Coronary artery disease – risk factors. Living with a ticking time bomb

Coronary artery disease, also known as ischemic heart disease, is characterized by insufficient blood supply and oxygen supply to the heart. The cause is a significant narrowing and sometimes occlusion of the lumen of the coronary arteries. Most often, coronary artery disease develops on the background of atherosclerosis. In the walls of the coronary vessels, as in the walls of other arteries, plaque forms, the accumulation of which leads to the gradual closing of the vessels and reduction of blood supply to the heart. Atherosclerotic plaques form at different sites in the coronary arteries. If the narrowing of the lumen affects a large coronary vessel, the main vascular trunk, or its branching, the effects – in the situation of rapid closure of the lumen by a thrombus – can be dramatic.

The incidence of coronary heart disease increases with age. On average, about 2,5-5% of people suffer from it. men aged 40-59, 10 percent after 60 years of age and about 25 percent. over 75 years of age It is estimated that for every patient hospitalized for myocardial infarction, there are 30 patients with stable coronary artery disease. Coronary heart disease causes 6,3 million deaths a year worldwide. According to data from the World Health Organization, coronary heart disease is the cause of 21 percent. deaths of men and 23 percent. women, and the number of deaths will increase from 7,1 million to 11,1 million in 2020. In Poland, coronary heart disease affects from 1 to 1,5 million people, and about 50 thousand. dies within a year.

Coronary artery disease is the price of civilization progress and life extension. Its occurrence in highly developed countries is primarily caused by lifestyle: improper nutrition, smoking, sedentary lifestyle, lack of physical activity, stress and the most important factor – cholesterol. It is lipid disorders that are the main risk factor for cardiovascular diseases in Poland. The problem affects as much as 60 percent. adult Poles, i.e. almost 18 million people. We advise on how to reduce the concentration of “bad cholesterol” and properly care for the heart.

Incorrect diet is the most common cause of high cholesterol. A diet rich in saturated fats, as well as cheese, eggs, fatty meats and cold cuts, is especially harmful. It is worth giving up these products in favor of foods rich in omega-3 acids. They include: eicosapentaenoic acid (EPA) and docosahexaenoic acid. Their large amounts are contained in the fat of the fish. They lower the concentration of triglycerides, have antithrombotic, antiarrhythmic, hypotensive, anti-inflammatory and anti-aggregating properties. For the prevention of hypercholesterolaemia, it is recommended to eat fatty marine fish twice a week. The diet should also include phytosterols that prevent the absorption of cholesterol. Their rich sources are: fruits and vegetables. Phytosterols are also found in some margarines.

The cigarette is the enemy not only of your heart but of your whole body. Quit smoking, also avoid exposure to tobacco smoke. Smoking men are twice as likely to develop coronary heart disease as non-smokers. Remember that secondhand smoke is also harmful. All cigarettes, including menthol and e-cigarettes, harm the heart and significantly increase the risk of developing cancer.

Abusing alcohol is harmful. It is associated with hypertriglyceridemia, cirrhosis of the liver and acute pancreatitis. But many studies have proven that moderate drinking is good for the heart. For men it is 30 g of pure alcohol a day, for women up to 20 g a day. Such amounts of alcohol reduce cardiovascular risk. However, drinking more alcohol does not protect the heart. On the contrary – it can seriously harm your heart.

Adipose tissue is a metabolically active organ that releases hormones, cytokines and vasoactive substances (affecting the condition of the vessels) into the bloodstream. Numerous studies have shown that obesity, and visceral obesity in particular, is a significant risk factor for coronary heart disease and other cardiovascular diseases. Obesity also increases the risk of sudden cardiac death. It has been found that the influence of adipokines (hormonal substances secreted by adipose tissue cells), insulin resistance, chronic inflammation and increased blood clotting contribute to the development of cardiovascular diseases in obese people. The metabolic effect of visceral fat and adipose tissue near the heart and blood vessels also plays an important role. The results of some studies indicate a beneficial effect of obesity on the prognosis of patients with cardiovascular diseases. This phenomenon is known as the “obesity paradox”.

It is common for lean people who lead a healthy, active lifestyle to have elevated levels of cholesterol. Why is this happening? There may be several reasons for this. It happens that stress, especially chronic stress, may affect the lipid metabolism in some people. More often, however, it is related to the medications taken, e.g. anti-inflammatory or immunosuppressive drugs. Cholesterol concentration is increased by: testosterone, progestins, estrogens and derivatives of retinoic acid. Hyperlipidemia can also accompany some diseases, incl. metabolic (diabetes), nephrological (chronic kidney disease, glomerulonephritis), hepatological (cirrhosis, obstructive jaundice) or endocrine diseases (acromegaly, hypothyroidism, Cushing’s syndrome) diseases. Another cause may be hereditary lipid disorders or rare familial hypercholesterolaemia. Recent studies on atherosclerosis indicate that some microorganisms may play an important role in the development of coronary artery disease. They are: Chlamydophila pneumoniae and Helicobacter pylori.