Apples have been investigated for their potential cardiovascular benefits, including the prevention and management of arteriosclerosis (hardening and narrowing of the arteries). The scientific evidence supporting their use is largely based on epidemiological studies and some clinical trials, though the evidence is not strong enough to be considered definitive (hence a score of 2). Apples are rich in dietary fiber (notably pectin) and polyphenols such as quercetin, catechin, and chlorogenic acid, which have demonstrated antioxidant and anti-inflammatory effects. These compounds may help reduce oxidative stress and inflammation, both of which are factors in the development of arteriosclerosis.

Several population-based studies suggest that higher apple consumption is associated with a reduced risk of cardiovascular diseases, including coronary artery disease. For example, a study published in the American Journal of Clinical Nutrition found that higher flavonoid intake (from apples and other sources) was inversely associated with cardiovascular mortality. Some small clinical trials have shown apples can improve lipid profiles by lowering total and LDL cholesterol, which are risk factors for arteriosclerosis.

However, most of the evidence is indirect; there are few, if any, clinical studies directly assessing apples in the treatment or prevention of arteriosclerosis itself. The benefit is thought to be due to the general cardiovascular protective effects of apple constituents rather than a specific anti-arteriosclerotic effect. Thus, while apples may support arterial health as part of a balanced diet, they should not be considered a standalone therapy for arteriosclerosis.