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
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
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
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
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
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. See our Health Solution
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
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
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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