Written by
Louise W Lu, PhD, MPH, BMLS
Reviewed by
Alexandra V Goldberg, Registered Dietitian
Most people think of atherosclerosis — the buildup of cholesterol plaque in the arteries — as something permanent and irreversible. Once you have it, the damage is done… right?
Not quite.
While you can’t magically erase plaque like deleting a file, science now shows us that with the right combination of lifestyle changes, medical treatments, and smart nutrition, you can shrink soft plaques, slow progression, and reduce your risk of heart attacks, strokes, and sudden death.
In our previous blog, “Arterial Plaque & Atherosclerosis: Is Your Blood Pressure Quietly Damaging Your Arteries?”, we explained how high blood pressure silently damages your arteries, contributes to arterial plaque buildup, and increases your risk of atherosclerosis, heart attacks, and stroke.
In this blog, we’ll walk you through 10 actionable, research-backed strategies to stop atherosclerosis in its tracks — and even help roll it back. Whether you’re already managing high blood pressure, have early signs of artery calcification, or just want to take control of your heart health before it’s too late, this guide is for you.
⚠️ Important Note: While atherosclerosis can’t be fully reversed, research from Harvard, NIH, and Healthline shows that aggressive lifestyle changes, targeted supplements, and timely medication can stabilise and shrink some plaques and prevent future ones.
Let’s dive into what really works — beyond fear, myths, and outdated advice.
Jump to Section:
Step 1: Adopt a Heart-Healing Diet
Food is not just fuel — it's information for your arteries. A well-designed diet can help lower inflammation, balance lipids, and reduce the oxidative stress that drives plaque formation.
🍎 How to Diet:
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Fruits and vegetables — Especially leafy greens, berries, tomatoes, and cruciferous vegetables like broccoli. These are rich in antioxidants and help reduce oxidative stress in arteries.
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Whole grains — Oats, quinoa, and brown rice help reduce LDL cholesterol.
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Legumes — Lentils and beans provide fiber and plant protein that support healthy cholesterol levels.
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Fatty fish — Salmon, sardines, and mackerel are rich in omega-3s that help reduce inflammation and support arterial health.
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Nuts and seeds — Almonds, walnuts, flaxseeds, and chia seeds contain heart-protective fats and fibre.
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Olive oil and avocado — These healthy fats improve HDL ("good") cholesterol and lower inflammation.
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MCT (Medium-Chain Triglyceride) Oils — Found in coconut oil or as concentrated MCT oil, these fats are metabolised quickly for energy, and some studies suggest they may support weight management, reduce LDL, and enhance HDL cholesterol.
❌ What to Cut Back On:
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Trans fats — Found in fried and processed foods. They increase inflammation and raise LDL.
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Saturated fats — Excess red meat and full-fat dairy may contribute to plaque if not balanced.
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Refined sugar — Triggers insulin resistance, which damages blood vessels.
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Highly processed carbs — Like white bread and pastries.
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Excess sodium — From canned, packaged, and fast foods, can raise blood pressure.
🔬 What Science Says:
✅ Proven Effects: A 2021 review in Nutrients and findings from the NHLBI confirm that a heart-healthy Mediterranean-style diet significantly reduces the risk and progression of cardiovascular disease.
✅ Clinical Trial Evidence: The original DASH trial, sponsored by the NIH and published in the New England Journal of Medicine in 1997, showed that participants who followed the DASH diet saw reductions of up to 11.4 mmHg in systolic blood pressure over just 8 weeks. Later follow-up studies have shown its effectiveness in reducing cardiovascular events, improving arterial function, and supporting lipid metabolism — making it a powerful long-term dietary strategy.
🥗 Try This: DASH Diet
The DASH Diet (Dietary Approaches to Stop Hypertension) is clinically proven to reduce blood pressure and improve heart health. It emphasises:
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Plenty of fruits, vegetables, whole grains
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Lean proteins (especially fish and legumes)
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Low-fat dairy
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Reduced sodium intake
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Low in red meat, sugar, and saturated fat
Numerous trials show that the DASH diet not only helps lower blood pressure but also slows the progression of arterial stiffness, which is a key contributor to atherosclerosis.
Step 2: Use High-EPA Omega-3 Fish Oil Daily
Omega-3 fatty acids — especially EPA (Eicosapentaenoic acid) — are among the most well-researched nutrients for cardiovascular health.
