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KEY
INDICATORS IN THE DEVELOPMENT OF CAD |
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The
number 1 indicator for if you are at high
risk for CAD is your family history and any
genetic predisposition you may have been
born with. “Coronary
artery disease begins in childhood, so that
by the teenage years, there is evidence that
plaques that will stay with us for life are
formed in most people. Preventive measures
instituted early are thought to have greater
lifetime benefits. Healthy lifestyles will
delay the progression of CAD, and there is
hope that CAD can be regressed before it
causes heart disease,” said Edward
A. Fisher, M.D., Ph.D., M.P.H., who is the
Leon H. Charney Professor of
Cardiovascular Medicine and also of the Marc
and Ruti Bell Vascular Biology and Disease
Program at the NYU School of Medicine.
Some of my earliest memories were of
attending my grandfather's funeral (heart
attack) and my grandmother's bypass surgery
and her death shortly after. One by
one my uncles passed away from CAD and heart
attacks that they didn't survive. The
link between untimely death (death below age
that is the national average) and heart
disease in my family is undeniable.
Once you've established that CAD is
something that runs in your family or not
(in my case it's an all caps "YES"), the
following list of indicators all represent
lifestyle and diet choices one can make to
put them at greater risk for CAD. |
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Risk
factors for the development of CAD:
Conventional risk factors:
-
Age: Over age 45 years in
men and over age 55 years in women -
plaques build up over time; the older
you get the more likely that stenosis
can and will develop
-
Family History: Likelihood
of increased risk with positive family
history is significant due to a number
of genes now identified that are linked
to CAD and are known to be hereditary
-
Race: Among persons with
CAD, the cardiovascular death rate for
African Americans is reported to be
particularly high; in Asians, low levels
of high-density lipoprotein cholesterol
(HDL-C), which are considered to be a
risk factor for coronary heart disease,
appear to be especially prevalent; South
Asians appear to have a higher
independent risk for cardiovascular
disease as well.
Modifiable risk factors:
- High
blood cholesterol levels (specifically,
low-density lipoprotein cholesterol [LDL-C])
- High
blood pressure
- Cigarette
smoking: Cessation of cigarette smoking
constitutes the single most important
preventive measure for CAD
- Diabetes
mellitus
- Obesity
- Lack of
physical activity
- Metabolic
syndrome
- Mental
stress and depression
Nontraditional or novel risk factors: High
levels of the following are considered to be
risk factors for CAD:
-
C-reactive protein (CRP): High levels
are related to the presence of
inflammation and, according to some
research results, may be associated with
an increased risk of CAD development and
heart attack
-
Lipoprotein(a)
-
Homocysteine: In the general population,
mild to moderate elevations are due to
insufficient dietary intake of folic
acid, but homocysteine levels may also
identify people at increased risk for
heart disease
- Small,
dense LDL-C particles - In some people
LDL-C particles are more dense than in
the general population; these smaller
particles allow for plaque build-up and
stenosis
-
Fibrinogen: a blood plasma glycoprotein
that is important in the formation of
blood clots; higher levels of fibrinogen
are associated with CAD; it is unknown
if this is a reaction to stenosis or yet
another variable that indicates a
trigger for the clotting mechanisms that
are typically associated with heart
attacks (MI).
Various
medical conditions that can contribute to
CAD include the following:
-
End-stage renal disease (ESRD)
-
Chronic
inflammatory diseases affecting
connective tissues (eg, lupus,
rheumatoid arthritis)
-
Human
immunodeficiency virus (HIV)
infection (acquired immunodeficiency
syndrome [AIDS], highly active
antiretroviral therapy [HAART])
-
Xanthelasmata (raised yellow patches
around the eyelids)
The
following are also considered to be risk
factors:
-
Tissue plasminogen
activator (tPA): An
imbalance of the clot dissolving
enzymes (eg, tPA) and their
respective inhibitors (plasminogen
activator inhibitor-1 [PAI-1]) may
predispose individuals to myocardial
infarctions
-
Low serum testosterone
levels: Have a
significant negative impact on
patients with CAD
-
Hysterectomy:
A study suggests that this
becomes a risk factor later in life
in women who have the surgery at or
before age 50 years
-
Lack of sleep
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When
looking at the exhaustive list of
contributing factors above remember that
just because you have family history and you
are overweight it doesn't mean that you are
going to develop CAD. It simply means
that you are at greater risk.
When looking at the indicators above
it becomes clear that there are two types of
risk factors: those that are beyond your
control such as family history, age, race,
sex, and any hereditary/genetic traits you
may have inherited, and there are those that
are in your control such as your weight,
diet, exercise and fitness choices, and
lifestyle choices such as smoking.
If you can indentify 4 or 5 risk factors
above in your lifestyle and could choose one
that would have the greatest impact on
improving your health; to quit smoking would
be the risk factor you'd want to eliminate.
Smoking puts a person at risk for a number
of life-threatening, deadly diseases and
conditions, the first of which is CAD.
Not all smokers develop lung cancer, but
lung cancer and cancer of the throat, mouth,
and sinuses are certainly a major risk.
Chronic Obstructive Pulmonary Disease (COPD)
is another deadly disease that smokers are
at a significantly higher risk for.
Complications from smoking include high
blood pressure. And since CAD is the
number one cause of death in the world, the
risk of CAD from smoking is probably the
single largest consideration anyone
concerned about developing CAD should have.
Exercise and a healthy diet in
themselves can fix so many things with your
health. With exercise and a healthy
diet comes weight loss and more energy.
Risk for Diabetes is greatly reduced.
Cholesterol levels in the blood improve.
People who exercise regularly report feeling
less stress and anxiety. Exercise
conditions your heart and circulatory
system, lowering blood pressure and
improving the efficiency of your lungs.
It is easy to look at your current
lifestyle if it is unhealthy and feel
overwhelmed. People do not suddenly go from
a healthy lifestyle to a high risk lifestyle
overnight. These choices are made over
time. Therefore it is fair to say that
changing your lifestyle and making better
choices for your health doesn't come
overnight. But make a concerted effort to
change the way you live for the better by
changing your diet to reduce unhealthy food
and increase healthy ones. Or add daily
exercise (20
minutes a day). And in a short period
of time, 60-90 days, you'll see a dramatic
change in how you feel and the amount of
energy you have to face each new day. |
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