Understanding Coronary Artery Disease

Atherosclerosis, which is the development of lesions in arteries, is the underlying pathologic process that is responsible for coronary artery disease. During childhood atherosclerosis may slowly cause a thickening, loss of elasticity, and calcification of the arterial walls, a condition known as arteriosclerosis.

The most common and serious result of atherosclerosis is the development of lesions in coronary arteries that can cause chest pain known as angina pectoris. Angina is caused when blood flow is partially blocked by a blood clot. If the blood flow to the heart is completely blocked a heart attack occurs.

If a blood clot occurs in a cerebral artery then a cerebrovascular accident or stroke can happen. Peripheral vascular disease occurs when atherosclerosis in the abdominal aorta, iliac arteries, and femoral arteries produces temporary insufficient blood flow in the arteries upon exertion. This can lead to tissue death and gangrene of the extremities.

Diagnosing the risk of coronary artery disease is done by measuring cholesterol and proportions of the different types of plasma lipoproteins that carry cholesterol in the blood. Cholesterol is not actually a lipid, but it travels in the bloodstream in spherical particles called lipoproteins, which contain lipids and proteins. A precursor of bile acids and steroid hormones, cholesterol is an essential component of cell membranes.

There are three classes of lipoproteins that are measured when analyzing cholesterol levels in a fasting individual:

• VLDL – Very low-density lipoproteins.
• LDL – Low-density lipoproteins.
• HDL – High-density lipoproteins.

60 to 70 percent of the total serum cholesterol is made up of LDL-cholesterol and high serum levels are known to increase the risk of coronary artery disease. HDL cholesterol usually makes up 20 to 30 percent of the total cholesterol and higher levels reduce the risk for coronary artery disease. Triglycerides make up the majority of the VLDL's and make up 10 to 15 percent of total serum cholesterol.

Of the three types of cholesterol two, LDL and VLDL, are considered to increase the risk for this disease. There are any number of medical studies and clinical trials that prove that lowering LDL-cholesterol levels reduces the risk of suffering from coronary artery disease.

The most common type of fat found in the body is triglycerides. The body gets triglyceride directly from foods and makes it in the liver from carbohydrates, alcohol, and some cholesterol. Factors that can raise triglyceride levels include:

• Obesity
• Sedentary lifestyle
• Smoking
• Alcohol
• Eating high amounts of carbohydrates
• Other disease such as type 2 diabetes, chronic renal failure, and nephritic syndrome
• Certain drugs
• Hereditary or genetic factors

For anyone who has coronary artery disease the treatment of choice is lifestyle change that limits or eliminates the above risk factors. For those looking to prevent this disease living a healthy lifestyle is the key to a long and healthy life.