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Risk Factors for Coronary Artery Disease

Quite simply put, coronary artery disease or CAD is the leading cause of death globally, and unlike other diseases that occur predominantly in either men or women; this disease occurs equally. India alone reports upwards of ten million fatalities per year! The disease is mostly attributed to the build up and deposit of “plaque” on the walls of our arteries, this is known as Arteriosclerosis or Atherosclerosis, which means hardened arteries. Plaque is found in the body’s bloodstream and is comprised of calcium, fat, cholesterol, waste from cells and a clotting agent called fibrin. A cholesterol test for discerning the levels of “good” cholesterol aka HDL (high density lipoprotein) and “bad” LDL (low density lipoprotein); is used to evaluate how much plaque has built up in arteries. Usually plaque deposits form around damaged arteries, after a while the plaque hardens and ruptures the artery. Platelets then form and clot around the ruptured area: causing blood clots that clog the artery. Unfortunately, the build up of plaque is a natural occurring phenomenon and cannot be reversed or stopped! It can only be slowed down by eliminating certain risk factors that aggravate it.

Given below are some of the most common causes of plaque build up and in turn; coronary artery disease: -

  • The “causes” of atherosclerosis are not known! Medical experts agree that it is an age related, slow and complicated process that can even begin during childhood. This clearly shows that even without external risk factors, plaque build-up occurs. Some studies have shown that women are at greater risk around the age of 55 and men at 45. Women are at even higher risk post menopause.
  • Some studies have shown greater prevalence of CAD in some ethnicities when compared to others.
  • A family history of cardiovascular disease and genetic predisposition are accounted for as hereditary risk factors. For example, if both parents have suffered heart problems before the age of 55, the chances of inheriting heart problems increase manifold. Even diseases like diabetes that are passed on from one generation to the next can aggravate heart diseases.      

The factors stated above are not under an individual’s control whereas these are: -

  • Smoking tobacco products or even inhaling secondhand smoke can highly aggravate the risk of developing CAD. Smoking clogs up vessels by contributing to higher cholesterol levels, it reduces oxygen in the blood and tissue which leads to damage, raises blood pressure which can cause clots and tightens blood vessels. Smoking, coupled with other risk factors such as a family history of heart disease or birth control pills; can increase risk furthermore.
  • Cholesterol Levels play a huge role in the build up of plaque and in turn CAD. High LDL and low HDL point towards an unhealthy amount of plaque buildup; there is even greater risk in case this is coupled with a high level of triglycerides. There are new studies that have re-examined acceptable and unacceptable cholesterol levels. In any case, a cholesterol test coupled with any heart disease should help determine the level of risk.
  • High Blood Pressure exerts immense pressure on arteries, causing enlargement and rupture, a 120/80 mmHg reading is ideal. High BP can be controlled through lifestyle changes like proper diet and exercise and even medications.
  • Physically inactive people are at higher risk of developing CAD as this leads to higher cholesterol levels and blood pressure, along with lower heart capacity.
  • Obesity and being overweight also exert greater stress on the heart and arteries. A body mass index between 18.5 to 24.9 is ideal whereas anything above 25 is not. Being heavy around the midsection greatly increases risk of CAD.
  • Diabetes Mellitus leads to higher levels of glucose in the blood. This coupled with other risk factors can also increase chances of CAD.
  • The use of narcotic and psychotropic substances like cocaine can cause heart disease and in some cases; failure. Heavy consumption of alcohol also causes such diseases.

The first thing a person needs to do in order to prevent coronary artery disease is establishing whether or not she/he is naturally predisposed to heart disease. In case there is predisposition, the person can consult a doctor in order to chart out a course of action that could keep the risks at bay. Apart from the factors that cannot be controlled, a person can deliberate and take control of their well being by opting for healthy life choices. Even if Coronary Artery Disease can’t be reversed or cured: managing and controlling it is more than possible.

Dr. Amrish Kumar
Consultant
Cardiology & Cardiac Surgery

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