4 Major Age-Related Cardiovascular Diseases

Cardiovascular diseases are a group of disorders that affect the heart and blood vessels. According to WHO, cardiovascular diseases are the leading cause of death globally, accounting for more than 17.9 million deaths each year.

Among the four most common age-related cardiovascular diseases are atherosclerosis, hypertension (high blood pressure), myocardial infarction (heart attack), and stroke.

Atherosclerosis is a condition in which the arteries become narrowed and hardened due to plaque buildup. Plaque is a mixture of cholesterol, fat, and other substances that can accumulate on the inner walls of the arteries. Over time, this buildup can reduce or block blood flow to the organs and tissues, increasing the risk of heart attack, stroke, and other serious health problems. Atherosclerosis is the main risk factor for cardiovascular disease, which is the leading cause of mortality worldwide.

The fundamental underlying cause of atherosclerosis has not been fully understood, but its pathophysiology process is well established.¹ Jebari-Benslaiman, Shifa et al. “Pathophysiology of Atherosclerosis.” International journal of molecular sciences vol. 23,6 3346. 20 Mar. 2022. PubMed Source Atherosclerosis is initiated by changes in the inner layer of the vessels, called the endothelium. The endothelium is located between circulating blood and the inner tissues of vessels, so it senses all changes in circulating blood. These changes include mechanical stress (depends on blood pressure) and concentration of metabolic factors in the blood (cholesterol, triglycerides, etc.).

After initial changes in the endothelium occur, plaques and other substances accumulate on the vessels’ inner wall, narrowing them. Plaques are usually comprised of cholesterol, fat, and calcium.

It is striking that atherosclerosis begins early in childhood² McGill, H C Jr et al. “Origin of atherosclerosis in childhood and adolescence.” The American journal of clinical nutrition vol. 72,5 Suppl (2000): 1307S-1315S. PubMed Source and manifests clinically as coronary heart disease later in life.

Some of the major risk factors for atherosclerosis include the following:³ Head, Trajen et al. “The Aging Risk and Atherosclerosis: A Fresh Look at Arterial Homeostasis.” Frontiers in genetics vol. 8 216. PubMed Source[7efn_note] ³ von Eckardstein, A. “Risk factors for atherosclerotic vascular disease.” Handbook of experimental pharmacology ,170 (2005): 71-105. PubMed Source

Age. It is considered that in men, the risk of atherosclerosis increases after age 45, while in women – after age 55.

A family history of early heart disease, such s myocardial infarction, or having a close relative with atherosclerosis can increase your risk.

High blood pressure is a major risk because it damages the walls of arteries, making it easier for plaque to build up.

High blood cholesterol and triglyceride levels. High levels of LDL (low-density lipoprotein) or triglycerides in the blood can contribute to the formation of plaque in the arteries. Also, elevated levels of apolipoprotein B (ApoB) have been found to increase the risk of developing atherosclerosis.⁴Behbodikhah, Jennifer et al. “Apolipoprotein B and Cardiovascular Disease: Biomarker and Potential Therapeutic Target.” Metabolites vol. 11,10 690. 8 Oct. 2021. PubMed Source

Metabolic disorders, like diabetes and obesity, can contribute to the development of high blood pressure, high cholesterol levels, all of which increase the risk of atherosclerosis.

Lifestyle factors include smoking, consuming high amounts of saturated fats in the diet, and a sedentary lifestyle.

Since atherosclerotic changes are already observed as early as childhood and adolescence, long-range prevention of atherosclerosis is the best way to decrease the risk of further cardiovascular diseases. This could be achieved by lifestyle habits or medications in people with high risk.

There are three classes of LDL cholesterol-lowering drugs (statins, ezetimibe, and PCSK9 inhibitors) widely used for the regression of atherosclerosis and reducing cardiovascular events in people with a high risk of atherosclerosis. Aspirin and blood pressure regulators are used as complementary treatments if needed.

