Over the past 30 years tremendous progress has been made in understanding how and why we get cardiovascular disease. Essentially this is a disease process of poor (bad) ageing of our heart and arteries driven by complex RISK factor interaction (see below). The disease process is a chronic INFLAMMATORY disease of our arteries involving oxidative stress; inflammatory cells; inflammatory chemicals predominantly through oxidised LDL cholesterol molecules in our arterial wall (and heart). The process involves increased coagulation (clotting) in our vessels. Data is available that we NEVER need to get cardio vascular disease and in those individuals who have vascular disease we now have powerful tools (allopathic medication) to halt and even reverse the process.
I praise you because I am fearfully and wonderfully made; your works are wonderful
1 Timothy 2:7
Have nothing to do with godless myths and old wives’ tales; rather, train yourself to be godly. 8 For physical training is of some value, but godliness has value for all things, holding promise for both the present life and the life to come. 9 This is a trustworthy saying that deserves full acceptance. 10 That is why we labour and strive, because we have put our hope in the living God, who is the Saviour of all people, and especially of those who believe.
The size of the problem?
The World Health Organisation has identified cardiovascular disease as the commonest cause of current death worldwide. Projected to 2030 ischaemic heart disease (atherosclerosis of coronary arteries) and stroke (atherosclerosis of head and neck arteries) will be two out of the top three killers in the world. Even more worrying though, cardiovascular disease disables many more people than it kills.
What is atherosclerosis?
Atherosclerosis (ath”er-o-skleh-RO’sis) comes from the Greek words athero (meaning gruel or paste) and sclerosis (hardness). It is a chronic inflammatory process in which deposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the wall and inner lining of an artery. This build up is called plaque. It usually affects large and medium-sized arteries. Plaques can grow large enough to significantly reduce the blood’s flow through an artery, but most of the damage occurs when plaques become fragile and rupture and cause blood clots to form that can block blood flow or break off and travel to vital organs.
There is a misperception that women are less at risk than men. While women do tend to be protected from cardiovascular disease throughout their childbearing years, this protection falls away rapidly after the menopause, when they are more likely to die from cardiovascular disease than from any other illness.
The spectrum of cardiovascular disease?
Atherosclerosis of our arteries is accelerated by certain conditions and lifestyle choices. Where this occurs in the arteries that supply blood to the heart this may manifest as heart attack, angina, arrhythmia, sudden death or heart failure. Atherosclerosis of the head and neck vessels may lead to stroke, dementia or other cognitive dysfunction. Arterial disease of the peripheral arteries may cause poor circulation to the legs, kidneys or bowel and even lead to aneurysms (swelling of the weakened arteries).
The benefits of early detection?
Normally patients only see a doctor once they are aware of symptoms and the disease is already advanced. By improving the precision of early detection to enable early treatment of cardiovascular disease, one can reduce the likelihood of premature death and disability. It is usually the most productive and the most active sector of the population that becomes affected by vascular disease. Early detection and intervention will result in a huge improvement in quality of life, a reduction in health care costs and a longer healthier and more productive life for the patient. Fortunately it is now possible to identify asymptomatic “healthy” people who have “sub clinical” cardiovascular disease (below) and to provide lifestyle advice and treatment to modify their cardiovascular risk.
Who is at risk for cardiovascular disease?
People with established cardiovascular disease require the most intensive lifestyle and drug intervention. Seemingly healthy individuals at risk can be identified by genetic predisposition to vascular disease with strong family history of members succumbing to heart attack, heart failure, stroke and peripheral vascular disease at a young age. They can also be identified by their own risk factor profile and the presence or absence of sub clinical atherosclerosis identified by Carotid artery Ultrasound technology and other complrehensive imaging techniques.
In the final part of this series “Matters of Health” Part 4 I will give solutions to PREVENT; arrest and reverse cardiovascular disease.