Cardiovascular diseases are diseases of the heart and blood vessels, and represent the number one cause of mortality and morbidity in the western world.
Atherosclerosis is the main reason for cardiovascular disease. It is a degenerative process of the arterial wall characterized by the formation of plaques in the blood vessel wall, as shown in the figures below.
The damage to the arteries (atherosclerotic process) is a gradual and diffuse (i.e. affecting many arteries) process that starts at a young age. The etiology (causes) of atherosclerosis are multiple, and go far beyond simply cholesterol, obesity, hypertension, or smoking. The figure and table below demonstrate some of the risk factors for developing atherosclerosis.
Risk Factors for Atherosclerosis and Cardiovascular Disease:
- Endothelial damage and dysfunction
- Age
- Hypertension
- Free radical damage
- Imbalance of essential fatty acids in phospholipids
- Insulin resistance
- Hormonal imbalance
- Elevated lipid profile
- Sedentary lifestyle
- Immunologic factors
- Excess or deficiency of essential elements or vitamins
- Gender
- Toxic Elements
- Homocysteine
- Inflammation
- Glycation
- Obesity
- Infection
- Platelet aggregation
- Cigarette smoking
The signs and symptoms of cardiovascular disease result from decreased blood flow to the heart and other organs of the body, including the brain, eyes, bowel, kidneys, limbs, and sex organs, among others.
The signs and symptoms of cardiovascular disease may include:
- changes in concentration, memory, and behaviour.
- changes in vision
- stroke, transient ischemic attack
- chest pain (angina) at rest or with exertion
- shortness of breath
- irregular heart beats
- changes in bowel function and absorption
- changes in kidney function and hypertension
- sexual dysfunction
- pain in the lower limbs at rest or with exertion
- skin ulceration
- death
Things to remember:
- cardiovascular disease continues to be the main reason for mortality and morbidity in industrialized nations. This remains true despite the billion of dollars spent on the campaign to fight cholesterol and hypertension and on different types of heart operations.
- the first stages of atherosclerosis begin in childhood.
- by age twenty, the atherosclerotic damage may already be quite advanced.
- angina pectoris (pain due to heart disease) often begins after the blood vessels to the heart (coronary arteries) are seventy percent occluded. This means that you may be pain free and given a clean bill of health despite having advanced heart disease.
- unstable plaques in the blood vessels are the main reason for heart attacks and sudden death
- in general, unstable plaques are not seen by angiography
- in many instances, bypass surgery does not prolong life-span
- coronary artery bypass surgery is associated with a high incidence of neuropsychiatric abnormalities. When formal testing is performed, various degrees of cognitive impairment are seen in up to 79% in the weeks following surgery (Shaw PJ, et al. Neurologic and neuropsychological morbidity following major surgery: comparison of coronary artery bypass and peripheral vascular surgery. Stroke. 1987 Jul-Aug;18(4):700-7).
- heart attacks may be painless
- The progression and manifestations of cardiovascular can be different in men and women.
- death can be the first sign of cardiovascular on twenty to thirty percent of us
- The Framingham Heart Study found that sudden death was the first symptom of coronary heart disease in two thirds of menopausal women (American Heart Association. 1997 Heart and Stroke Facts: Statistical Update. Dallas, Tex: American Heart Association; 1996).
- A stress test may be normal if the blood vessel to the heart is less than 70 percent occluded. This means that you may receive a clean bill of health despite having advanced heart disease.
