WEST MICHIGAN — Cardiovascular disease is a progressive chronic condition affecting blood vessels in the heart, kidneys and brain. Dr. Diana Bitner is the Chief Medical Officer and Cofounder of True Women's Health, and she says more women die of CVD than any other, but even one woman dying from heart disease is one too many.
Many people know that heart disease means blockages or stiffening of blood vessels, but it might not be known how it applies to them. The process can happen in arteries across the body, including the heart, kidney, neck and brain. Cardiovascular disease is when cholesterol forms plaques in and on vessel walls, making them stiff and hard to open.
What is a plaque? It’s a preventable sticky mess which develops over time:
- First, LDL Cholesterol which is tiny and hard slips into the artery wall and gets oxidized
- Then Foam cells arrive-immune cells that look foamy because they ingest the cholesterol
- Next are Inflammatory cells-surrounding to the microscopic mess and causing more mess
- To hide it all, smooth muscle cells migrate from deep in the vessel wall to try and patch things up but cause more stiffness
- The final step is a fiber cap which can pull in calcium-making it hard and brittle
What is the result? It depends on the organ affected:
- Heart: When you exercise, your heart must work harder and requires more blood and oxygen to keep up. Vessels have to be flexible and open to supply more blood, and if they cannot, the result is fatigue, exercise intolerance, or shortness of breath, or pain.
- Kidneys: Your kidneys need blood flow to do their job of filtering and monitoring fluid levels, and when the vessels get stiff and blocked, the kidney cells become damaged. High blood pressure is a frequent result.
- Brain: When vessels get stiff and in the neck and brain, the brain gets less oxygen, cannot clear waste, and risk develops for stroke and dementia.
What do I do about it?
Know what risks of plaque you face today. The ASCVD score done in most doctor's office will not tell you the full story. It is largely based on age, and doesn't often help a person to be aggressively treated until they are 65. By 65, much of the damage is done and the opportunity to stop heart disease from progressing is more difficult. It's never too late to manage, but the earlier the better.
Know your numbers:
- LDL and lipoprotein particles
- HgA1C: blood sugar over 3 months
- Blood pressure: if you blood pressure is higher than 120/70, and even periodically higher, there is more daily stress on the lining cells of the vessel and which can allow fat to get into the tiny breaks, increasing places plaque formation AND can cause plaques to rupture and make a heart attack or stroke. Think big sudden stress, shoveling snow, exercise-
- Waist circumference
- Menopause status:
- Calcium score of heart on CT scan
Takeaway tip: Know your risk, if you are younger than 65, the ASCVD score isn't enough.
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