Causes of Coronary Artery Atherosclerotic Heart Disease

Coronary atherosclerotic heart disease is what we are familiar with in daily life. Suffering from coronary heart disease will undoubtedly have a great impact on our body and family. So why do we suffer from coronary atherosclerotic heart disease? In daily life, can we avoid coronary atherosclerotic heart disease by avoiding the causes?

A large number of epidemiological studies on coronary atherosclerotic heart disease have shown that the following factors are closely related to the onset of coronary heart disease. These factors are called susceptibility factors (also called risk factors) for coronary heart disease:

1. Age: This disease is more common in people over 40 years old. The onset of atherosclerosis can begin in childhood, and the incidence of coronary heart disease increases with age.

2. Gender: It is more common in males, with the male-to-female incidence ratio being approximately 2:1. Because estrogen has an anti-atherosclerotic effect, the incidence rate in women increases rapidly after menopause.

3. People with a family history of coronary heart disease, diabetes, hypertension, and hyperlipidemia have an increased incidence of coronary heart disease.

4. Individuals with type A personality (competitive and aggressive) have a higher incidence of coronary heart disease, and those who are overly stressed are also prone to the disease. It may be related to the long-term high concentration of catecholamines in the body.

5. Smoking is an important risk factor for coronary heart disease. The prevalence of coronary heart disease in smokers is 5 times higher than that in non-smokers, and is directly proportional to the amount of smoking. The carbon monoxide hemoglobin level in smokers' blood increases, and the nicotine in the smoke constricts blood vessels, causing oxygen deprivation of the arterial walls and arterial damage.

6. Hypertension is an important risk factor for coronary heart disease. The risk of coronary heart disease in patients with hypertension is four times that of those with normal blood pressure, and 60% to 70% of patients with coronary heart disease suffer from hypertension. When arterial pressure increases, changes in shear stress and side wall pressure cause damage to the vascular endothelium. At the same time, increased blood pressure causes plasma lipids to penetrate into the vascular endothelial cells, thereby causing platelet aggregation and smooth muscle cell proliferation, leading to atherosclerosis.

7. Hyperlipidemia Hypercholesterolemia is an important risk factor for coronary heart disease. People with hypercholesterolemia (total cholesterol > 6.76mmol/L, low-density lipoprotein cholesterol > 4.42mmol/L) have a five-fold increased risk of coronary heart disease compared to those with normal cholesterol (total cholesterol < 5.2mmol/L). Recent studies have shown that hypertriglyceridemia is also an independent risk factor for coronary heart disease. High-density lipoprotein has a protective effect against coronary heart disease. People with lowered high-density lipoprotein cholesterol are more susceptible to coronary heart disease. The ratio of high-density lipoprotein cholesterol to total cholesterol is <0.15, which is a valuable predictive indicator for coronary atherosclerosis. Recent studies have found that elevated serum α-lipoprotein [Lp(α)] concentration (>0.3 g/L) is also an independent risk factor for coronary heart disease.

8.Diabetes is an important risk factor for coronary heart disease. The risk of coronary heart disease in diabetic patients is twice that of normal people; the risk of coronary heart disease in female diabetic patients is three times that of male patients, and they are more likely to suffer from heart failure, stroke and death. When blood sugar is high, the glycosylated low-density lipoprotein in the blood increases, which inhibits the degradation metabolism through the low-density lipoprotein receptor pathway; at the same time, high blood sugar also damages the vascular endothelium. In addition, diabetes is often accompanied by abnormal lipid metabolism, so people with diabetes are prone to coronary heart disease.

9. Obesity and lack of exercise ① Standard weight (kg) = height (cm) - 105 (or 110). ②Body mass index = weight (kg)/(height (m)2. A person who is 20% above the standard weight or has a body mass index > 24 is considered obese. Although obesity is not as important as hypertension, hyperlipidemia and diabetes, it can indirectly affect coronary heart disease by promoting the occurrence and development of these three factors. Exercise can regulate and improve vascular endothelial function, and promote the establishment of coronary collateral circulation in patients with coronary heart disease. Insufficient exercise can easily lead to obesity, so we should fully realize the urgency of treating obesity and the importance of increasing exercise.

10. Others

(1) Drinking: Long-term and excessive consumption of strong liquor can damage the functions of the heart, blood vessels, liver and other organs, and can lead to alcoholic cardiomyopathy, cirrhosis and hypertension. However, drinking low-alcohol colored liquor (such as wine) in moderation can reduce the risk of coronary heart disease, because drinking alcohol can increase the concentration of high-density lipoprotein.

(2) Oral contraceptives: Long-term use of oral contraceptives can increase blood pressure, blood lipids, and glucose tolerance. It can also change the coagulation mechanism and increase the chance of thrombosis.

(3) Eating habits: Eating a high-calorie, high-animal fat, high-cholesterol, and high-sugar diet is prone to coronary heart disease. Other factors include changes in the intake of trace elements.

Coronary heart disease is the abbreviation of coronary atherosclerotic heart disease, and atherosclerosis is the result of the interaction of many complex factors such as cells of the arterial wall, extracellular matrix, blood components (especially monocytes, platelets and LDL), local hemodynamics, environment and genetics. Therefore, it should be noted that the presence of risk factors for coronary heart disease does not mean that one has coronary heart disease.