Coronary Heart Disease
How Obesity Increases the Risk of Coronary Heart Disease
Coronary heart disease, otherwise known as arteriosclerotic heart disease, is when the small blood vessels which supply oxygen to the heart begin to become narrower. (1) Other related conditions are angina, heart attack and stress. (2) Coronary heart disease is caused by something called atherosclerosis, (3) which is when fatty substances build up a layer of plaque on the walls of the arteries. This layer of plaque causes the arteries to become narrower. The plaque is made up mostly of cholesterol (4) and as the arteries get narrower, the blood flow to the heart can slow down or even stop entirely (5) This lack of oxygenated blood in the heart is what causes chest pain (angina), shortness of breath, heart attacks and other symptoms which are indicators of coronary heart disease, and which usually show up most when your body is active. (6) According to the National Center for Biotechnology Information, coronary heart disease is the leading cause of death in the United States. (7)
Obesity is related to coronary heart disease through cholesterol. Overweight or obese people usually have far more cholesterol in their blood than people of a regular weight and for this reason, the cholesterol could be layering down on the arteries, causing plaque and coronary heart disease. (8) There are three substances found in the bloodstream which are related to obesity and created by the liver. First, there is HDL cholesterol and LDL cholesterol. These two types of cholesterol need to be in balance so that there are no irregularities in the bloodstream. (9) Another type of substance created by the liver is triglycerides. (10) These are sugar molecules which are sent into the bloodstream when there is too much sugar in the body (acquired through dietary sources). This sugar can be converted to body-fat, or can spike the blood-sugar. (11) Cholesterol and triglycerides are regulated by a hormone excreted from the pancreas called insulin. (12) In normally functioning bodies, insulin is strong enough to keep the cholesterol levels at the right balance and the triglyceride levels down. However, in people who are suffering from type 1 diabetes, the pancreas cannot create insulin so it needs to be injected separately to regulate blood-sugar and cholesterol. (13) In obese people, which is one of the first stages of type 2 diabetes, the pancreas is creating so much insulin that the body can become immunized to the hormone’s effects. (14) This results in a metabolic disorder in which triglycerides and cholesterol are completely out of control. Obese people are particularly susceptible to developing type 2 diabetes and other diseases, such as coronary heart disease.
Coronary heart disease and the metabolic syndrome
Obesity and coronary heart disease are related through insulin, the pancreas, the liver, cholesterol and triglycerides. Furthermore, it can be quite difficult for an already obese person to lose weight for a variety of reasons. One of the most significant is a hormone called leptin, which is released from the body-fat. (15) Leptin is supposed to be an appetite-suppressing and regulating hormone, but in a person with metabolic disorder, like insulin, it may be in such abundance that the body becomes desensitized to its effects. (16) In this case, the obese patient will keep eating in many circumstances when they are not actually hungry.
Atherosclerosis
Atherosclerosis is a hardening of the arteries and is also known as plaque buildup. (17) The fatty material that collects on the walls of the arteries forms calcium deposits and can eventually end up blocking the arteries. It is mostly the medium and large arteries that are affected by atherosclerosis, making the arteries narrow and less flexible. When these coronary arteries become too narrow, not much oxygen reaches the heart and chest pain (angina) can be the result, shortness of breath and even a heart attack. (18)
Another huge risk is that pieces of plaque can break off the larger arteries and move to smaller blood vessels, blocking them off and causing severe damage to tissue, or in the worst case, death, through a malady called embolism. (19) Blood clots, that can move around an artery to the heart, lungs or brain can cause death. (20) If the blood clot is in the heart a heart attack is caused, if in the brain a stroke and if in the lungs pulmonary embolism.
Risk factors for coronary heart disease
Most of the risk factors, at least the main ones that can promote the development of coronary heart disease, are related to obesity. (21) Diabetes is a huge problem, both types, because of the lack of cholesterol, triglyceride (body-fat) and insulin regulation. High blood pressure and increasing age are also causes for concern. (22) Other factors which may contribute to the development of coronary heart disease are heavy alcohol use (destroys the liver, the primary body-fat regulating mechanism in the body and detoxifier), (23) increasing age, a family history of heart disease and even smoking.
While atherosclerosis affects the heart, lungs and brain mostly, it can also cause severe damage to the intestines, kidneys and the limbs. (24)
Treatment of coronary heart disease and obesity
People who are obese should consider losing weight seriously as a first line of defense against coronary heart disease. Losing weight reduces the amount of excess body-fat in the body, subsequently reducing the amount of leptin that is going through the body. This can return leptin to its normal function of regulating appetite and make it easier to return to a normal body-weight. Additionally, balancing the amount of cholesterol in the body becomes easier for the insulin as it can now travel more efficiently around the body to regulate triglycerides. Triglyceride formation can also be reduced in the body by eating less foods that are converted into sugar (carbohydrates and sucrose). When there is less triglycerides in the body the insulin can get to work on regulating the cholesterol instead. Thus, before any medical or surgical intervention, losing weight and eating a balanced, healthy diet can be the frontline preventative defense against coronary heart disease.
Regular exercise also promotes blood movement faster, getting the insulin, cholesterol and white blood cells to the right places to repair any arterial damage that has been caused by the buildup of plaque through atherosclerosis.
---
(1) Coronary heart disease, National Center for Biotechnology Information, May 23, 2011. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004449/
(2) ibid.
(3) Atherosclerosis, National Center for Biotechnology Information, May 26, 2010. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001224/
(4) Cholesterol, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Cholesterol
(5) Coronary artery disease, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Coronary_artery_disease
(6) Atherosclerosis, National Center for Biotechnology Information, May 26, 2010. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001224/
(7) Coronary heart disease, National Center for Biotechnology Information, May 23, 2011. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004449/
(8) Cholesterol, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Cholesterol
(9) The Intestinal Absorption of Biliary and Dietary Cholesterol: Maintenance of Cholesterol Balance Across the Body, Stephen D. Turley, PhD, John M. Dietschy, MD, Medscape. Retrieved July 25th, 2011, http://www.medscape.com/viewarticle/450777_4
(10) Triglyceride, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Triglyceride
(11) High triglycerides, WebMD, December 09, 2010. Retrieved July 25th, 2011, http://www.webmd.com/cholesterol-management/tc/high-triglycerides-overview
(12) Corticosterone and insulin interact to regulate glucose and triglyceride levels during stress in a bird. Remage-Healey L, Romero LM. Am J Physiol Regul Integr Comp Physiol. 2001 Sep;281(3):R994-1003. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmed/11507018
(13) Type 1 diabetes, National Center for Biotechnology Information, May 10, 2010. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001350/
(14) Type 2 diabetes, National Center for Biotechnology Information, May 10, 2010. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001356/
(15) Leptin, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Leptin
(16) Obesity and leptin resistance, Leptin, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Leptin#Obesity_and_leptin_resistance
(17) Atherosclerosis, National Center for Biotechnology Information, May 26, 2010. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001224/
(18) ibid.
(19) Embolism, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Embolism
(20) ibid.
(21) Obesity and Heart Disease, Robert H. Eckel, MD, Circulation. 1997;96:3248-3250
doi: 10.1161/01.CIR.96.9.3248, American Heart Association. Retrieved July 25th, 2011, http://circ.ahajournals.org/content/96/9/3248.full
(22) Coronary heart disease, National Center for Biotechnology Information, May 23, 2011. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004449/
(23) Liver, Wikipedia. Retrieved July 25th, 2011, http://en.wikipedia.org/wiki/Liver
(24) Atherosclerosis, National Center for Biotechnology Information, May 26, 2010. Retrieved July 25th, 2011, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001224/