A 68-year-old patient – followed-up for 10 years – recently began having frequent episodes of angina. Diabetic and hypertensive for 15 years, he had suffered a heart attack, and Dr. Sameer Kubba, Director, Clinical and Interventional Cardiology, Max Super Specialty Hospital, Vaishali, stented his two coronary arteries. The patient was doing well and was very diligent in following a heart-healthy lifestyle in addition to taking his cardiac medications religiously. Despite controlling for all modifiable risk factors, the patient had progression of atherosclerotic heart disease, which was discouraging. We put another stent and optimized it with medicines.
Atherosclerosis, the hardening of the arteries due to a build-up of cholesterol-rich plaques in the artery walls, is the primary cause of heart attacks and strokes, which account for more than half of all deaths worldwide. Scientists are exploring ways to prevent early-stage atherosclerosis from progressing to a more dangerous, advanced stage in order to improve outcomes for patients at risk of coronary artery disease (CAD). The good news is that there is data to suggest that early stage atherosclerosis can be significantly and even completely reversed in some situations. Later-stage atherosclerosis is relatively resistant to reversal, although its progression may be delayed. This suggests that individuals at increased CAD risk would greatly benefit from early prevention through dietary and lifestyle measures and the use of cholesterol-lowering drugs such as statins.
Even healthy people at increased risk of CAD are likely to benefit from statin therapy, even if their LDL cholesterol levels are moderately elevated. Prescribing statin therapy to people with early blockages may be more effective at delaying progression or sometimes reversing atherosclerosis than administering these drugs to patients with more advanced forms of arterial plaque.
In mice with early-stage atherosclerosis, a gene was found to be involved in causing complete regression. In mature and advanced cases, research studies have identified various genes in the network that have been shown to be influential in controlling the regression of atherosclerosis. Although, as of now, reversal of the disease is usually not possible except in the very early stages, disease progression can certainly be slowed down by following evidence-based guidelines on diet, lifestyle, and use of appropriate medications. A landmark study 16 years ago called the steroid trial found that patients who took a very strong statin daily for 2 years were able to reduce plaque buildup and the thickening of their arteries.
Lifestyle changes alone are not enough when CAD develops, but there is no doubt that they are a powerful addition to medication. Substitutes for non-fat dairy and egg whites in a diet rich in fruits, vegetables, whole grains, low-fat dairy products, nuts, legumes, and soy products have been shown to lower cholesterol and reduce CAD to a lesser extent. Has gone. Some short studies. This diet plan is low in fat, limiting fat to about 10% of total calories, which can be difficult to stick to long term.
Other parts of a healthy lifestyle won’t necessarily reverse coronary artery disease, but may prevent it from getting worse. This includes:
Regular exercise: Regular physical activity helps repair some of the damage to the endothelium, the thin membrane that lines the inside of blood vessels. This, in turn, allows more blood to be pumped through your vessels.
Not smoking: Cigarette smoke causes platelets in your blood to become sticky and stick together, which can lead to the formation of a blood clot that can lead to a heart attack.
Stress Management: If you are under stress for too long, it can become a problem. Prolonged high levels of stress hormones like cortisol raise blood cholesterol and also cause changes that promote plaque build-up in your arteries.
The American Heart Association strongly advocates Life’s Essential 8 as key measures to improve and maintain cardiovascular health. These eight imperatives cover two major areas: health behaviors and health factors. Eating better, being more active, quitting tobacco and getting healthy sleep are 4 essential health behaviors, while managing weight, blood sugar, blood pressure and cholesterol are 4 essential health factors.
With age and the passage of time, there will be progression of the atherosclerotic process, becoming more resistant to reversal. Taken together, these steps can reduce the risk of developing a heart attack and the progression of the disease. The goal is to keep you alive and healthy, even if your coronary artery disease is not completely cured.
(Disclaimer: The author of this article is Dr. Sameer Kubba, Director, Clinical & Interventional Cardiology, Max Super Specialty Hospital, Vaishali. This information is only suggestion for patient education and should not be considered as a substitute for doctor’s advice or recommendations Please consult your doctor for more details. The article is published from a syndicated feed, Zee News does not endorse it.)