New Delhi: Atherosclerosis is a common disorder that occurs when a plaque builds up on the walls of arteries, narrowing or blocking them with time. Over time, the fatty plaques build up inside the arteries where they can slow down the blood flow and when they break loose, they can be fatal leading to strokes and heart attacks. Coronary heart disease is now one of the most common causes of death worldwide. It’s crucial to understand that 50 per cent of heart attacks occur in individuals with normal cholesterol levels.
Dr H. N. Ravikumar, VP, of Metropolis Healthcare, Karnataka shared with News9“Atherosclerosis, the underlying cause of most heart attacks, can develop due to factors beyond just high cholesterol. This means that other conditions, lifestyle factors, and genetic predispositions also play a significant role in the development of heart disease.”
What is Atherosclerosis?
Dr Ravikumar explained, “Atherosclerosis is a process in which plaque builds up inside the walls of arteries, leading to the narrowing and eventual blockage of blood flow to certain areas of the body. When a blood vessel supplying the heart becomes blocked, it results in a heart attack. Additionally, these plaques can sometimes break off and travel to other parts of the body, such as the brain, where they can cause strokes or other serious complications.”
Familial conditions and risk factors
In some families, there are genetic conditions such as familial hypercholesterolemia, hypertriglyceridemia, and hyperhomocysteinemia, which make individuals more prone to developing cardiovascular disease. “Familial hypercholesterolemia leads to dangerously high levels of cholesterol, while hyperhomocysteinemia refers to elevated levels of homocysteine, an amino acid linked to heart disease. High homocysteine levels can also occur due to vitamin deficiencies, especially Vitamin B12 and B6, which is why ensuring adequate intake of these vitamins is essential for maintaining heart health,” said Dr Ravikumar.
“Another key player in heart disease risk is Vitamin D. Although it is often associated with bone health, recent research suggests that Vitamin D also plays a role in cardiovascular health, and deficiency in this vitamin may contribute to heart disease. This is why testing for vitamin levels has become an integral part of many health checkup packages, especially those focused on heart health.”
Lipoprotein(a) and early risk of heart disease
In India, Lipoprotein(a), or Lp(a), has become a common finding as more people undergo comprehensive heart health screening. High levels of Lp(a) are associated with an increased risk of cardiovascular disease, especially in younger individuals. People with high Lp(a) levels and other familial conditions may experience heart attacks as early as their 40s or 50s, even if they appear fit and healthy on the outside. This highlights the importance of understanding and addressing familial risk factors early on.
New guidelines for preventing early onset heart disease
Recognising the growing need for early detection, The Cardiology Society of India has introduced new guidelines recommending heart health tests as early as 18. These tests include a lipid profile to assess cholesterol and triglyceride levels, homocysteine, Lp(a), and more specialized markers like Apolipoprotein A1 and B. These tests provide a more detailed picture of an individual’s cardiovascular risk than traditional cholesterol tests alone.
Importance of addressing risk factors early
While genetic predisposition plays a significant role, lifestyle factors also cannot be ignored. Obesity, diabetes, hypertension, and smoking are all significant contributors to heart disease. Additionally, a sedentary lifestyle, poor diet, and lack of sleep further elevate the risk. Addressing these factors early, especially in young adults, is critical to preventing heart disease later in life.
Additional diagnostic tools
For those at higher risk, additional tests such as high-sensitivity C-reactive protein (hs-CRP) and high-sensitivity Troponin I are valuable for risk stratification. These tests can detect inflammation and heart muscle damage, respectively, even before symptoms of heart disease appear. Regular monitoring through ECG, treadmill tests, and echocardiograms also plays a vital role in ensuring heart health. Consultation with a cardiologist is essential to interpreting these tests and developing a personalised plan for managing heart disease risk.
Early health check-ups and reducing risk factors such as poor diet and inactivity are the most effective ways to maintain heart health. Proactive screening and lifestyle changes can significantly reduce the risk of coronary heart disease, particularly for those with a family history of cardiovascular conditions. By focusing on early detection and personalised intervention, individuals can manage and reduce their risk of heart disease, leading to longer, healthier lives.
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