Let’s Talk About Atherosclerosis

When plaque builds up in your blood vessels, your heart, brain, and major organs can be robbed of oxygen from narrowed arteries or a blood clot. Here’s how to prevent, manage, and treat this condition.

by Matt McMillen Health Writer

A chronic, slow-moving and, in its early stages, silent disease, atherosclerosis can sometimes announce itself in a dramatic and even deadly manner: a heart attack or stroke. We know how scary that sounds, especially if you’re among the 1.5 million Americans who are diagnosed with this artery-clogging disease each year. Still, there’s plenty you can do, right now, to prevent heart attack or stroke from ever developing. With the right treatments and lifestyle changes, you can reduce your risk of life-threatening complications from this condition. So, take heart: We’ll tell you all we know.

Atherosclerosis

Our Pro Panel

We went to some of the nation’s top experts on atherosclerosis to bring you the most up-to-date information possible:

Joel Garcia, M.D. headshot.

Joel Garcia, M.D.

Cardiologist

Orlando Health Heart and Vascular Institute

Orlando, FL

Andrew Freeman, M.D. headshot.

Andrew Freeman, M.D.

Director of Cardiovascular Prevention and Wellness

National Jewish Health

Denver

Guy L. Mintz, M.D. headshot.

Guy L. Mintz, M.D.

Northwell Health’s Director of Cardiovascular Health & Lipidology

Sandra Atlas Bass Heart Hospital

Manhasset, NY

Atherosclerosis
Frequently Asked Questions
What are the causes of plaque buildup?

Turns out, there are many causes. Hardened, narrowed arteries that lead to blockages and blood clots forming in your blood vessels can be caused by high blood pressure, unhealthy cholesterol levels, complications from diabetes, and even toxins (like those you inhale from cigarettes) that can damage your arteries.

Does smoking lead to atherosclerosis?

Smoking and vaping are both major risk factors for developing this condition. Both damage the cells that line the arteries and other blood vessels, increase the odds of your blood clotting, lower your oxygen levels, and decrease your HDL “good” cholesterol (which helps protect the lining of your arteries).

If I have diabetes, am I at greater risk for atherosclerosis?

Yes. The high blood glucose levels associated with unmanaged diabetes causes damage to the arteries, making them susceptible to plaque buildup, which leads to the arteries hardening. If you have diabetes, ask your doctor about how best to protect your blood vessels from this condition.

Can atherosclerosis lead to stroke?

Another yes. This can occur when a plaque buildup ruptures in the blood vessels and then travels to other parts of the body. When a blockage cuts off oxygen to the brain, a stroke occurs.

What Is Atherosclerosis?

The disease is quite complex and not fully understood, but its impact is clear: Atherosclerosis causes your arteries—the tube-like blood vessels that function like interstate highways for your blood to travel throughout your body—to harden and stiffen. (That’s why you may have heard this disease being referred to as a “hardening of the arteries.”) Such hardening hampers blood flow, leading to a host of health problems. Let’s take a closer look at how it all goes down.

Your heart tirelessly pumps blood to the rest of your body, delivering oxygen and other important nutrients to everything from major organs (see: brain, liver, and kidneys) down to the smallest cells. That blood, when delivered in sufficient amounts, helps keep you alive and functioning.

To reach the parts of your body that are both distant and near, your blood travels through a network of arteries that make up a critical part of your circulatory system. The path begins at your aorta, your body’s largest artery, which connects directly to your heart. From there, the system branches into smaller and smaller arteries.

Healthy arteries are flexible, and their inner walls are smooth. They need to remain so in order for your blood to flow steadily and without obstruction. Atherosclerosis, a chronic inflammatory disease that worsens over time, literally gums up the works. The disease causes a substance known as plaque to build up on the walls of your arteries. Made up of fatty material such as cholesterol, this plaque can thicken to the point that it prevents an adequate amount of blood from reaching your vital organs—causing potentially dangerous blockages.

Atherosclerosis does not always have symptoms, so it often goes undetected. That means it’s tough to determine how many people have it. However, here’s what we do know: It’s the number-one cause of heart disease, which kills more than 650,000 people each year in the U.S., making heart disease responsible for about one in every four American deaths. We also know that nearly half of all Americans (48%, or roughly 122 million people) have some type of heart disease, comprised of heart failure, stroke, and/or high blood pressure—all of which can be caused by atherosclerosis. Before COVID-19, heart disease was the leading cause of death in this country, and it likely will be again after the pandemic fades in our collective rear view mirrors.

