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Heart Disease

The Fundamentals of Heart Disease


Author:

Windsor Ting, MD

College of Physicians and Surgeons, Columbia University

Medically Reviewed On: October 27, 2010

Heart disease is the leading cause of death in this country, claiming the lives of approximately half a million people each year. Caused by blockages in the blood vessels surrounding the heart (coronary arteries), heart disease is a preventable and treatable condition. The following are answers to some common questions about heart disease, risk factors associated with the disease, and important prevention measures.

What is atherosclerosis?
Atherosclerosis is the process that causes heart disease, or the narrowing of blood vessels that can lead to blockage of the coronary artery. It involves the build-up of a yellowish substance, termed atherosclerotic plaque, which contain cholesterol and fat material. Atherosclerosis can develop in many different arteries in the body, resulting in a number of different conditions, such as stroke and peripheral arterial disease. Like atherosclerosis in other areas of the body, the process in the heart that leads to the blockage of a coronary artery is complex and usually takes many years. A blockage that is more than 50 percent is considered significant and becomes critical when it is 90 percent or more. The blockage may be localized at a specific point in the artery or it may be diffuse, involving the entire length of the artery. The location of the blockage in an artery is also important; the further downstream the blockage in the artery, the less important the stoppage of blood becomes because there is less heart muscle to supply. These factors are important in determining the choice of treatment. For example, balloon angioplasty offers the best results when damaged areas (lesions) are short in length and the artery is not completely blocked.

What are the risk factors associated with coronary artery disease?
The common risk factors include:

  • high cholesterol
  • family history of coronary artery disease
  • male gender
  • smoking
  • high blood pressure (hypertension)
  • obesity
  • sedentary lifestyle
  • diabetes
  • kidney failure
  • depression

    What happens if I have smoked for many years but now have stopped?
    The risk factor from smoking decreases but is still likely to be higher than for someone who has never smoked.

    Is smoking a pipe or cigars a risk factor?
    Pipes and cigars are probably intermediate risk factors between cigarettes and not smoking at all. The bottom line is don't smoke.

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