What Heart Disease Is
Heart disease, also called coronary artery disease, is the narrowing or closure of arteries that supply blood to the heart. The narrowing is caused by deposits of cholesterol and calcium that slowly build up along the artery wall and restrict blood flow. These deposits can break away from the artery wall and cause a blockage that prevents blood from reaching the heart muscle. This may result in a myocardial infarction, commonly known as a heart attack.
Heart disease is the leading cause of death among American men and women. Over 64 million Americans live with cardiovascular disease, which includes heart disease and also causes stroke. Cardiovascular disease is also the leading cause of permanent disability in the workforce.
The first signs of heart disease are most often heart attack or sudden death, making it a challenge for doctors and patients to proactively diagnose and prevent it. Fortunately, there are tests that enable heart disease to be detected early, before it causes a heart attack and/or disability.
Facts About Heart Disease
There are widely available non-invasive stress tests, as well as invasive angiography, that show if there is a significant blockage in a coronary artery. However, the blockages leading to heart attacks are most often in vessels that are not particularly narrowed. More commonly, small plaques — the kinds that frequently are not seen by these tests — rupture and obstruct blood flow.
For many years, doctors thought that heart attacks were caused by the gradual narrowing of the coronary arteries because of atherosclerosis. This gradual narrowing would eventually prevent enough blood from reaching the heart muscle and cause a heart attack. Recently, however, researchers noticed that blockages leading to heart attacks were most often in fairly clear vessels. In fact, they found it impossible to predict which blood vessel will become blocked, even when they knew which vessels had been narrowed by atherosclerosis.
At the same time, researchers also discovered that atherosclerosis behaves like an inflammatory process. Cells of the immune system can interact with the fatty deposits in the artery walls and cause inflammation. Plaques with more inflammation tend to be less stable and prone to rupture. When the plaque ruptures, a blood clot forms and the involved blood vessel may become blocked. This explains why smaller plaques, which may not be visible by invasive angiography, are often the cause of fatal heart attacks. These inflamed plaques are referred to as vulnerable plaques.
Plaques with less inflammation tend to calcify and are less likely to rupture and cause a heart attack.
Here are some additional facts about heart disease:
- Each year, 1.5 million Americans have a heart attack and 30% of them are fatal.
- On average, every 40 seconds, someone in the United States dies from heart disease.
- Based on the Framington heart study, 5% of heart attacks occur in people under the age
of 40 and 45% of heart attacks occur in people under the age of 65.
- Most people who suffer from heart disease and heart attacks have average or only
slightly elevated cholesterol levels.
- In about 50% of cases, the first sign of heart disease is sudden death.
- Only 13% of women consider cardiovascular disease their greatest health risk despite
the fact that it is the number one cause of death for women as well as men.
- Heart disease is treatable and preventable once you know your risk.