What Are the Complications of Atherosclerosis?

A blockage from a thickened artery caused by atherosclerosis can have disastrous consequences. However, the specific fallout depends on where a blockage occurs. Lose blood flow to your heart, for example, and you’ll have a heart attack. Insufficient blood flow to your brain can cause a stroke. And a blockage to the kidneys can lead to kidney failure.

But it’s not only blockages that cause significant harm. Plaque that collects on the walls of your arteries may be vulnerable to rupture, or breaking apart. When a rupture occurs, it triggers the formation of blood clots. Such clots can be large enough to completely stymy the flow of blood. Similar to arterial blockages, if a clot occurs in a coronary artery, it can cut off oxygen to your heart, causing a heart attack. If a clot prevents blood from reaching your brain, you will have a stroke.

What Other Diseases Can Atherosclerosis Cause?

In addition to life-threatening events (heart attack, stroke) and the development of heart disease, atherosclerosis can lead to other chronic disorders and complications. Where, exactly, plaque forms in the body varies from person to person, according to the American Heart Association. Complications from plaque buildup can include:

Peripheral Artery Disease (PAD)

Approximately 6.5 million Americans who are 40 and up have peripheral artery disease (PAD), according to the Centers for Disease Control and Prevention (CDC). This occurs when atherosclerosis affects arteries other than those that deliver blood to your heart or brain. Such arteries include those that supply your legs and arms. Circulation problems result, potentially causing weakness, numbness, and pain when walking, a condition called claudication. Untreated, peripheral artery disease can lead to tissue death, a.k.a., gangrene, in the affected limbs. In extreme cases, amputation may be required.

Renal Artery Stenosis

Your renal arteries supply blood to your kidneys so that they can perform their main job: removing waste and excess water from your body. If that blood supply becomes hindered, it can cause your kidneys to fail. It also may boost your blood pressure to a dangerously high level and is thought to be a leading cause of hypertension. It’s estimated that this condition is found to some degree in roughly 18% of adults between the ages of 65 and 75 and 42% of those who are 75 and up.

Carotid Artery Disease

Your brain needs blood, and the oxygen it delivers, in order to function. The main suppliers are your carotid arteries, found on each side of your neck. If atherosclerosis develops in these arteries, your risk of stroke rises. Strokes occur when sufficient amounts of blood cannot reach your brain, either because your arteries have become narrowed or they’ve become blocked. Strokes cause brain cells to die. This can lead to severe disability or even death, so it’s important to seek help as soon as any stroke symptoms present themselves. According to the CDC, someone in the U.S. has a stroke every 40 seconds, with 87% directly attributed to a blockage of blood flow to the brain. Every four minutes, someone dies of stroke.

Abdominal Aortic Aneurysm (AAA)

AAA is a bulge in the wall of your aorta that can result from damage to your arteries due to atherosclerosis. It develops slowly, but if an AAA bursts, the internal bleeding that results can be quickly fatal. Another worry: Blood clots that form at the site of the aneurysm can break away and travel through your blood vessels, potentially causing a harmful blockage somewhere else in the body. Every year, 200,000 Americans are diagnosed with AAA, making it the fifteenth-leading cause of death in this country, according to the Society for Vascular Surgery.

What Are the Causes of Atherosclerosis?

The causes are not always certain, but it appears that atherosclerosis begins to develop when the inner layer of an artery becomes damaged. There are many things that can cause that damage. They include:

High Cholesterol

Unhealthy cholesterol levels lead to inflammation, which can damage your arteries. It also can reduce your arteries’ ability to maintain a healthy blood pressure. There are two types of cholesterol: low density lipoprotein (LDL), which is considered “bad” cholesterol because it’s the type that builds up on the walls of your arteries, and high density lipoprotein (HDL), or “good” cholesterol, so called because it helps remove excess cholesterol from your body via your liver. You get in trouble when you have too much of the former and too little of the latter.

Most often, high cholesterol results from poor diet, lack of exercise, and other unhealthy lifestyle factors. However, high cholesterol can also be caused by a genetic condition inherited from your parents called family hypercholesterolemia. Your ideal cholesterol level depends on your age and sex. Diet, exercise, and medications can help you manage your cholesterol levels.

