UNDERSTANDING CORONARY HEART DISEASE (CHD)

According to current estimates, 64.4 million Americans have one or more types of cardiovascular disease. Within cardiovascular diseases, coronary heart disease (CHD) is the single largest killer of Americans. CHD caused 502,189 deaths in the US in 2001 – about 1 in every 5. The American Heart Association estimates that 13.2 million Americans have CHD. In fact, up to half of all sudden, out-of-hospital cardiac deaths occur in people with no prior diagnosis of heart disease, and over two-thirds of heart attach sufferers have blockages in their arteries considered to be clinically “insignificant” in terms of plaque burden and percent stenosis. Until recently, it was widely held that most heart attacks were caused by a gradual build-up of atherosclerotic plaque within the arteries of the heart (“hardening of the arteries”), impedes blood flow, and eventually results in blocked blood vessels that can cause acute ischemic events such as unstable angina, heart attack, stroke, peripheral vascular disease, and a variety of other related debilitating conditions.

Source: Association for the Eradication of Heart Attack

Scientists now know that life-threatening cardiac events are very often linked to unstable, rupture-prone arterial deposits known as “vulnerable plaques.” These unstable plaques are associated with enlargement of the arterial vessel wall, and consist of soft, biologically active, thrombogenic fatty material covered by a thin fibrous cap and characterized by a large infiltration of activated macrophages, indicating a high level of inflammation. Inflammation leads to an accumulation of proteolytic enzymes, which leads to a breakdown or sudden rupture of the fibrous cap, without warning, resulting in the release or erosion of the fatty lipid core into the blood stream. Exposure to the thromboemboli cascade promotes the formation of blood clots that can cause acute ischemic events, such as unstable angina or myocardial infarction.

Researchers believe that these vulnerable plaques are responsible for 85% or more of all heart attacks, and that the same types of plaque deposits in the carotid and cerebral arteries may account for the majority of ischemic strokes.