Novel alternative treatments, like the usage of nanomedicines and theranostics for atherosclerosis, are under development.⁵ Zhang, Yicong et al. “Treatment of atherosclerotic plaque: perspectives on theranostics.” The Journal of pharmacy and pharmacology vol. 71,7 (2019): 1029-1043. PubMed Source Thi way of treatment uses nanoparticles to deliver drugs to the location of arterial plaque. It enables more efficient absorption of the drug by the body and aids in reducing plaque accumulation.

There are several preventive and protective factors against atherosclerosis. These include:

• Healthy diet, in particular, the Mediterranean diet, rich in whole food and fish oil.
• Regular exercise, such as aerobic and muscle strength training.
• Physical activity can help improve cholesterol levels, reduce blood pressure, and maintain a healthy weight, all of which can lower the risk of atherosclerosis.
• Quitting smoking can significantly reduce the risk of atherosclerosis and other cardiovascular diseases.
• Healthy gut microbiome.
• Good stress management and good sleep.
• Clean environment: smoke/air pollutant-free
• Regular checkups with a healthcare provider can help identify and manage risk factors for atherosclerosis before they develop into more serious health problems.

High blood pressure can be caused by various factors, including genetic, lifestyle, and environmental factors. Some of the most common risk factors for hypertension include:

• Age. The risk of hypertension increases as you age, especially at the age of over 65 years.
• Family history. If you have a family history of hypertension, you may be more likely to develop the condition.
• Ethnicity and race. Hypertension is more common in African, Hispanic, and Native Americans.
• Chronic conditions, such as kidney disease, adrenal and thyroid disorders, sleep apnea, and obesity.
• Taking birth control pills with estrogen.
• Lifestyle factors: smoking, being overweight, sedentary lifestyle, too much salt in the diet, too much alcohol consumption, too little potassium, calcium or magnesium in the diet, poor stress management.

There are several risk factors that can increase the chances of having a heart attack. Some of the most common risk factors include:

• Age. The risk of heart attack increases with age, especially for men over 45 and women over 55.
• Gender. Before the age of 55, men are more likely to have a heart attack than women, but women’s risk increases after menopause.
• Family history. If a close family member has had a heart attack, your risk is higher.
• Genetic factors. Variations in some genes may predispose to a higher risk of having a heart attack.
• Medical conditions, such as diabetes, high blood pressure, high blood cholesterol and triglyceride levels, obstructive sleep apnea
• Lifestyle factors, such as smoking, poor stress management, being overweight, a sedentary lifestyle, too much alcohol, a diet high in saturated fat

Some of the most common risk factors for stroke include:

• Age. It is more common to occur after age of 55.
• Genetic factors
• Family history of stroke.
• Race and ethnicity. Asian, African, or Caribbean are at higher risk)
• Previous medical history. Any of the following conditions increase the risk of stroke: previous incidents of stroke, heart attack, transient ischaemic attack, high blood pressure, high blood cholesterol, obstructive sleep apnea.
• Taking some oral contraceptives and hormone replacement therapy.
• Lifestyle factors, such as being overweight, too much alcohol, smoking, poor stress management, sedentary lifestyle.

The symptoms of stroke can vary depending on the type of stroke and the area of the brain affected. However, they are usually sudden and include weakness or numbness in the face, arm, or leg, especially on one side of the body, difficulty speaking or understanding speech, vision problems in one or both eyes, dizziness, loss of balance, or difficulty walking, severe headache with no known cause.

Cardiovascular diseases are a leading cause of mortality worldwide. While such conditions can manifest at a young age, the risk of developing them increases considerably with age. This group of ailments comprises atherosclerosis, hypertension, heart attack, and stroke.

While a genetic or familial predisposition to cardiovascular diseases exists, they are preventable and can be mitigated through basic lifestyle interventions. Examples of such interventions include engaging in regular exercise, consuming a healthy diet (such as the Mediterranean diet, which emphasizes whole foods and fish oil while limiting salt), quitting smoking and alcohol consumption, and managing stress effectively.