Hypertension (a.k.a. High Blood Pressure)

High blood pressure is considered a potential trigger for atherosclerosis because of the damage it can do to your arteries. When you have HBP, your arteries have to work harder to keep blood flowing. This leads to damage of blood vessels that can trigger atherosclerosis. A healthy blood pressure is 120/80 or lower. You have high blood pressure if yours measures above 130/80. If yours is too high, talk to your doctor about how best to manage it.

Toxins

Toxins, including environmental pollutants, can cause damage to major heart vessels. They can be found in tobacco smoke, including carbon monoxide, and they damage the endothelium, a.k.a., the lining of your arteries.

The damage caused by any the above conditions and/or pollutants encourages the process of atherosclerosis to kick-off. Over time, plaque builds up at the site of the damage. These plaques, also known as atheromas, usually develop where the arteries branch and spread out, though they can turn up anywhere in the arteries.

Covered with a fibrous cap, plaque deposits contain cholesterol, calcium, smooth muscle cells, and other material. Some plaques grow until they hamper blood flow. Not all plaques become large enough to block your arteries, but, again, they can still split open, or rupture, leading to the formation of dangerous blood clots.

What Raises Your Risk of Atherosclerosis?

As you’ll see, the list of risk factors for atherosclerosis is long, but let’s preface that with some positive news: You can eliminate nearly all of them. It will take some work, but it’s worth the reward: a longer, healthier life. Here is a list of the conditions and lifestyle choices that can be managed or curbed altogether to prevent plaque buildup from developing in the first place:

Being a Smoker

Smoking seriously raises your risk of atherosclerosis because the toxins in cigarettes damage the lining of your arteries. If you smoke (or vape), you’ve likely already tried to quit countless times—and we know how hard stubbing out this addictive habit can be. But you don’t have to do it alone or cold turkey. Talk to your doctor about tools like nicotine patches, and check out the American Heart Association’s smoking cessation support page for help. When it comes to atherosclerosis, quitters win.

Diabetes

If you have diabetes, you have a higher than usual risk of atherosclerosis because elevated blood glucose levels aggravate your arteries and can cause the type of arterial damage that triggers the disease. Keeping your diabetes well-managed will help protect your arteries.

Heredity

Some research shows that your family history can influence your genetic susceptibility for developing atherosclerosis. However, as of yet researchers have not found the specific genes associated with this risk. If atherosclerosis runs in your family, speak to your doctor about your individual risk level—and ask if you should be tested or treated for this condition.

Poor Diet

If you overindulge in foods loaded with saturated fat—think fatty red meat, butter, bacon, and cheese—your LDL cholesterol level may be too high. Foods and drinks with added sugar, high amounts of salt, and trans fats (such as fried foods and sweet baked treats like cakes and cookies), also increase your risk. A healthier alternative: Focus on fruits and vegetables, whole grains and high-fiber foods, lean meats, and healthy fats like olive oil. The Mediterranean diet is an example of one such eating plan.

Obesity

Speaking of weight, carrying too many excess pounds is also a major risk factor of atherosclerosis. Being dangerously overweight can raise your blood pressure, cholesterol, and your blood glucose level while also causing harmful inflammation. But what is obesity?

For decades, a simple mathematical formula has been used to measure it: If your body mass index (BMI), a ratio of your weight to your height, is 30 or higher, you are considered obese. However, this number alone may not present a full picture of health. Ask your doctor about what is a healthy weight for you—and if you do need to lose some weight to prevent the complications of atherosclerosis, inquire about effective weight loss treatments, too.

Sedentary Lifestyle

If you spend too much time on your couch (or sitting at a desk) rather than moving around, your arteries suffer. Why? You won’t get the many health benefits of exercise. Regular exercise helps control your cholesterol, blood pressure, and weight—so get up and get going!

The AHA recommends getting at least 150 minutes of moderate aerobic activity, or 75 minutes of vigorous aerobic activity, each and every week. This might include anything from a brisk walk a few times a week to a sweat-inducing class at your gym—get the minimum of minutes, then build up from there.

Chronic Stress

It’s normal to feel stressed on occasion. After all, life happens, right? But if that stress becomes a constant, it can have unhealthy consequences. How it harms your arteries is not fully understood, but researchers speculate that the inflammation it causes may contribute to damage to your arterial walls. Also, hormones released into the bloodstream during times of stress may raise both your cholesterol and your blood pressure levels.

