The severity of oxygen starvation, the clinical picture and malfunctions in hemodynamics (blood flow) depends on the degree of narrowing of the lumen of the arteries. If stenosis has reached 70%, then cardiomyocytes respond to the resulting nutritional deficiency with bouts of angina pectoris.
There are other reasons that can provoke some types of cardiac ischemia. Among them, a separation of a thrombus with subsequent blockage of the vessel and spasm of the coronary arteries can be distinguished, but they also almost always arise due to advanced atherosclerosis.
The risk of coronary heart disease increases under the influence of various factors. Because of them, the course of the pathology will quickly worsen and lead to the development of complications. Here is a list of circumstances that increase the degree of oxygen starvation:
- Modifiable risk factors for coronary heart disease (smoking, hypertension, metabolic disturbances, inactive lifestyle, sexual activity).
- Unmodifiable group of causes of ischemia (gender, age, genetic predisposition).
In the first case, we are talking about controlled factors, the modification of which is possible. It is enough for the patient to eliminate them to alleviate the condition. The second option includes uncontrollable circumstances. They cannot be modified, therefore, treatment is aimed at maintaining the working capacity of the heart muscle.
The calculation of the probability of a fatal outcome in people with coronary heart disease who have pathological risk factors (controlled and uncontrolled) is carried out using the SCORE system. It takes into account the following indicators:
- cholesterol concentration;
- cigarette abuse;
- blood pressure indicator.
Experts believe that the highest chance of developing oxygen starvation of the heart in people who have the following problems:
- decompensated diabetes;
- other ailments of the cardiovascular system;
- kidney dysfunction lasting over 3 months;
- the presence of several risk factors at the same time.
All the recommendations of specialists are aimed at getting rid of risk factors or reducing their impact and maintaining a healthy lifestyle as a preventive measure. If this advice is neglected, then the chances of developing myocardial oxygen starvation and related complications will be much greater.
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Gender The occurrence of atherosclerotic deposits, which is actually the only reason for the development of ischemia, occurs 3 times more often in males aged 40 to 65 years and older. This phenomenon is associated with exposure to estrogen (a hormone produced by the ovaries in women). It affects the tissues that make up the blood vessels, reducing the likelihood of stenosis as a plaque.
Statistics are aligned closer to 70 years. In women, menopause occurs and hormonal activity decreases, which leads to a decrease in the degree of resistance to the development of atherosclerosis.
Age. According to statistics, with age, the likelihood of developing atherosclerotic plaques in the vessels significantly increases. The risk group includes men older than 50 years and women after 65.
Genetic predisposition. Heredity often becomes the main factor provoking the development of coronary disease. It applies to people who have relatives suffering from atherosclerosis. Especially if they have identified a problem before 55 years in men, and up to 65 in women.
Smoking. The likelihood of developing cardiac muscle ischemia due to smoking increases several times. Among the components that make up the cigarette, one can distinguish nicotine and carbon monoxide. They have a negative effect on the body:
- lower the concentration of high density lipoproteins;
- contribute to increased blood coagulation;
- affect the myocardium, reducing its nutrition and the strength of contractions;
- affect the synthesis of adrenal hormones that increase blood pressure.
The constant vasospasm caused by cigarettes leads to damage to their walls. Against this background, the patient is more likely to develop atherosclerotic plaques.
Sedentary lifestyle. If a person does not actually experience physical exertion, then the likelihood of coronary disease increases by almost 3 times. Due to inactivity, the following consequences occur:
- metabolism slows down;
- bradycardia (a decrease in heart rate) is manifested;
- myocardial oxygen supply decreases.
If physical activity is absent for a long time, then excess body weight is gradually gaining. Because of it, it becomes harder for the heart to work and blood pressure rises, which is one of the risk factors.
Excess weight. Obesity can be detected using a body mass index. It is the ratio between height (m²) and weight (kg). The permissible indicator varies from 18 to 25 kg / m². The chance of occurrence of ischemia begins to increase, not reaching the upper mark. In males, it increases with an index of more than 23 kg / m². In women, the risk of developing atherosclerosis increases at 22 kg / m².
The abdominal form of obesity is characterized by deposition of fat in the abdomen. In this case, ischemia manifests itself even at low rates of body mass index.
If excess weight increases rapidly in young years (by 10 kg or more), then the likelihood of developing atherosclerosis increases significantly. A similar factor is easily modified by correcting the diet.
Sexual activity. Over the years, representatives of both sexes gradually fade away sexual activity. Estrogens and androgens cease to be produced. Cholesterol, which is considered their predecessor, no longer takes part in the synthesis of sex hormones, which increases its concentration and the likelihood of developing atherosclerosis.
Extinct sexual function also contributes to the appearance of extra pounds and dyslipidemia due to reduced physical activity. The reverse side of this risk factor is no less relevant. In patients with revealed cardiac ischemia, excessive sexual activity can trigger the development of myocardial infarction.
Psychosocial factors. Scientists say that people who have a choleric temperament and have an overactive reaction to surrounding events have a heart attack 3-4 times more likely. A pathological deviation is associated with the impact of stressful situations on the adrenal glands, regulated by the central nervous system.
Failures in fat metabolism. Pathological abnormalities in the metabolism of fats manifest as dyslipidemia and hyperlipidemia. In the first case, failures occur in the proportion of particles transporting lipids, and in the second, the concentration of these substances increases significantly.
Fats are part of lipoproteins (complex proteins), which are divided into certain classes according to their density (from low to high). The development of atherosclerotic plaques is affected only by some of them:
- Low density lipoproteins transport phospholipids, cholesterol and triglycerides from the liver to the periphery.
- High-density proteins transport fats in the reverse order.
The highest danger comes from low density lipoproteins. They facilitate the transport of cholesterol directly to the walls of blood vessels, where it is deposited in the form of atherosclerotic plaques. High-density proteins have protective functions, as they inhibit the development of deposits. With their decrease to 1 mmol / L and lower, the likelihood of stenosis of the coronary arteries and ischemia of the heart increases.
Hypercholesterolemia. With hyperdyscholesterolemia, an increase in cholesterol concentration is observed. Its norm in a healthy person should vary between 5-6 mmol / l. Exceeding the permitted level increases the likelihood of developing atherosclerotic deposits and coronary heart disease by 4-5 times.
Hypertonic disease. Hypertension is accompanied by high blood pressure. Normally, indicators remain in the region of 120/80 mm. Hg. Art. With a deviation upward by 20 or more units, an attack of arterial hypertension is recorded. Due to pressure surges, the heartbeat becomes more frequent and the vessels narrow, which leads to their gradual wear, destabilization of existing deposits and narrowing of the lumen due to wall compaction.
Failures in carbohydrate metabolism and diabetes. In diabetics, carbohydrate metabolism is impaired. The failure is associated with a deterioration in the perception of their own insulin or its production. Glucose ceases to be fully absorbed, which leads to an increase in its level. Dyslipidemia occurs in patients with a characteristic increase in triglycerides and low density lipoproteins.
In diabetes mellitus, the likelihood of manifestation of myocardial infarction, leading to death in 35-50% of cases, is significantly increased. Approximately 1/3 of patients have its painless form, which is a consequence of nerve damage due to diabetic neuropathy.
Knowing the risk factors for coronary heart disease, you can prevent the development of its main cause, which is atherosclerosis. This is especially true for people who do not lead a healthy lifestyle, often living in stressful situations and abusing bad habits. If nothing is done, then the disease will be aggravated and manifest itself in other dangerous forms and a more pronounced clinical picture.
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