Risk Factors for Atherosclerosis

Atherosclerotic disease develops through non-modifiable and
modifiable risk factors. Age, gender and genetic predisposition are all
factors that cannot be changed. Environmental factors are related to
diet, physical activity and behavior. The main external factors
affecting both men and women include hypertension,
hypercholesterolemia, glucose intolerance and obesity. Men are also
affected by cigarette smoking and left ventricular
hypertrophy.

The Framingham study found smoking
to be an independent factor. The effect of smoking was only evident in
men ages 45 to 64 but not for older men and women. The Nutrition Canada
Survey found high cardiovascular mortality among 47% of men who smoked
and only 10% among women who smoked.

Risk factors related
to diet include increased concentration of serum cholesterol, lower HDL
level cholesterol, hypertension and high blood sugar levels (Goto
1990). Those with diabetes mellitus were 3 times more likely to develop
atherosclerosis than those without (Yamada 1997). Food rich with
antioxidants and enzymes like glutathione peroxidase work to disable
the reactive oxygen species (ROS) that produces oxidized LDL that
ultimately leads to atherosclerosis (Blankenberg et al 2003).
Incorporating a variety of diet choices might work better in lowering
the risk of atherosclerosis than merely taking supplementation.
Traditional Mediterranean diet was found to be capable of overcoming
oxidative stress whereas clinical trials using antioxidant was not as
effective (Trichopoulou et al 2003).

Stenosis is usually caused by atherosclerosis

Stenosis is usually caused by atherosclerosis

35-55% of ischemic
heart disease can be prevented with increased physical activity.
Exercise improves insulin sensitivity and increases HDL cholesterol
leading to decreased risk factors connected to heart disease. HDL
cholesterol has antiatherosclerotic activity (Tarui 1987) in which low
HDL levels increase heart disease complications.

Nevertheless
2 or more factors and not just a single mechanism must be present to
lead to ischemic heart disease. Other factors are not so common but
research has found strong links for them. Acute respiratory infection
through pathogens like Chlamydia pneumonae, Helicobacter pylori
and cytomeglalovirus has been linked to atherosclerosis. A Polish study
compared the state of periodontitis between patients with myocardial
infarction and the general public and found a strong link between
periodontal and coronary heart disease (Bochniak et al 2004).

Recently
a pathogenic gene in the MEF2A signaling pathway was found to be
involved in the development of coronary artery disease. According to
Wang and colleagues in 2003, deletion mutation that occurred in the
gene may affect coronary artery walls that ultimately make it
vulnerable to plaque buildup.

Electron beam tomography
measures calcium score and is used for early detection of the
development of atherosclerotic plaque (Cooil & Raggi 2005).

REFERENCES

Goto Y. (1990). Etiology and prevention of ischemic heart diseases. Asian Med J.:33(5);265-274

Yamada N. (1997). Atherosclerosis and control of risk factors. Asian Med J.:40(8); 423-428.

Blankenberg
S, Rupprecht HJ, Bickel C, Torzewski M, Hafner G, Tiret L, Smieja M,
Cambien F, Meyer J and Lackner KJ. (2003). Glutathione peroxidase 1
activity and cardiovascular events in patients with coronary artery
disease. N Engl J Med 349;1605-1613.

Trichopoulou
A, Costacou T, Bamia C and Trichopoulos D. (2003). Adherence to a
Mediterranean diet and survival in a Greek population. N Engl J Med :348;2599-2608.

Tarui S. (1987). A report by the research committee on primary hyperlipidemia of the Ministry of Health and Welfare.

Bochniak
M, Sadlak-Nowicka J, Tyrzyk S, Sobiczewski W, Rynkiewicz A.(2004).
Periodontal and dental state of patients with coronary heart disease. Przegl Lek.: 61(9);910-3

Wang et al. (2003). Mutation of MEF2A in an inherited disorder with features of coronary heart disease. Science: 302; 1578-1581

Cooil
B, Raggi P. (2005). On the prediction and prevention of myocardial
infarctions: models based on retrospective and doubly censored
prospective data. Stat Med.

 

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