In addition to the above, there are a few risk factors for atherosclerosis that you can’t change:

Age

As you get older, the wear and tear on your arteries accumulates and begins to take its toll. Plaque deposits form, and your arteries become firmer and less elastic. Men’s risk typically begins at age 45, while women’s begins at age 55. Why the gap? Turns out the hormone estrogen, which women have in greater abundance, helps keep cholesterol in check. With menopause, however, estrogen levels drop and that added protection disappears.

Family History

If your father or a brother had heart disease before age 55, or your mother or a sister had heart disease before age 65, your risk of atherosclerosis is higher.

What Are the Symptoms of Atherosclerosis?

The symptoms that develop as atherosclerosis worsens depend on which arteries are most affected:

Coronary Arteries

These are the arteries that supply your heart with blood and oxygen. As they narrow, your heart may not be able to get all the oxygen it needs to do its job. This can cause chest pain, or angina. This pain most often occurs when you exert yourself, such as when you climb stairs or exercise, and goes away when you rest.

Other symptoms include:

  • Dizziness

  • Heart palpitations, such as irregular heartbeats or skipped heartbeats

  • Nausea

  • Racing heartbeat

  • Shortness of breath

  • Sweating

  • Weakness

Because these symptoms may also indicate a heart attack, call 911 if you are experiencing them.

Peripheral Arteries

These are the arteries that supply your limbs, such as your legs and arms, with blood and oxygen. Peripheral artery disease (PAD) most often affects your legs. When you don’t get enough oxygen to your legs, you may experience pain in your calves and/or thighs, called claudication, while walking.

Other symptoms include:

  • Discoloration of a leg or foot

  • Hair loss on your legs

  • Sores or wounds on your feet, legs, or toes that do not heal or heal slowly

  • Weakness or numbness in a leg

Worst-case scenario: Reduced oxygen to your legs, which can occur gradually or happen suddenly, can cause gangrene that may require amputation.

Carotid Arteries

These are the arteries that supply blood and oxygen to your brain. You likely won’t have any symptoms prior to a stroke or a transient ischemic attack (TIA), which is sometimes called a “silent stroke.” Both have symptoms described above. Unlike a stroke, a TIA lasts momentarily and usually causes no lasting harm. However, having a TIA indicates that you are likely to have a real, full-blown stroke. If you suspect you’re having either a stroke or TIA, don’t hesitate: Call 911. Strokes are a life-threatening emergency.

Renal Arteries

These arteries supply blood and oxygen to your kidneys. Symptoms rarely occur in the early stages of plaque buildup, a condition caused by atherosclerosis called renal artery stenosis. This will elevate your blood pressure significantly, though that, too, has no symptoms. When this occurs, your high blood pressure will be difficult to treat.

As the blockage becomes more pronounced and less blood and oxygen reach your kidneys, your risk of chronic kidney disease rises. Symptoms of kidney disease include:

  • Muscle cramping at night

  • Poor appetite

  • Reduced or increased need to urinate

  • Swelling, called edema, in your feet and ankles

  • Trouble sleeping

  • Weakness, tiredness, fatigue, and inability to concentrate

Abdominal Aortic Aneurysm (AAA)

An AAA rarely causes symptoms in its early stages. However, as it becomes larger, you may feel pain in your chest, lower back, or groin. If the aneurysm bursts, you likely will feel intense pain, sweating, dizziness, nausea, and other discomfort. Call 911. A burst aneurysm causes life-threatening internal bleeding.

What Are the Symptoms of Heart Attack and Stroke Caused by Atherosclerosis?

Generally speaking, your body won’t tell you that you have atherosclerosis until it has advanced significantly. That’s because the disease progresses quite gradually—and usually silently. Sometimes, the first indication that you have it is when a heart attack or stroke occurs.

Symptoms of a heart attack can include:

  • Chest pain. It may come and go and not be terribly severe, or it could feel like crushing pressure on your chest.

  • Cold sweats. A drop in blood pressures can trigger your nervous system to respond by making your skin feel cold and clammy.

  • Lightheadedness or dizziness. This may be caused by a drop in blood pressure, decreased blood flow to your brain due to a blockage, damage to your heart’s valves that occur during a heart attack, and/or problems with your heart’s ability to maintain its proper rhythm.

