Etiology of cardiovascular disease.
Cardiovascular disease, caused by the accumulation of cholesterol and other substances in the arteries (atherosclerotic plaque), are the leading cause of mortality in the world.
According to ISTISAN, for example, in Italy 160,000 people each year are affected by a heart attack, with an incidence of mortality from diseases of the cardiovascular system that are 38.7% for males and 48.4% for females.
The etiology of these disorders is multifactorial, which means there are multiple risk factors that simultaneously contribute to their onset and development, and according to European standard, NatrixLab proposes a test to calculate the risk of developing cardiovascular disease in the next 10 years in an asymptomatic person.
Let’s look at these factors, some of which are modifiable or resizable, through changes in lifestyle or drug therapies; others do not.
The modifiable factors are:
- Smoking: nicotine accelerates the heartbeat, while the carbon monoxide decreases the amount of oxygen in the blood, producing an increase of free radicals which are used in the oxidative stress by accelerating the arteriosclerotic process;
- Styles improper food: an unbalanced diet with excessive intake of saturated fat results in an increased plasma concentrations of LDL, which are the basis of the genesis of atherosclerotic plaque;
- Blood pressure: high blood pressure forces the heart muscle to overwork and promotes the formation of atherosclerotic plaques on the walls of the arteries;
- Total Cholesterol: excessive cholesterol increases the risk of deposits on artery walls;
- HDL – Cholesterol: it is a high-density lipoprotein useful to remove excess cholesterol. The smaller the quantity, the greater the cardiovascular risk;
- Diabetes: promotes atherosclerosis because it contributes the stiffening of the vasal endothelium of the arteries, and promotes oxidative processes by increasing cardiovascular risk;
- Overweight and obesity: excess weight increases the risk of hypertension, hypercholesterolemia and diabetes, risk factors for cardiovascular disease and stroke;
- Sedentary lifestyle: physical activity reduces body fat, allows a good control of blood sugar, increases insulin sensitivity, lowers ‘bad’ cholesterol and increases the ‘good’ one.
The non-modifiable factors are:
- Gender: in women the risk of cardiovascular disease increases dramatically after menopause;
- Inheritance: relatives with dyslipidemia, or with cardiovascular events before age 60;
- Age: The risk increases progressively over the years.
The Mediterranean diet? A magic formula!
In two previous articles, first talking about Ancel Keys, inventor of the Mediterranean diet, then about the principles of this style food, it emerged immediately that the Mediterranean diet, interpreted in the proper sense of the term and in the context of a healthy lifestyle, is one of the fundamental levers to act on modifiable factors that go to reduce the risk of cardiovascular disease.
The study in 2013 by Joanna Hlebowicz, ‘A high quality diet is associated with lower incidence of cardiovascular events in the Malmo diet and cancer cohort‘, describes that eating with a high consumption of vegetables, legumes, fruits, nuts, whole grain products, and mono and polyunsaturated fats reduces the risk of cardiovascular events in 32% for men and 27% for women.
There’s a ‘magic formula’ to feel good, it is called Mediterranean Adequacy Index (MAI-IAM), and the value is obtained by dividing the sum of the percentages of total kilocalories from food groups belonging to the Mediterranean diet by the sum of the percentages of the total kilocalories provided by food groups not belonging to this diet, namely:
|MAI-IAM =||(% kcal cereals + potatoes + vegetables + fruit + vegetables + fish + olive oils and seeds + wine)|
|(% kcal milk + cheese + meat + eggs + animal fats and margarines + candy + sugar)|
If the result of the index-MAI IAM is between 5 and 10, it means that we’re taking good care of our heart and ultimately our health: subject to the risk factors which cannot be changed, it is possible to measure the overall risk of developing cardiovascular disease and greatly reduce this index by acting on our lifestyle.