MadSci Network: Medicine |
Hello Terry, Coronary artery disease is caused by the formation of atherosclerotic plaques in the coronary arteries that restrict blood flow and may lead to thrombosis, where the plaque ruptures and a blood clot forms. These clots further restrict the artery and may break off and completely block the artery further down. These are the reasons for chest pain known as angina where the flow of blood is restricted and more seriously myocardial infarction when an artery becomes blocked. It is generally accepted by almost everyone in the field that cholesterol is a crucial element during the first stages in the formation of an atherosclerotic plaque. Therefore, elevated cholesterol levels are an important RISK FACTOR in the development of atherosclerotic plaques. The most important thing about the development of this disease is that it is associated with a large number of different risk factors. Risk factors are environmental or genetic factors that affect your chances of getting the disease. The most obvious risk factor in this disease is high levels of cholesterol or more specifically low density lipoproteins (LDLs). High fat, high cholesterol diets are usually required for the development of atherosclerosis in experimental animals. Other important risk factors associated with atherosclerosis and coronary heart disease are: elevated blood pressure; family history of atherosclerosis; diabetes; smoking; lack of exercise; and reduced levels of high density lipoproteins (HDLs), which protect against the formation of atherosclerotic plaques. Therefore, I am afraid to say that under certain circumstances, it is possible for people with normal levels of cholesterol to get atherosclerosis and coronary artery disease. However, by keeping cholesterol levels low the likelihood of getting the disease is very much reduced and reducing cholesterol levels once someone has the disease significantly improves their prognosis, especially if this is done whilst concurrently reducing other risk factors such as stopping smoking and doing more exercise. Thank you for your question. David Burton Ph.D.
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