Coronary heart disease

Coronary heart disease (CHD) also called coronary artery disease, remains the most common cause of death worldwide and generates a large economic burden.

Previous studies have shown that the largest portion of this reduction in CHD burden can be attributed to improvements in modifiable lifestyle and dietary risk factors.

CHD is affecting the coronary arteries, which are supplying oxygenated blood to the cardiac muscle. CHD encompasses atherosclerotic plaques within the coronary arteries, resulting in the stenosis of the artery.

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Plaque buildup causes the inside of the arteries to narrow over time.

Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery.

Stenosis and reduced blood supply via any of these arterial segments may have harmful effects on the cardiac muscle and lead to a myocardial infarction.

Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease. The risk factors of CHD have been divided into non-modifiable and modifiable. The non-modifiable risk factors include: age, male sex, and family history which cannot be altered.

The modifiable risk factors which can be altered by medical and lifestyle interventions are: elevated levels of blood pressure, hypercholesterolemia, physical inactivity, diabetes, overweight, obesity, low socioeconomic position and tobacco smoking.

There are three main types of coronary heart disease: obstructive coronary artery disease, nonobstructive coronary artery disease, and coronary microvascular disease.
Coronary heart disease

What is plaque?

Plaque is a fatty material made up of fat, cholesterol, calcium, and other particles found in the blood. Scar tissue and calcium from vessel injury can also add to the plaque buildup. The process leading to this may begin in childhood. It takes decades before it causes serious health problems.

A piece of plaque can break off and be carried by the bloodstream until it gets stuck. Over time, plaque hardens and narrows the arteries. The plaque makes arteries less flexible, a condition called atherosclerosis or “hardening of the arteries.”

Early observations that cholesterol is a key component of arterial plaques gave rise to the cholesterol hypothesis for the pathogenesis of atherosclerosis.

This process can happen to blood vessels anywhere in the body, including those of the heart, which are called the coronary arteries. If the coronary arteries become partly blocked by plaque, then the blood may not be able to bring enough oxygen and nutrients to the heart muscle. This can cause chest pain, or angina. If an artery supplying oxygen to the extremities (often the legs) is blocked, gangrene, or tissue death, can result.

There are often no signs or symptoms of high blood cholesterol. A high level of cholesterol in the blood is due to abnormal levels of lipoproteins. These are the particles that carry cholesterol in the bloodstream. This may be related to:
• Diet
• Weight
• Lack of physical activity
• Genetic factors and
• Presence of other diseases (diabetes, underactive thyroid, etc.)

Smoking makes fatty deposits more likely to form, and it accelerates the growth of plaque.
What is plaque?

Arteriosclerosis and heart disease

What is arteriosclerosis? Arteriosclerosis is literally means hardening of the arteries, includes all kinds of diseases that damage the arteries and eventfully lead to coronary artery diseases. It involving arteries of various sizes and different layers of the arterial walls.

Arteriosclerosis is responsible for most of the deaths resulting from heart attacks.

The arterials diseases begins with damage to cells of the heart’s arteries and lead to the formation of a fibrous, fatty deposit called plaque.

The arterial plaque slowly increases in size until eventually the amount of blood flowing through the artery is greatly reduced or completely blocked.

If the coronary arteries that carry oxygen and nutrients to the heart muscle become obstructed , the flow of blood is cut off completely and a heart attack, or myocardial infarction, can occur resulting damage to the heart muscle.

Arteriosclerosis is the most prevalent chronic among senior citizens and the number one killer in the United States. It mostly affects those between the ages of 40 to 70.
Arteriosclerosis and heart disease