Cardiovascular risk factors

4 Cardiovascular risk factors


People are not at equal risk for heart disease. Atherosclerotic lesions can develop early, sometimes even in adolescence. However, they form even earlier in the presence of known cardiovascular risk factors.


Risk factors include behaviors, situations, or antecedents that influence the frequency of heart problems.


A predisposing factor can be defined as a physiological state (e.g. age), pathological condition (e.g. hypertension), or a habit (smoking, for example) that is associated with a higher rate of occurrence.


Cardiovascular risk factors are:



• age and sex: over age 50 years in men, and age 60 years in women


• smoking: current or having quit for less than 3 years


• diabetes: treated or not


• arterial hypertension: treated or not


• heredity


• an excess of ‘bad’ cholesterol, insufficient ‘good’ cholesterol, or both


• obesity or overweight


• sedentary lifestyle


• stress


• alcohol.



4.1 Age and sex


Arteries lose elasticity and become more rigid with age. Atheromatous plaque forms on the artery walls and these endothelial lesions can be the starting point for cardiovascular problems.


The probability of cardiac disorders or cerebral vascular accident rises sharply after the age of 50 years in men and 60 years in women. The variation in cardiovascular rates between the sexes is most likely explained by hormonal differences.



• Before menopause, women have a reduced risk.


• After menopause, when estrogen falls, cardiovascular disease rises sharply in women and reaches that of men of the same age.


• Several years after the menopause, women are at higher risk than men.



4.2 Smoking


Smoking is directly or indirectly responsible for many deaths. Aside from the numerous lung pathologies it causes, tobacco is a key factor in cardiovascular disease.


Smoking is linked particularly to the sudden death associated with myocardial infarction. Smoking 10 cigarettes a day doubles the risk of a heart attack. Smoking 20 cigarettes daily increases the risk threefold compared with that in a non-smoker.


Passive smoke inhalation presents the same health risk. It has been demonstrated than a nonsmoking spouse married to a smoker has a 25% increased risk of infarction.


The benefits of quitting are progressive. Two to three years after quitting, the coronary risk is still not significantly different from that of a smoker.


However, in the case of myocardial infarction, the risk of recurrence or death diminishes significantly after the first year of quitting and eventually falls to the same risk level as that in nonsmokers.



4.3 Diabetes


The consequences of diabetes carry numerous health risks. Excess blood glucose over many years is toxic to the arteries and the nervous system.


In terms of small arteries, diabetes chiefly affects the eyes and the kidneys:



• In the eyes, the disease creates retinopathy, which manifests as visual disturbances and can eventually cause blindness. Diabetes is the principal cause of adult blindness.


• In the kidneys, arteriopathy – ‘disease of the artery’ – can evolve into chronic renal insufficiency requiring dialysis, and even renal transplantation.


In large arteries, diabetes favors the formation of atheromatous plaque, greatly increasing cardiovascular risk. The three target areas are:



1 The heart: coronary heart disease and angina pectoris


2 The brain: affected carotid arteries can be the source of cerebrovascular accidents


3 The lower extremities: there is a predisposition to the development of arteriosclerosis obliterans of the lower extremity.


Nerves can suffer diabetic neuropathy, bringing with it intractable leg pain. Frequency increases with the duration of the diabetes and the age of the person affected. Such neuropathy linked with affliction to the smaller vessels can cause wounds to the foot leading to amputation.



4.4 Arterial hypertension


The link between cardiovascular tension and risk is well established. The incidence of hypertension is particularly high in industrialized countries. Often it has no identifiable origin and for this reason is called essential hypertension.


Nevertheless, in some cases there are known causes (alcohol, drugs such as corticosteroids, oral contraceptives, cocaine, ecstasy, and certain illnesses, notably renal disease), in which case the term secondary hypertension applies.


Arterial hypertension is usually silent; it has no symptoms or visible sign and is therefore called the ‘silent killer’. It is detectable only through regular blood pressure testing.


Large-scale epidemiological studies show that the relationship between arterial pressure and cerebral risk is greater than the relationship between arterial pressure and coronary risk.


Arteriosclerosis (hardening of the arteries) linked specifically to high blood pressure (HBP) and aging is distinguished from the process of atherosclerosis (formation of plaque) in which HBP does not intervene except as a general risk factor. Arteriosclerosis is mainly a pathology of the intima of the large arterial vessel walls, notably in the areas of turbulent flux.


In the brain, arteriosclerosis is implicated in at least 50% of cardiovascular accidents. It is responsible for the small cerebral infarcts resulting from the occlusion of perforating arteries. Atherosclerosis is responsible for one-third of cerebral lesions in people with hypertension. It causes large cerebral infarcts. Hemorrhage occurs in only 20% of cases.


In the heart HBP:



• favors the formation of atheromatous plaque in the large coronary trunks responsible for ‘organic’ cardiac insufficiency


• contributes, in collaboration with various neurohormonal factors, to hypertrophy of the left ventricle. This hypertrophy then contributes to structural and functional anomalies of the small coronary arteries, further contributing to coronary insufficiency.

Related posts:

Common cardiovascular diseases The external carotid artery The common carotid artery Neurovascular techniques Iliac vessels Vessels of the breast

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Nov 7, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Cardiovascular risk factors

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