  • Fatigue. Reduced blood flow to the heart can cause a deep feeling of tiredness. Women tend to experience fatigue more often than men do because blood clots can form more slowly in women—over many days—which may not entirely interrupt blood flow. Despite the fatigue, you may still have difficulty falling and staying asleep.

  • Nausea and vomiting. This may accompany chest pain, and, again, women tend to report queasiness more often than men do. Doctors suspect that a heart attack stimulates the vagus nerve, which runs down from the brain through the chest into the abdomen—and an overstimulated vagus nerve can make you feel like throwing up.

  • Pain or discomfort in your upper body. Pain can be sharp, like an elephant is sitting on your chest, or dull and constant, radiating across your shoulders, back, arms, jaw and stomach.

  • Shortness of breath. If you’re panting without exerting yourself, this can signal that a blockage is preventing your heart from delivering enough oxygen through your lungs to the rest of your body.

If you are experiencing any of the above symptoms and suspect you’re having a heart attack, don’t hesitate: Call 911!

Symptoms of a stroke can include:

  • Facial drooping. This occurs when nerves that control facial muscles are damaged in the brain.

  • Slurred speech or trouble understanding others. When the oxygen supply is cut off to your brain, important cognitive functions can be negatively affected.

  • Sudden movement difficulties. This may include a lack of balance.

  • Vision problems. Blurred vision is a common symptom after a stroke.

  • Weakness, numbness, or paralysis on one side of your body. When one side of the brain is affected by stroke, the other side of the body can present with these symptoms.

If any of the above occur, seek medical care immediately. That means getting an ambulance and getting to a hospital—STAT!

How Do Doctors Diagnosis Atherosclerosis?

If your doctor suspects that you have atherosclerosis—which basically means you have any degree of plaque buildup in your arteries and other blood vessels—you’ll undergo a series of tests. While currently there are no biomarkers for this condition, some imaging scans and invasive exams can actually show the damage caused by plaque buildup.

Here’s what you can expect:

Physical Exam and Health History

This will likely include measuring your blood pressure and listening to your heart. You’ll also be asked about any risk factors (such as your exercise habits and diet, and whether or not you smoke); your family’s health history; and any symptoms that you may have.

Electrocardiogram (ECG)

Your doctor will likely order an ECG, a painless, non-invasive test that records your heart’s electrical activity. It’s used to determine if your heart is working too hard or has suffered any damage, which may indicate that your heart is getting too little oxygen. You also will undergo blood tests to measure your cholesterol level, your triglycerides, your blood glucose, and level of c-reactive protein, a measure of inflammation.

Your doctor may order some other tests as well. These include:

  • Chest X-ray. This captures pictures of your heart, lungs, and blood vessels in your chest.

  • Ankle/brachial index. During this test, your doctor will compare the blood pressure in your ankle with the blood pressure in your arm. If the test reveals that less blood flows to your ankles, this may indicate PAD.

  • Ultrasound of your carotid arteries. This can detect plaque in your neck arteries and help diagnose carotid artery disease.

  • Renal ultrasound. This will help your doctor view what’s happening in the arteries that supply your kidneys.

  • Abdominal ultrasound. This will give your doctor a picture of your aorta to look for signs of an abdominal aortic aneurysm and, if present, measure its size. The larger it grows, the more likely it is to burst.

  • Echocardiography. This test uses sound waves to take pictures of our heart as it beats. It can help your doctor spot places where blood flow to your heart has been constricted.

  • Computed tomography (CT) scan. This imaging test can be used to identify areas in your large arteries where hardening and narrowing has developed. Another type of CT scan, called coronary CT calcium scan, is used to produce what’s called your calcium score, a measure of plaque buildup in your coronary arteries.

  • Exercise stress test. You’ll hop on a treadmill and walk at a progressively faster pace and steeper incline while hooked up to an ECG. This will evaluate your heart’s response to exercise and allow your doctor to determine when symptoms like chest pain occur. It also will show if your heart has any electrical abnormalities. If you are unable to exercise, you will be given a medication that will induce the stresses of exercise.

  • Cardiac catheterization. A long, thin tube called a catheter is threaded through your blood vessels, usually starting at a blood vessel in your leg or groin. Your doctor will inject a dye into your arteries via the catheter. This dye will show up on an X-ray, revealing problem spots where plaque has narrowed your arteries.

