This is divided into medical measures and surgical measures.

Medical:
Treatment includes using drugs to reduce high blood pressure and high blood cholesterol levels and using drugs to help widen the arteries and improve blood flow to the heart. Other conditions causing the problem such as diabetes and smoking need to be treated and controlled first to prevent further progression of the atherosclerosis.

If damage has already occurred to the heart, muscles, tissues or brain, such as after a heart attack, stroke or blood clot to another area of the body, medications to aid the heart, improve brain function or dissolve the clot are given. Medications able to help prevent further clotting, such as aspirin, are also used routinely for these conditions.

Physiotherapy and massage are frequently used to improve blood circulation in the limbs.

Surgical:
Atherosclerosis in the coronary arteries is treated by either clearing the arteries with cardiac catheterization and angioplasty using either the balloon method (see investigations under the diagnosis section) or in some cases, a tiny burr drill is able to remove tough plaques containing a lot of calcium. Another method, used for more extensive disease is coronary artery bypass grafting (CABG). This is a major surgical procedure where the chest is opened, the heart is stopped, and its functions taken over by a machine able to pump oxygenated blood around the body. The diseased arteries are removed and replaced by either an artery taken from the chest wall or sections of veins taken from the patient's leg.

Atherosclerotic disease in the arteries leading to the brain is treated by cutting open the blocked carotid artery and removing the plaque, a procedure known as carotid endarterectomy.

Atherosclerotic disease in the limbs is treated by cutting out the diseased artery sections and replacing them with artificial materials or by bypassing the damaged area and using an artificial graft. If the disease is too extensive, surgeons may end up amputating a foot, or even part of the leg. However, this treatment is a last resort and only done when the blood supply is so poor the toes or other parts of the limb are dead and developing gangrene.

Elsewhere in the body where atherosclerotic damage occurs, especially in the aorta, the largest and most powerful artery in the body, the damaged sections are replaced or strengthened with artificial material strong enough to withstand the massive pressure created by the heart as it tries to pump blood around the body.

TCM treatments are syndrome basis, below are the usual clinical syndromes associated with atherosclerosis:

1. Obstruction of heart-blood

Therapeutic aims: activating the blood and removing the obstructions.

Sample of Prescription: (1) Dan Shen Drink (丹參飲)

In the prescription, red sage root specializes in activating the blood and removing the blood stasis, moreover, it can ease the pain that induced by the stasis. The sandalwood warms the middle burner and helps to regulate the qi circulation in the region. Villous Amomum fortifies the transforming and transporting functions, which help to dispel the qi stagnation in the middle burner. The three herbs interact and promote each other to resume the balance of the heart.

Sample of Prescription: (2) Decoction of Driving out Stasis in the Mansion of Blood (血府逐瘀湯)

In the prescription, angelica, lovage, kernel and safflower flower specialized in activating the blood and removing stasis; hare’s ear regulates the liver functions, orange fruit enhances the qi circulation. The qi dominates the blood movement, as a result, the body’s blood circulation can be improved and cardiac pain is eased.

2. Obstruction of turbid phlegm
Therapeutic aim: dispelling the turbid phlegm.

Sample of prescription: Decoction of Melon pedicel, Longstamen onion bulb and Pinella tuber (瓜蔞薤白半夏湯加減).

In the prescription, Snakegourd fruit dispels the phlegm stagnated in the chest, Pinella tuber dissolves the phlegm in the lung and smooth the lung’s qi flow, onion bulb has pungent and warm properties which enhance the yang to expel the turbid phlegm.

3. Deficiency of both qi and yin

Therapeutic aim: replenishing the qi, nourishing yin and activating the blood.
Sample of prescription: Decoction of Nourishment (生脈散合人參養營湯).

In the prescription, ginseng, milkvetch root, atractylodes root, Indian bread and liquorice root tonify the spleen so as to ensure the source of the blood and qi. Lily-turf, rhemannia root, angelica and peony root nourish the blood. Senega and Schisandra tranquilize the spirit and invigorate the heart. In the case of severe chest pain, red sage root and noto-ginseng will be added to strength the potency.

4. Obstruction of heart yang

Therapetic aim: Resuming the flow of heart yang
Sample of prescription: Decoction of Melon pedicel & Longstamen onion bulb (瓜蔞薤白白酒湯加減).

In the prescription, the cassia twig, monkshood and onion bulb are pungent and warm in properties, which help to promote the yang and relief the obstructions. Snakegourd fruit and trifoliate orange expel the phlegm so as to smooth the qi flow. Sandalwood warms the middle burner and red sage root activates the blood and removes the blockage in the meridians.

5. Deficiency of kidney yang

Therapetic aim: Replenishing the qi and yin, activating the blood and meridians.
Sample of prescription: Modified Decoction of Ginseng and Monkshood plus You Gui Drink (參附湯合右歸飲加減).

In the prescription, ginseng plays a major role in replenishing the qi which helps to recover the primordial qi greatly. The monkshood and cassia twig warm and tonify the true yang of the body. Rhemannia root, wolfberry fruit, cornelian cherry fruit and eucommia replenish the kidney essence, which is the material basis for all kinds of physiological functions. Thought different approaches to support the yang, the chest pain can be relieved.

When the heart yang is collapsed, which manifested with purplish complexion, limbs coldness, thready or fading pulse, extra dose for ginseng and monkshood can be added, or/and plus fossil bone (long gu) and oyster shell (mu li) to rescue the yang.