Atherosclerosis: Causes and Risk Factors

The causes of atherosclerosis are many and in some respects still unknown. At the base of the disease, however, there are numerous genetic and environmental risk factors such as sex, smoking and obesity.

Non-modifiable risk factors

AGE: atherosclerosis is a disease linked to aging and as such mainly affects elderly subjects. Although the pathology is less frequent among the youngest, it nevertheless affects a "wide segment of the population. Often, when it comes to atherosclerosis, the results of a study conducted on American soldiers who died in Korea and Vietnam are reported which highlighted a significant percentage of injuries. coronary artery disease at a young age. Even more surprising are the results of another study in which 50% of fetuses from hypercholesterolemic mothers already had lipid striae in the walls of the aorta.

In any case, statistical data in hand, it turns out that on average acute coronary syndromes arise from the age of 50 in men and from 65 years in women.

SEX: atherosclerosis, like many other cardiovascular diseases, is more frequent among males. The explanation for this phenomenon is linked to the hormonal profile of females which, at least until menopause, significantly reduces cardiovascular risk.

GENETICS: familiarity with the disease is undoubtedly an important risk factor that should push the subject to adopt a healthy lifestyle. Particular attention should be paid in the presence of a young family member for atherosclerotic disease.

Modifiable risk factors

CIGARETTE SMOKING: smoking increases oxidative stress also affecting the vascular endothelium cells, favoring the appearance and worsening of atherosclerosis (increases the inflammatory response). The interruption of tobacco consumption leads to a rapid regression of adverse effects .

HYPERCHOLESTEROLEMIA: is a very important risk factor; controlling bad (LDL) and good (HDL) cholesterol considerably reduces the likelihood of developing atherosclerosis (each 1% reduction in plasma cholesterol is associated with a 2-3% decrease in the risk of atherosclerosis).

HYPERTENSION: there is a relationship between the increase in systolic and diastolic pressure and the risk of stroke, heart attack, heart failure and renal failure.

OBESITY: in the United States it is the second leading cause of death after smoking. Obese subjects have a high probability of developing atherosclerotic plaques due to the simultaneous presence of multiple risk factors (often those who are obese also suffer from hypertension, hypercholesterolemia and lead a sedentary lifestyle).

SEDENTARITY: physical activity is an independent factor for human health; on its own it is in fact able to reduce the risk of mortality from any disease, including atherosclerotic disease. Some benefits: improvement of cardiovascular function, endogenous antioxidants, capillaries and blood lipid profile (increase in the HDL fraction). Physical activity also prevents other risk factors related to atherosclerosis such as hypertension and hypercholesterolemia.

DIABETES MELLITUS: the severity of atherosclerosis is associated with glycemic levels: the higher the blood sugar, the greater the cardiovascular risk.

Synergy between risk factors

The concept of synergy between the various risk factors is very important and explains, at least in part, why some people with high LDL cholesterol never develop atherosclerotic disease and others with normal values have had a heart attack at a young age.

The danger of LDL cholesterol and other individual risk factors varies from person to person based on the correlation of all the other elements seen so far. In particular, the coexistence of these conditions determines an exponential increase and not just a summation on the probability of undergoing future vascular events.