk?

When your doctor puts a stethoscope on your carotids, it’s to listen for a bruit, an abnormal sound that may indicate irregular blood flow associated with carotid artery disease.

I love the hands-on, low-tech option of this simple and enduring test. But I also recommend the carotid intima-media thickness (CIMT) test, which uses ultrasound to check the artery’s internal wall’s thickness and to spot plaque or cholesterol buildup.

Other diagnostic tools to discuss with your doctor:

• Magnetic resonance angiography (MRA)
• Computerized tomography angiography (CTA)
• Cerebral angiography (carotid angiogram), considered by some to be the diagnostic gold standard

How is carotid artery disease treated?

Lifestyle changes are the least intrusive way to slow or stop the disease:

• Quit smoking

• Control high blood pressure
• Control diabetes
• Have regular checkups with your doctor, always checking cholesterol
• Eat a heart-healthy diet, like the Mediterranean diet, supplemented by omega-3 fatty acids and phytosterols
• Maintain a healthy weight
• Exercise at least 30 minutes most days of the week
• Limit alcohol to 1 drink per day for women, 2 for men

A respected doctor in the Cleveland Clinic says he’s proven that diet alone can not just slow or halt carotid artery and other diseases—it can make them disappear. Of course, not all doctors are on board with that, but I am. Ask your doctor about the Esselstyn diet.

If you’re in the danger zone

If you’ve been diagnosed with dangerous narrowing or blockage in the carotid artery, there are surgical procedures to correct the problem to prevent future stroke.

One option is a carotid endarterectomy (CEA), which involves opening the artery where it’s blocked, removing the plaque causing the problem, then re-closing the artery.

A less invasive option is carotid artery stenting (CAS), which inserts a tiny balloon in the artery that inflates to expand it, then inserts a mesh tube (the stent) that keeps it opened.

I, of course, prefer the lifestyle changes to all other options.

Keep those carotids clean.

References

• Esseltyn’s Prevent and Reverse Heart Disease Program. About the book. http://www.dresselstyn.com/site/books/prevent-reverse/about-the-book/
• Connealy, L. Newport Natural Health. Cardiac Technology Lifesavers: EECP, CIMT, Chelation, Heart Quest. http://www.newportnaturalhealth.com/2014/02/cardiac-technology-lifesavers-eecp-cimt-chelation-heartquest/
• Kernan WN, et al. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the AmericanHeart Association/American Stroke Association. Stroke, 45(7): 2160-2236. DOI: 10.1161/STR.0000000000000024.
• Rerkasem K, Rothwell PM (2011). Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database of Systematic Reviews (4).
• Carotid artery disease. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/catd/. Accessed April 27, 2014.

Last Updated: June 22, 2021
Originally Published: March 4, 2016