Cardiovascular diseases have been the leading cause of morbidity and mortality in Malaysia for more than a decade. Furthermore, data from the 2013 National Cardiovascular Disease Database indicated that the mean age at which Malaysians developed heart attacks was 58.5 years. This is much younger than that reported in Thailand (63.5) and Singapore (68.3). Heart attack or myocardial infarction, results from the sudden blockage of a blood vessel (coronary artery) that supplies oxygen-rich blood to the heart muscle. This results in muscle death and thus a weakening of the heart’s pump function. Most alarmingly in up to 50% of cases, the heart will stop suddenly due to rhythm abnormalities causing sudden death.

The principle cause of heart attack is a complex inflammatory process called atherosclerosis. This gives rise to the formation of plaques consisting of cholesterol and other materials, which can cause the lining of the coronary artery to narrow or even rupture inwards. This process coupled with its resultant effects is termed coronary artery disease; the No.1 worldwide health problem. The risk factors for developing coronary artery disease can be divided into 2 groups; modifiable and non-modifiable.

Based on a recent study called INTERHEART, the modifiable risk factors were present in 80% of all cases of myocardial infarction. As the name suggests, these risk factors can be identified through early medical screening and optimally managed by lifestyle and drug treatment. These measures have been shown to reduce the prevalence of this disease in many parts of the world.

One of the most common causes for heart attacks arises from coronary artery disease. It results from a complex inflammatory process called atherosclerosis. Atherosclerosis leads to the formation of plaque (fat, cholesterol, calcium, and other substances), which causes the arteries supplying the heart with oxygen rich blood to become narrowed. These cholesterol-rich plaques may also burst into the channel and cause clot formation that lead to heart attack. The majority of risk factors contributing to this process are controllable.

There are different types of cholesterol

• Low-density lipoprotein (LDL or bad cholesterol), which is the main source of artery-clogging plaque
• High-density lipoprotein (HDL or good cholesterol), which works to clear cholesterol from the blood
• Triglycerides; commonest type of fat that stores excess calories from diet. The combination with low HDL cholesterol or high LDL cholesterol, is what is commonly referred to as High Cholesterol and is linked with plaque buildup

Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood.

If this pressure rises and stays high over time, it can injure the inner surface of the arteries and trigger a cascade of inflammatory processes that promote atherosclerosis

All levels above 120/80 mmHg raise your risk of CAD. Either one of the two blood pressure numbers has to be above normal to put you at risk.

Obesity, apart from being an independent risk factor is associated with other risk factors i.e. hypertension, diabetes, high cholesterol levels, etc. 

A higher body mass also puts more strain on the heart as it needs to generate more cardiac output. 

Regular exercise / physical activity leads to improvements in

• Blood pressure
• Cholesterol profile
• Sugar control
• Body weight
• Improvements in coronary blood flow

High levels of blood sugar is associated with

• Higher triglyceride levels
• Lower HDL levels

These in turn, promotes plaque buildup. Diabetics have 2 to 4 times greater risk of developing heart attacks.

Smoking causes CAD in the following ways

• Raises triglycerides
• Lowers HDL level
• Makes blood more likely to clot
• Damages cells that line the blood vessels

All of the above increases the buildup of plaque.

As such, it's important to get regular checkups and understand if you have any of these conditions which put you at increased risk for heart attacks. If you do have an existing condition, there's no need to panic, there are a number of steps you can take to manage your condition and substantially reduce your risk for heart attacks.

Credits:

Cardiac Vascular Sentral Kuala Lumpur

Image source: http://www.metalyse.com/myocardial-infarction/risk-factors