🚨 Why It Matters:
What EPA Does:
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Reduces inflammation — Atherosclerosis is an inflammatory process. EPA helps block inflammatory cytokines and reduces arterial wall irritation.
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Anti-thrombosis — EPA thins the blood slightly, lowering the risk of clots that could block narrowed arteries.
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Improves endothelial function — It enhances the health of the vessel lining (endothelium), allowing better dilation and blood flow.
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Lowers triglycerides — High triglycerides are associated with more unstable plaque.
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Stabilises plaque — EPA may help firm up soft plaques, making them less likely to rupture.
🔬 What Science Says:
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The REDUCE-IT trial (2019) showed that high-dose purified EPA (4g/day) reduced major cardiovascular events by 25%.
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Harvard Health notes that fish oil can shrink existing soft plaque and reduce C-reactive protein, a key inflammation marker.
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A 2020 meta-analysis confirmed EPA (not DHA) is the main contributor to cardiovascular protection in omega-3 supplements.
💊 Supplement Option:
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Choose high-purity fish oil with 95%+ EPA content.
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Examples: PNZ™ Omega 1440 "Golden Bottle", NYO3® 97% EPA, Aulando® 1425 "Blue Bottle".
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Dosage: Clinical trials suggest 1,000–4,000 mg EPA per day, depending on your cardiovascular risk (consult your registered nutritionist, dietitian, and doctor).
💊 Additional Vascular Support:
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NMN (Nicotinamide Mononucleotide) — Supports cellular NAD+ levels and improves vascular elasticity and repair. Recommended dosage: 250-500 mg/day. In individuals with advanced age or metabolic syndrome, higher doses up to 900 mg/day have been used under professional supervision.
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PQQ (Pyrroloquinoline Quinone) — Works synergistically with NMN to enhance mitochondrial function and reduce oxidative stress in vascular tissues. Recommended dosage: 10–20 mg/day. Some advanced protocols use up to 60 mg/day, though long-term safety at high doses requires further research.
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Combining NMN + PQQ may be especially beneficial for aging arteries and those with metabolic syndrome.
Step 3: Lower LDL — The "Bad" Cholesterol That Fuels Plaque
LDL (low-density lipoprotein) is the main type of cholesterol that contributes to plaque formation in arteries. When LDL particles become oxidised, they stick to the vessel walls and trigger inflammation — a key step in atherosclerosis.
🚨 Why It Matters:
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High LDL levels are a direct risk factor for heart attack and stroke.
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Smaller, denser LDL particles (common in insulin resistance) are more atherogenic.
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Lowering LDL helps shrink the lipid core of plaques and reduce their rupture risk.
🍎 How to Diet:
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Oats and barley — Rich in beta-glucan, a type of soluble fibre that lowers LDL.
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Legumes — Lentils, beans, and peas are high in fiber and help bind cholesterol in the gut.
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Nuts (especially almonds and walnuts) — Provide healthy fats and phytosterols that lower LDL.
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Fruits like apples, berries, and citrus — Contain pectin, another form of soluble fibre.
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Avocados — High in monounsaturated fats and fiber, which improve lipid profiles.
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Vegetables (especially eggplant, okra, leafy greens) — Support gut health and cholesterol metabolism.
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Soy-based foods — Tofu, tempeh, and soy milk may modestly reduce LDL when replacing animal protein.
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Foods fortified with plant sterols and stanols — Like spreads, yogurt drinks, or cereals. When LDL particles become oxidised, they stick to the vessel walls and trigger inflammation — a key step in atherosclerosis.
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Prescription statins: most effective class for LDL reduction; proven to reduce cardiovascular events
🔬 What Science Says:
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A 2019 meta-analysis found that each 1 mmol/L (~39 mg/dL) reduction in LDL with statins reduced major vascular events by 22%.
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The JUPITER trial showed that statins also reduce CRP (inflammation marker), offering dual benefit.
💊 Supplement Option:
- Niacin (Vitamin B3): reduces LDL and raises HDL
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Red yeast rice extract (600–1,200 mg/day)
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Soluble fibre supplements (e.g., psyllium husk 10 g/day): binds cholesterol in the gut
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Phytosterol-enriched margarine or capsules (1.5–2 g/day)
- Red yeast rice: contains monacolin K, a natural statin
- Plant sterols and stanols: block cholesterol absorption
LDL management should be tailored. If your LDL is above 100 mg/dL and you have plaque or high blood pressure, talk to your doctor about combining lifestyle with appropriate medication or supplements.
