Coronary heart disease as a multifactorial disease
Knowledge of the biological mechanisms of atherosclerosis led to an understanding of the progression of this disease and many of its etiological factors. Coronary heart disease (CHD) develops as a result of the interaction of many RFs.
Often, people with cardiovascular diseases (CVD) simultaneously have small changes in several risk factors (RF), rather than extreme deviations in the level of one. If these risk factors (RF) are not controlled, then atherosclerosis will continue to develop. Predisposing RF, for example, genetic, interact with behavioral RF, such as diet, alcohol consumption and physical activity.
The combination of these predisposing and behavioral factors can cause metabolic changes – dyslipidemia (DLP), hypertension, obesity and diabetes, which ultimately lead to a pronounced disease. The key point in identifying susceptibility to this disease may be various diagnostic tests. Some tests that assess physical changes in the arteries, such as the thickness of the TCIM CA or the presence of calcium in the CA, can be used to assess the severity of atherosclerosis, while an exercise test helps diagnose stenosis of the ischemia.
Other tests, such as determining the level of chrish, suggest the likelihood of a cardiovascular event (SSSob), but may not clearly correlate with the severity of atherosclerosis. This latent disease can manifest as a transient ischemic attack (TIA), MI, or another Ssob. DFs useful for prediction, both modifiable and non-modifiable, can be identified at any stage of this process. For example, FRs are hereditary predispositions for heart disease and smoking. Such a metabolic factor, such as a high level of LDL, also serves as a risk factor.
Migrated IM or MI is also a strong predictor of future events. This reflects the relationship between predisposing risk factors (RF) and disease markers, which may be important for identifying people at increased risk of developing clinical complications.
Risk assessment (RF) is useful, but sometimes they are conditional, i.e. they are difficult to classify as a specific category. For example, hereditary predisposition may be in the presence of certain genes in the descendants, but also in the lifestyle of the family, which passes from one generation to another.
It is not known whether hypertension is a consequence of the influence of such features of a family lifestyle as a diet predisposing to atherosclerosis, low physical activity (NFA), or is it a manifestation of ED, thus serving as a marker of atherosclerosis.