What Is the Best Treatment for Atherosclerosis?

A key part of treatment is keeping your atherosclerosis from getting worse. Remember all those modifiable risk factors we discussed? Your treatment will involve getting those under control. It may feel like a long list—and an even harder ask—but here’s something that may help it feel more manageable: As you improve one risk factor, chances are really good that others will improve at the same time.

So, if you eat a more nutritious diet, for example, you’ll likely also lose weight. Two for the price of one, right? But, wait! You’ll also lower your cholesterol. And as you lose weight, your blood pressure will probably drop, as well. You’ll feel better—and that’ll make you want to move more.

Now, you’re exercising, too! And guess what: Exercise lowers stress. It also helps curb inflammation, as does weight loss. If you smoke, exercise can be tough to do, so now you have even more motivation to quit. See how it all ties together? You do have to make a lifelong commitment to healthier living, but the tradeoff is a pretty good one: a longer, more robust life.

You and your doctor will work on a health plan that sets reasonable, achievable goals to eat better, lose weight, and exercise, based on your current health and abilities.

Medications for Atherosclerosis

Your doctor also may prescribe different medications—which mainly help prevent complications from atherosclerosis but won’t necessarily tackle narrowed arteries and plaque directly—to help control the factors that lifestyle changes alone can’t fix. These include:

  • Cholesterol-lowering drugs. Statins are the most commonly prescribed type of drug to lower the amount of plaque-forming LDL, a.k.a., “bad”, cholesterol in your bloodstream. If you can’t take statins, your doctor will prescribe an alternative.

  • Antiplatelet drugs. These drugs help prevent platelets in your bloodstream from forming dangerous, artery-blocking blood clots. Aspirin is a frequent prescription.

  • Anticoagulants. Also called blood thinners, this type of medication also lowers your risk of blood clots.

  • Blood pressure medications. Many different types of blood pressure medications exist to lower your blood pressure to a healthy level. These include beta blockers, angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers, and diuretics.

Procedures for Atherosclerosis

If your atherosclerosis is severe, you may need a procedure to relieve symptoms and to protect yourself from heart attack, stroke, and other dangerous consequences of the disease. The two most common procedures are:

  • Angioplasty and stenting. A long, thin tube called a catheter is guided through a blood vessel to a blocked artery. Once there, it’s used to inflate a tiny balloon, which flattens the plaque growth against the artery wall so it no longer blocks the flow of blood. Often, a tiny device made of metal, called a stent, is placed in the trouble spot. It keeps the artery open. This procedure can be performed on your coronary, carotid, renal, and peripheral arteries. Both angioplasty and stenting may need to be performed more than once if the artery closes again after the procedure.

  • Artery bypass. During this surgical procedure, your doctor will take a healthy blood vessel from another part of your body and graft it to spots adjacent to your blockage. This will allow blood to flow through the grafted blood vessel and around the trouble spot. Bypasses can be done for your coronary, carotid, renal, and peripheral arteries.

What’s Life Like with Atherosclerosis?

The answer to this question is almost entirely up to you! Because the primary way to treat atherosclerosis involves making significant lifestyle changes, you are the one in control. According to Harvard Health, research shows that plaque buildups can be reversed (to a degree, although there is no cure) through exercise and reduced cholesterol—and knowing you have a hand in lowering your risk of having dangerous complications from this condition is a powerful feeling.

But it can also feel overwhelming. So, don’t be shy about asking for help. For example, if you struggle to eat a nutritious diet and lose weight, ask your doctor to recommend a dietitian or an effective weight loss program.

Engage your spouse, partner, or a friend in your physical activities. Having someone with you helps keep you stay committed and ups the fun factor. Pay close attention to your mental and emotional health, too. Depression and anxiety can seriously hinder your efforts to improve your health. Both are highly treatable, so talk to your doctor if you struggle with either.

The most important takeaway? Atherosclerosis can be prevented, controlled, and/or treated. Which means you can get on with the business of living.

Matt McMillen
Meet Our Writer
Matt McMillen

Matt McMillen has been a freelance health reporter since 2002. In that time he’s written about everything from acupuncture to the Zika virus. He covers breaking medical news and the latest medical studies, profiles celebrities, and crafts easy to digest overviews of medical conditions. His work has appeared, both online and in print, in The Washington Post, WebMD Magazine, Diabetes Forecast, AARP, and elsewhere.