Where it all begins
What causes cardiovascular disease?
Cardiovascular disease (CVD) remains the number one killer in North America. These diseases—such as heart attack, stroke, angina pectoris, atherosclerosis and arteriosclerosis, and high blood pressure—and their risk factors are so interrelated that it is very difficult to say “where it all begins.” One place to look when sorting this out is with atherosclerosis.
Atherosclerosis is the buildup of plaque in the arteries. It develops slowly, with soft, fatty streaks gradually accumulating along the inner walls of the arteries, especially where they branch. With time, the streaks grow larger and start hardening into plaque.
The danger is that plaque can lead to aneurysms and blood clots, and clots in turn can result in thrombosis, heart attack, and stroke.
An aneurysm occurs when the wall of a blood vessel weakens and balloons out. Like a balloon, the aneurysm can eventually burst. If this happens in a major artery, such as the aorta, it can lead to massive bleeding and death.
Atherosclerosis can also upset the delicate balance of blood clots. Clots continually form and dissolve in our bloodstream, and it is important that this balance be kept. Clots form when blood platelets encounter an injury. Because the body considers plaque buildup an injury, platelets rush to the scene and begin the clotting process. The formed clot may remain attached to the plaque and continue growing. A clot that grows to the point that it obstructs a blood vessel is called a thrombus. It can shut off the blood supply to some body tissues. If this occurs in a blood vessel that feeds the heart, it is called a coronary thrombosis. If it occurs in an artery in the brain, killing brain tissue, it is called a cerebral thrombosis.
A clot can also break loose (called an embolus) and travel throughout the circulatory system. In its travels, it may get stuck in a smaller artery, blocking the flow of blood. This blockage cuts off the supply of life-giving oxygen and nutrients, and the tissue fed by the artery dies. If an embolus lodges in an artery of the heart, depriving the heart of essential nutrients, a part of the heart can die—a heart attack. If the embolus lodges in an artery of the brain, it is a stroke.
Once this begins
If plaque and atherosclerosis are a beginning for CVD, a number of risk factors accelerate the process.
As we age, risk increases. About four out of five people who die of a heart attack are over age 65. At older ages, women who have heart attacks are twice as likely as men who have heart attacks to die from them within a few weeks.
Gender and genes make a difference. Males are more likely to have coronary heart disease than females, whether younger or older. Children of those who have had some type of CVD are more likely to develop it.
Smokers’ risk of heart attack is more than twice that of nonsmokers’, and smokers’ risk of sudden cardiac death is two to four times that of nonsmokers’.
High cholesterol levels bring increased risk. As LDL cholesterol (the “bad” cholesterol) levels increase, CVD risk increases. When other risk factors are present, risk increases even more. A person’s lipid levels are also affected by age, sex, heredity, and diet.
High blood pressure increases the heart’s workload and can lead to increased arterial damage, opening the door further for atherosclerosis. This is because increased blood pressure scars the artery walls and causes damage. Where the damage occurs, more plaque is likely to form, and the plaque causes the artery walls to narrow and lose flexibility. This in turn causes the body to increase blood pressure.
High blood pressure is also the biggest risk factor for stroke. When high blood pressure exists with obesity, smoking, high blood cholesterol levels, or diabetes, the risk of heart attack or stroke increases several times.
The amino acid homocysteine is now regarded as a major risk factor. Researchers say it may play a cholesterol-like role in heart disease; that is, it may contribute to the buildup of plaque in the arteries.
Obesity, a sedentary lifestyle, and diabetes are closely linked risk factors. Those who are overweight are more likely to develop heart disease and stroke even if they have no other risk factors. The weight itself is not the culprit; rather, the excess pounds concentrate other risk factors. Obesity has a negative influence on blood pressure and cholesterol, and may lead to diabetes. And, of course, one of the reasons for obesity is a sedentary lifestyle.
Stress is also a contributing factor. Research indicates that there is a relationship between the risk of developing coronary heart disease and stress. This is because stress releases certain chemicals, which can increase heart rate and raise blood pressure. Stress also contributes indirectly to CVD, as people under stress may smoke and drink more than those who lead stress-free lives.
Fortunately, many of the risk factors associated with CVD can be lessened through the wise use of dietary supplements and implementation of lifestyle solutions. AIM has a Cardio Defense health solution that will help you with your cardiovascular health.
Women be aware
Women have special concerns relating to CVD. One of these is due to the changes that menopause brings. Many scientists believe that estrogen, a hormone produced in a woman’s body, offers some protection against heart disease, and there is evidence, although less, that estrogen may protect against stroke. Several population studies show that the loss of natural estrogen as women age may contribute to a higher risk of heart disease. If menopause is caused by surgery to remove the uterus and ovaries, the risk rises sharply.
Another concern is the use of birth control pills. Although today’s low-dose pills carry a much lower risk of heart disease and stroke than the early pill did, women who smoke or have high blood pressure should take special care.
Finally, and sadly, women have often been treated different from men at the doctor’s office. Although physicians routinely talk to men about heart disease and risk factors, they do not always do this with women. Fortunately, things are changing in this regard.
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