The National Heart, Blood and Lung Institute states that coronary vessel disease is the most common form of heart disease in the United States. The underlying cause of coronary vessel disease is fat deposits in the arteries of the heart. Accumulation of fat narrows the vessels and damages vessel walls. As a result, blood flow to the heart muscle is reduced, increasing the potential risk of a heart attack. Fat deposits are also the leading contributor of stroke and kidney failure.
Pathogenesis
Coronary vessel disease starts when the blood vessel wall is damaged due to high blood pressure, certain drugs or infection, explains Kenneth S. Saladin, author of "Anatomy and Physiology: The Unity of Form and Function." The body reacts by repairing the damage with specialized cells; however, these cells accumulate LDL cholesterol from the bloodstream, and fat streaks are left along the vessel wall. After repeated instances of this process, a sizable plaque formation is created inside the blood vessels supplying blood to the heart. This obstructs blood flow, potentially leading to heart attack and other complications.
Cause
Coronary vessel disease is caused primarily by high levels of circulating low-density lipoprotein, or LDL, in the blood and the inability of blood vessel receptors to take LDL from the bloodstream. Obesity, high saturated fat diet and smoking are major causes of coronary vessel disease--all of which increase the amount of LDL, more commonly known as the bad cholesterol. Coronary disease also is caused by genetic factors that reduce the ability of LDL receptors to remove LDL, says Saladin, a five-time Phi Kappa Phi Honor Professor award recipient.
Risk Factors
Genetics and being male are coronary vessel disease risk factors that cannot be avoided or prevented. A common inherited risk factor is high cholesterol due defective genes, which is carried on from generation to generation. In some cases, those with a rare form of hereditary high cholesterol may suffer a heart attack during childhood, sometimes before the age of 2, explains Saladin. Males are at higher risk of developing coronary vessel disease because of their tendency to store fat around the midsection. Fat accumulation around the stomach area is linked to higher incidence of heart disease, explains Leonard S. Lilly, M.D., author of "Pathophysiology of Heart Disease."
Prevention
Most risk factors for coronary vessel disease can be prevented. Sedentary lifestyle and obesity promote the formation of LDL, which is a major contributor in depositing fat along blood vessel walls. Anxiety, aggressive behavior and stress increases blood pressure and the risk of vessel disease, as does smoking. However, there are some solutions to these problems. Controlling weight through diet and exercise decreases LDL and increases high-density lipoprotein, or HDL, the good cholesterol. Exercise also reduces stress and lowers blood pressure. In addition, diets high in fiber and low in saturated fat will lower LDL and help prevent coronary vessel disease. Another avoidable risk factor is smoking. Dr. Lilly reports that people who stop smoking return to normal risk levels within a five-year period.
Treatment
Balloon angioplasty is a minimally invasive technique used effectively in treating coronary vessel disease. This procedure involves insertion of a thin flexible wire, called a catheter, into the coronary artery to the point of plaque buildup. A balloon attached to the catheter is then inflated to press the plaque aside. A more complicated procedure, coronary artery bypass surgery involves creation of a detour around the blocked vessel using a vessel from another part of the body, usually the leg or arm. Cardiologist Lilly notes that, although angioplasty is much cheaper and less risky than bypass surgery, the plaque usually returns after a few months, making it only a temporary fix in some cases.
References
- National Heart Lung and Blood Institute: Coronary Artery Disease
- "Anatomy and Physiology: The Unity of Form and Function"; The Circulatory System: The Heart"; Kenneth S. Saladin, Ph.D.; 2007
- "Pathophysiology of Heart Disease"; Cardiovascular Diseases; Leonard S. Lilly, M.D.; 2003
