Cardiovascular diseases have significant impacts on the lives of those affected as well as on their loved ones.
They encompass various conditions such as coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that disease, strokes, and peripheral vascular diseases. These conditions remain among the leading causes of death in the country.
Scientific Efforts
The scientific community is working tirelessly to reduce the incidence of cardiovascular diseases. Before the 1980s, these conditions were the leading cause of death. The introduction of cholesterol-lowering treatments, particularly statins, significantly reduced their impact, pushing cardiovascular diseases behind the leading cause of death: cancer.
According to recent data, a significant portion of the Canadian population faces health issues such as hypertension, diabetes, obesity, and smoking, all of which contribute to the increased occurrence and severity of cardiovascular diseases.
Impact of Urbanization
The aging population and increasing urbanization further complicate the situation.
Urban life is often associated with a more sedentary lifestyle, with fewer opportunities for daily physical activity, such as walking or cycling, compared to rural areas. Additionally, urban environments expose residents to higher levels of air pollution, a factor that can negatively impact cardiovascular health.
Moreover, the fast-paced nature of big cities can generate significant stress, leaving less time for preparing balanced meals or maintaining overall health. This contributes to unhealthy eating habits and less favorable lifestyle choices, ultimately increasing the risk of cardiovascular diseases in urban populations.
Atherosclerotic Plaque
Atherosclerotic plaque is the underlying cause of many cardiovascular diseases. Although it is commonly referred to as a cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> plaque, it is not composed solely of cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >>. However, cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> remains its primary component.
- The Footprint of CholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> in the Arteries
From a young age, cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> begins to leave traces on the walls of the arteries. Over time, these deposits thicken and can form plaques.
- How does a cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> plaque form?
The process starts with the accumulation of LDL cholesterol, often referred to as “bad” cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >>, on the arterial walls. Gradually, this cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> is absorbed and infiltrates the muscular layer of the vessel, known as the media, promoting the formation of an atherosclerotic plaque.
- An inflammatory process
Its presence in the artery walls triggers inflammation. Macrophages, cells responsible for cleaning the body, attempt to remove these deposits. As they absorb cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >>, they become oversized and get trapped in the vessel walls.
To learn more: Atheromatous plaque
Some Plaques Are More Fragile Than Others
Not all atherosclerotic plaques pose the same risk. Some are more likely to trigger a cardiovascular event.
The most dangerous plaques are not necessarily the largest, but rather those containing a high amount of cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >>. Similar to an acne pimple, their surface becomes thin and fragile, making them more prone to rupture.
In contrast, more chronic plaques tend to be more solid. The initial inflammation has stabilized, leading to the formation of fibrosis—a dense, white, leathery tissue similar to that found in meat. This fibrosis makes the plaque more rigid.
Over time, calcium deposits may also develop. This represents the final stage of the inflammatory process, contributing to further hardening and stabilization of the lesion.
Learn more: SCAD-Stable angina
No One Is Immune
No one is immune to coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that disease. It is important to stay vigilant, both for yourself and those around you, by recognizing the signs, symptoms, and risk factors.
Risk Factors
Various factors contribute to the development of coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that disease.
Some are unchangeable, such as male sex, age, or family history.
Others, however, are influenced by lifestyle and can be adjusted or managed, including smoking, high cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> levels, lack of physical activity, diabetes, and high bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure.
Calculating Cardiovascular Risk
It is possible to estimate the likelihood of developing cardiovascular disease over the next 10 years using the Framingham Risk Score, which is easily accessible online.
This tool categorizes risk into three levels:
- Low: less than 10%
- Moderate: between 10% and 20%
- High: more than 20%
-Factors Considered in the Assessment
Each of the following factors contributes points, helping to determine the overall risk percentage:
- Sex
- Age
- HDL cholesterol level (“good” cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >>)
- Average blood pressure
- Smoking status
- Presence of diabetes
Cases Automatically Classified as High Risk
Certain conditions place an individual directly in the high-risk category (more than 20% over 10 years) without requiring additional calculations:
- Diabetes under treatment
- History of heart attack
- Angioplasty with stent placement or coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that bypass
- Stroke
- Peripheral artery disease (leg involvement)
Knowing your score allows for the adoption of tailored preventive measures to reduce risks and protect cardiovascular health.
When Should Treatment Begin?
Regardless of the level of risk, and especially when it is high, adopting healthy lifestyle habits is essential to correct certain risk factors. Prevention remains the best treatment!
Recommended Reading: Healthy Lifestyle Habits
If cardiovascular risk is significant, medication may be added to lower bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> to a target level, determined based on the degree of risk, in addition to adopting a healthy lifestyle.
Primary and Secondary Prevention
It is important to distinguish between medical treatment for an already diagnosed disease and treatment prescribed for prevention when the risk of developing cardiovascular disease is high.
- Primary prevention aims to prevent the occurrence of a first cardiovascular event in individuals at risk.
- Secondary prevention applies to patients who have already experienced a heart attack, stroke, or other cardiovascular disease, with the goal of preventing a recurrence.
In both cases, the objective is to minimize the risk of severe cardiac events as much as possible.
Clinical Certainties
Numerous studies confirm the positive impact of secondary prevention on cardiovascular diseases.
For primary prevention, adding preventive pharmacological therapy is necessary alongside healthy lifestyle habits for all high-risk patients and some at moderate risk.
Learn more: Clinical Impact of Primary Prevention
Low Calculated Risk
Everyone has a baseline risk of experiencing a cardiovascular event. When a risk is considered low, it simply means it is close to or slightly below that of the general population.
Just as financial investments help prepare for retirement, maintaining cardiovascular health relies on adopting good lifestyle habits.
However, an exception exists: individuals with familial hypercholesterolemia. Despite a low calculated risk, medication is necessary alongside preventive measures.
Moderate Calculated Risk
When the risk is moderate and the level of bad cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> does not immediately justify pharmacological intervention, further evaluation is required before considering long-term preventive treatment.
A simple blood test can analyze specific biomarkers. These small proteins include a fraction of the transporter for “bad” cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >>, often compared to a cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> taxi, as well as an indicator of inflammation levels.
These elements help refine cardiovascular risk assessment and guide the need for treatment.
Additional Imaging Examination
If the previous evaluation does not provide a clear risk assessment, an imaging test may be considered. A healthcare professional may recommend a calcium score calculation using a non-contrast CT scan.
This exam evaluates the amount of calcium present in the coronary arteriesThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that. As previously mentioned, some plaques are stabilized by fibrosis and calcified deposits.
A high calcium score indicates an increased cardiovascular risk over the next ten years. In such cases, preventive therapy is recommended in addition to maintaining healthy lifestyle habits.
Further reading: The Calcium Score
Conclusion
It is possible to estimate one’s risk of developing cardiovascular disease over the next 10 years. The Framingham table is a simple and easily accessible tool for this assessment.
In some cases, additional tests may be necessary to further clarify the level of risk.
The best treatment remains prevention, starting with the adoption of healthy lifestyle habits, and if necessary, the addition of tailored therapy aimed at reducing bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> levels based on personalized targets for each individual.
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