Atherosclerosis can affect any artery in the body. When it occurs in the heart, it may cause angina, MI and sudden death; in the brain, stroke and transient ischaemic attack ; and in the limbs, claudication and critical limb ischaemia.
Risk factors
Age and sex
Age is the most powerful independent risk factor for atherosclerosis. Pre-menopausal
women have lower rates of disease than men, although this sex difference disappears after the
menopause
Family history
Atherosclerotic vascular disease often runs in families, due to a combination of shared
genetic, environmental and lifestyle factors. The most common inherited risk characteristics
(hypertension, hyperlipidaemia, diabetes mellitus) are polygenic
Hypertension
The incidence of atherosclerosis increases as BP rises, and this excess risk is related to both systolic and diastolic BP, as well as pulse pressure
Hypercholesterolaemia
Risk rises with increasing serum cholesterol concentrations. Lowering serum total and LDL cholesterol concentrations reduces the risk of cardiovascular events, including death
Diabetes mellitus
This is a potent risk factor for all forms of atherosclerosis and is often associated with
diffuse disease that is difficult to treat
Haemostatic factors
Platelet activation and high plasma fibrinogen concentrations are associated with an increased risk of coronary thrombosis.
Physical activity
Physical inactivity roughly doubles the risk of coronary artery disease and is a major risk factor for stroke
Obesity
Obesity, particularly if central or truncal, is an independent risk factor, although it is
often associated with other adverse factors, such as hypertension, diabetes mellitus .
Alcohol
Alcohol consumption is associated with reduced rates of coronary artery disease.
Other dietary factors
Diets deficient in fresh fruit, vegetables and polyunsaturated fatty acids are associated with an increased risk of cardiovascular disease.
Personality
Certain personality traits are associated with an increased risk of coronary disease.
Social deprivation
Health inequalities have a major influence on cardiovascular disease.
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