Researchers at the University of Copenhagen, Denmark, have found that people with no known cardiovascular disease but with undetected obstructive coronary atherosclerosis increase their risk of heart attack eightfold. These results suggest that nearly half of adults over 40 may have “hidden” heart conditions that go undetected. In 2019, approximately 17.9 million people worldwide died from cardiovascular diseases, with 85% of these deaths attributed to strokes and myocardial infarctions, also known as heart attacks.

There are several modifiable risk factors for heart attacks, including smoking, high blood pressure, high cholesterol, and obesity. There are also non-modifiable risk factors, including family history and different diseases such as diabetes. The study is published in Annals of Internal Medicine, a journal of the American College of Physicians.

Coronary atherosclerosis and heart attack

Coronary atherosclerosis, also called coronary artery disease, occurs when cholesterol deposits build up inside the arteries that supply blood to the heart.
This plaque narrows the arteries, making it harder for blood to get to the heart.

Symptoms of coronary atherosclerosis can be the following:

pressure, crushing, or pain in the chest
shortness of breath
heartburn and/or indigestion

Although coronary artery disease is incurable, it can be managed with lifestyle changes and medication. Sometimes surgery may be needed to open or replace completely clogged arteries. Coronary atherosclerosis is the most common cause of heart attack. A person suffers a heart attack when blood can no longer reach their heart.

Symptoms of a heart attack are:

a feeling of pressure, tightness, heaviness, or pain in the chest
pain that spreads from the chest to other parts of the body, such as the arms, back, or neck
shortness of breath
nausea and/or vomiting
coughing and/or wheezing due to fluid buildup in the lungs Trusted Source
Symptoms of a heart attack can appear very quickly or last for a few days. The sooner a person is treated for a heart attack, the higher their survival rate.

Heart attack risk review

Atherosclerosis can develop many years before an individual shows symptoms. To prevent heart attacks, it is therefore very important to understand what characteristics define an asymptomatic individual at high risk for clinically manifesting diseases. In this study, Dr. Kofoed and his team examined more than 9,500 people aged 40 or older who had no known symptoms of cardiovascular disease. Study participants were evaluated using computed tomography (CTA) angiography to check for previously undiagnosed obstructive coronary atherosclerosis.

After analysis, the researchers found that 54% of study participants had no detectable coronary atherosclerosis. Of the remaining 46%, 36% had non-obstructive coronary atherosclerosis and 10% obstructive disease. Furthermore, the scientists found that among the participants who were diagnosed with previously undetected coronary atherosclerosis, 61% were male and 36% female. The biggest surprise was that up to 10% of participants had an obstructive disease without showing any symptoms.

Improving heart attack prevention measures

This study is exciting because it answers a fundamental question in cardiology: how important is coronary artery disease in asymptomatic people? Until now, the understanding of the importance of coronary artery disease has come mainly from people who present with clinical symptoms of the disease and who have undergone invasive coronary angiography. People with obstructive coronary stenoses on invasive coronary angiography have historically been considered to be at high risk, but with the advent of computed tomography coronary angiography and improvements in technology, it is increasingly recognized that features specific to the plate may confer an additional risk.

“It was telling to find that among people with no symptoms, subclinical atherosclerosis can be detected in more than 50% of men and almost a third of women. The finding that 10% of this study population had obstructive coronary artery disease is equally striking.

Furthermore, the results of this study are very useful for determining the risk of a cardiovascular event in an asymptomatic person.

The use of CT coronary angiography in the prevention setting would help establish whether coronary heart disease really exists, a question that doctors are often unable to definitively answer for patients in the setting. of current practice. Based on the results of CT coronary angiography, doctors should now be able to better determine whether an asymptomatic person is at higher risk of having a heart attack or dying.

This will help to develop appropriate prevention strategies so that those considered to be at high risk have a much better chance of not succumbing to a cardiovascular event.

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