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Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks a coronary, carotid, peripheral, or renal artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke.

Certain traits, conditions, or habits may raise your risk for the disease. Major risk factors include unhealthy blood cholesterol levels, high blood pressure, smoking, insulin resistance, diabetes, being overweight, lack of physical activity, an unhealthy diet, older age, and family history of early heart disease.

Changes, either from genes or the environment, in the body’s normal functions may cause high blood pressure, including changes to kidney fluid and salt balances, the renin-angiotensin-aldosterone system, sympathetic nervous system activity, and blood vessel structure and function.

Although the exact cause of atherosclerosis isn't known, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age.