Step 4: Lower Blood Pressure — The Arterial Wall Protector
Hypertension (high blood pressure) doesn’t just raise your risk of stroke — it actively damages the lining of your arteries, making them more vulnerable to plaque formation and rupture.
🚨 Why It Matters:
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High BP increases shear stress on vessel walls
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Weakens endothelial cells and elastic fibres
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Facilitates infiltration of oxidised LDL
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Promotes chronic low-grade inflammation in arteries
Even "mild" elevations (like 130–139/80–89 mmHg) significantly increase plaque risk in East Asians.
🍎 How to Diet:
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Reduce sodium to under 2,300 mg/day (ideal: <1,500 mg)
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Eat potassium-rich foods (bananas, spinach, beans, sweet potatoes)
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Follow DASH diet (see Step 1)
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Practice stress relief — yoga, deep breathing, walking
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Limit alcohol and caffeine
🔬 What Science Says:
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A 2023 review in Journal of Human Hypertension found that every 10 mmHg reduction in SBP reduced heart disease risk by 20%.
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A meta-analysis showed that CoQ10 supplementation reduced systolic BP by 11 mmHg on average.
Managing blood pressure is one of the fastest ways to reduce damage to the arterial wall and halt progression of atherosclerosis.
💊 Supplement Option:
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Magnesium (200–400 mg/day) — vasodilator, improves endothelial tone
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Coenzyme Q10 (CoQ10) (100–300 mg/day, ubiquinol form) — supports energy in vascular cells, may lower SBP by 10 mmHg (Read "NZ & AU Ubiquinol Face-Off: Which CoQ₁₀ Supplement Reigns Supreme?") Try NYO3 EPA Fish Oil + FREE Super Ubiquinol Q10
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Hibiscus tea — 1–2 cups/day, shown to lower BP in several small RCTs
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Omega-3 fish oil — see Step 2
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Enzogenol (100–240 mg/day) — A pine bark extract rich in polyphenols, shown to reduce arterial stiffness and oxidative damage. Try PNZ Enzogenol New Zealand Maritime Pine Bark Extract, Health Life® Bee Propolis + NZ Pine Bark
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Propolis (extract 200-400 mg/day) — A bee-derived antioxidant that supports endothelial integrity and reduces inflammatory markers like CRP. Try Health Life® High Strength Propolis 5000mg
Step 5: Get Moving — Exercise Your Arteries
Regular physical activity does far more than burn calories — it triggers your arteries to become more flexible, improves endothelial function, and reduces inflammation.
🚨 Why It Matters:
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Enhances nitric oxide production, which dilates blood vessels
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Improves HDL cholesterol and lowers triglycerides
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Reduces insulin resistance
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Helps control body weight and visceral fat
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Stimulates antioxidant enzymes
🏃 How to Move:
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150 minutes per week of moderate-intensity aerobic activity (e.g., brisk walking, cycling, swimming)
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Or 75 minutes of vigorous activity (e.g., running, HIIT)
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Strength training 2–3 times/week — improves vascular tone and metabolic health
Even light movement (like walking 10 minutes after meals or standing every hour) helps improve circulation and lower post-meal blood sugar.
🔬 What Science Says:
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A study published in Circulation (2017) found that just 6 months of aerobic exercise led to significant reductions in arterial stiffness among middle-aged adults with elevated BP.
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HIIT training was shown to improve endothelial function even more effectively than continuous moderate exercise in certain populations.
Regular exercise is one of the most reliable ways to maintain flexible arteries and prevent plaque buildup — and it's never too late to start.
Final Thoughts (Part 1 of 2)
These first 5 steps — focused on food, essential supplements, and lifestyle habits — lay a strong foundation for halting and even partially reversing early-stage atherosclerosis.
But we're not done yet. In Part 2, we’ll go deeper into advanced strategies, blood sugar control, stress reduction, better sleep, and medical monitoring — so you can take full control of your arterial health.
🔜 Stay tuned for Blog 5: Reverse Atherosclerosis in 10 Simple Steps (Part 2)
