夢的部落格

◎年齡
◎缺乏重要的營養，如多酚抗氧化劑
◎糖尿病
◎高膽固醇血症（高膽固醇水平）及不正常的脂蛋白狀況
◎吸煙及二手菸
◎空氣污染
◎較高的纖維蛋白素原及纖溶酶原激活物抑製劑-1的血液濃度
◎提升的高半胱氨酸，或正常的上半水平
◎非對稱性二甲基精氨酸攀升的血液含量
◎高血壓
◎噪音
◎肥胖症，尤其是腹部肥胖或男性肥胖；除了與糖尿病有所關聯外，這種肥胖症獨立地增加患上心血管疾病的風險，即引起炎症及凝血的情況。
◎遺傳因素或患上心血管疾病的家族歷史
◎缺乏運動
◎憂鬱症

雖然男性患上心血管疾病的比率較女性高，但在工業國家這仍是女性的頭號健康問題。在更年期後，女性患病的風險可以比過男性。荷爾蒙補充療法可以減輕部份後更年期的問題，但心血管疾病的患病風險卻似乎因而增加。

防止心血管疾病:
要防止心血管疾病，就要修正上述的風險因素。有些因素，如年齡、性別、遺傳基因及家族歷史都不能更改，但經由基因檢測篩檢出心血管脆弱基因，及早預防能有效降低發病機會。停止吸煙是其中一種最有效及容易修正的因素。經常性的有氧運動加上健康的飲食習慣，可以改善脂蛋白的水平。如果不能，醫生可以處方減低膽固醇的藥物，如他汀等，這種用藥亦可以有額外的保護作用。阿司匹林亦是另一種處方的藥物，它可以減低導致心肌梗死及中風的血凝的形成。這些都是一般給予患有一種或以上風險因素的病人的處方。
其中一種經常被疏忽去消除心血管疾病風險的方法是維持總膽固醇水平低於150。有研究指總膽固醇水平低於150的人甚少患上冠心病。
每星期最少吃兩次油性魚類可以幫助減低突然死亡及心律不整。橄欖油亦可以有最好的幫助。研究個別心臟細胞顯示脂肪酸阻止心臟內多餘的鈉及鈣，這些都是引起心臟調律的危險及不可測的改變。

Risk factors

Epidemiology suggests a number of risk factors for heart disease: age, gender, high blood pressure, high serum cholesterol levels, tobacco smoking, excessive alcohol consumption, family history, obesity, lack of physical activity, psychosocial factors, diabetes mellitus, air pollution. While the individual contribution of each risk factor varies between different communities or ethnic groups the consistency of the overall contribution of these risk factors to epidemiological studies is remarkably strong. Some of these risk factors, such as age, gender or family history, are immutable; however, many important cardiovascular risk factors are modifiable by lifestyle change, drug treatment or social change.

Age
Age is an important risk factor in developing cardiovascular diseases. It is estimated that 87 percent of people who die of coronary heart disease are 60 and older. At the same time, the risk of stroke doubles every decade after age 55.
Multiple explanations have been proposed to explain why age increases the risk of cardiovascular diseases. One of them is related to serum cholesterol level. In most populations, the serum total cholesterol level increases as age increases. In men, this increase levels off around age 45 to 50 years. In women, the increase continues sharply until age 60 to 65 years.
Aging is also associated with changes in the mechanical and structural properties of the vascular wall, which leads to the loss of arterial elasticity and reduced arterial compliance and may subsequently lead to coronary artery disease.

Sex
Men are at greater risk of heart disease than pre-menopausal women.[12] However, once past menopause, a woman’s risk is similar to a man’s.
Among middle-aged people, coronary heart disease is 2 to 5 times more common in men than in women. In a study done by the World Health Organization, sex contributes to approximately 40% of the variation in the sex ratios of coronary heart disease mortality. Another study reports similar results that gender difference explains nearly half of the risk associated with cardiovascular diseases[10] One of the proposed explanations for the gender difference in cardiovascular disease is hormonal difference. Among women, estrogen is the predominant sex hormone. Estrogen may have protective effects through glucose metabolism and hemostatic system, and it may have a direct effect on improving endothelial cell function. The production of estrogen decreases after menopause, and may change the female lipid metabolism toward a more atherogenic form by decreasing the HDL cholesterol level and by increasing LDL and total cholesterol levels. Women who have experienced early menopause, either naturally or because they have had a hysterectomy, are twice as likely to develop heart disease as women of the same age group who have not yet gone through menopause.
Among men and women, there are differences in body weight, height, body fat distribution, heart rate, stroke volume, and arterial compliance. In the very elderly, age related large artery pulsatility and stiffness is more pronounced in women. This may be caused by the smaller body size and arterial dimensions independent of menopause.

Air pollution
Particulate matter has been studied for its short- and long-term exposure effects on cardiovascular disease. Currently, PM2.5 is the major focus, in which gradients are used to determine CVD risk. For every 10 μg/m3 of PM2.5 long-term exposure, there was an estimated 8-18% CVD mortality risk. Women had a higher relative risk (RR) (1.42) for PM2.5 induced coronary artery disease than men (0.90) did. Overall, long-term PM exposure increased rate of atherosclerosis and inflammation. In regards to short-term exposure (2 hours), every 25 μg/m3 of PM2.5 resulted in a 48% increase of CVD mortality risk.[16] Additionally, after only 5 days of exposure, a rise in systolic (2.8 mmHg) and diastolic (2.7 mmHg) blood pressure occurred for every 10.5 μg/m3 of PM2.5.[16] Other research has implicated PM2.5 in irregular heart rhythm, reduced heart rate variability (decreased vagal tone), and most notably heart failure.[16][17] PM2.5 is also linked to carotid artery thickening and increased risk of acute myocardial infarction.

Pathophysiology
Population based studies show that atherosclerosis the major precursor of cardiovascular disease begins in childhood. The Pathobiological Determinants of Atherosclerosis in Youth Study demonstrated that intimal lesions appear in all the aortas and more than half of the right coronary arteries of youths aged 7–9 years.
This s is extremely important considering that 1 in 3 people will die from complications attributable to atherosclerosis. In order to stem the tide education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken.
Obesity and diabetes mellitus are often linked to cardiovascular disease, as are a history of chronic kidney disease and hypercholesterolaemia . In fact, cardiovascular disease is the most life threatening of the diabetic complications and diabetics are two- to four-fold more likely to die of cardiovascular-related causes than nondiabetics.

Prevention

Currently practiced measures to prevent cardiovascular disease include:
a low-fat, high-fiber diet including whole grains and plenty of fresh fruit and vegetables (at least five portions a day)
tobacco cessation and avoidance of second-hand smoke;
limit alcohol consumption to the recommended daily limits; consumption of 1-2 standard alcoholic drinks per day may reduce risk by 30%[31][32] However excessive alcohol intake increases the risk of cardiovascular disease.
lower blood pressures, if elevated, through the use of antihypertensive medications[citation needed];
decrease body fat (BMI) if overweight or obese;
increase daily activity to 30 minutes of vigorous exercise per day at least five times per week;
decrease psychosocial stress.
Routine counselling of adults to advise them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended.

(Article From Wikipedia, the free encyclopedia- Cardiovascular disease, Photo from 904Fitness.com)