Coronary heart disease

Coronary heart disease is the illness caused by the presence of atherosclerosis in the coronary arteries. Atherosclerosis is the accumulation of lipids and inflammatory cells in the blood vessel walls, a slow and silent process that leads to the narrowing of the vessels and the potential lack of oxygen in the tissues. It is the main cause of ischemic heart disease, potentially leading to myocardial infarction.

Coronary heart disease is responsible for up to one-third of deaths in people over 40 in developed countries. Additionally, it is estimated that half of men and one-third of women will experience some form of heart disease in these regions throughout their lives. Therefore, it is a significant global health problem.

In addition to genetic risk factors, whose contribution seems to be important, there are also non-genetic risk factors that can significantly increase the likelihood of developing coronary heart disease. Among them:

• Aging increases the risk of artery damage.
• Due to the protective factor of estrogen, men are at higher risk of heart disease than women. However, after menopause, the risk is equal.
• Smoking and passive exposure to tobacco smoke.
• Uncontrolled high blood pressure.
• High blood cholesterol levels. Hypercholesterolemia can lead to the formation of atheroma plaques in the blood vessels, consequently narrowing them.
• Diabetes.
• Overweight and obesity.
• Sedentary lifestyle.
• Stress.
• Unhealthy diet. High consumption of saturated fats and sugar can increase the risk of coronary heart disease.

Additionally, although to a lesser extent, there are other risk factors such as having an autoimmune disease like rheumatoid arthritis or lupus, which can increase the risk of atherosclerosis.

This is a heterogeneous condition whose symptoms vary from person to person, ranging from no symptoms at all to severe symptoms that can be life-threatening.

It is most common for the narrowing of the arteries due to the presence of atheroma plaques to cause no symptoms in its early stages. However, as the plaque continues to build up, the following signs and symptoms may manifest:

• Sharp chest pain. Known as "angina," it is a sudden pain that usually occurs in the middle or left side of the chest. It may feel like pressure. It can be triggered by physical or emotional stress and usually disappears within a few minutes.
• Shortness of breath. If the heart cannot pump blood efficiently, shortness of breath or fatigue may develop.
• Heart attack. This is the most severe sign caused by a coronary artery in which blood flow is completely blocked. In this case, it is common to feel significant chest pressure, pain in the shoulder or arm, and/or shortness of breath and sweating.

Due to the significant contribution of environmental factors in the development of coronary heart disease, there are actions that can be taken to effectively reduce the risk of developing it. These include:

• Control of blood pressure.
• Maintaining low levels of cholesterol and triglycerides.
• Maintaining a healthy weight.
• Healthy diet, avoiding the consumption of ultra-processed foods and those rich in fats and sugars.
• Regular physical exercise.
• Avoiding tobacco smoke.
• Stress management.
• Controlling blood sugar levels and managing diabetes if present.