What is going on? iwith HBP, Coronary heart disease, Heart attack, Stroke, Arrythmia, Angina, Thrombosis / Embolism. Heart / kidney failure
Coronary Heart Disease (CHD) aka. Coronary Artery Disease (CAD) / Ischaemic Heart Disease (ICD)
CHD can result in a reduced blood supply to the heart (ischaemia).  This occurs primarily as a consequence of atherosclerotic blockage in the walls of the aorta and 2 main coronary arteries that supply oxygen and nutrients to the heart muscle. American Heart Association, 2008
In the U.S., Coronary Heart Disease (CHD) kills one person every minute.   CHD is the most common cardiovascular disease in the Western world and responsible for about half of heart disease related deaths. CHD claimed 371,506 American lives in 2022, with more women than men dying each year since 1984.
CHD can cause arrythmia (abnormal heartbeat).
Chronic high blood pressure (HBP) / hypertension
HBP occurs due to narrowing of the body’s smaller arteries (arterioles) increasing resistance to blood flow.   This can be caused by the presence of arterial plaque (atherosclerosis) or the body’s constriction of blood vessels in response to many triggers.
Normal blood pressure is typically less than 120 / 80 (systolic pressure / diastolic pressure) mm Hg.  A chronic HBP higher than 130 / 80 is considered to be hypertension – almost half of U.S. adults in 2017   American college of Cardiology
Hypertension is either primary (due to such as age, genetics, lifestyle /diet and occurs over time) or secondary (5-10% of people with HBP have a specific attributable cause, such as hyperthyroidism)
Hypertension is either stage 1 ( systolic 130-139 mm Hg, or diastolic 80-89 mm Hg), stage 2 (systolic at least 140 mm Hg or diastolic at least 90 mm Hg), or hypertensive crisis / medical emergency (systolic > 180 mm Hg or diastolic > 120 mm Hg )
Both globally and in N. America high blood pressure presents the highest risk factor for death (measured across all age groups and both sexes). After HBP, comes smoking, high blood sugar, obesity and outdoor air pollution.  World in data, 2017
Heart Attack - a.k.a. Myocardial Infarction (MI)
The peak time for a heart attack is between 6:00 A.M. and 12:00 noon.
A heart attack occurs when coronary arteries supplying the heart with oxygenated blood become narrowed by atherosclerotic plaque reducing or blocking the blood flow. Without oxygen the heart muscle suffers injury and begins to die. If not quickly treated this can be fatal.
Atherosclerotic plaque rupture forming a blood clot (called arterial thrombosis) is present in coronary arteries of 80-90% of fatal heart attacks. Davies MJ et al, Thrombosis and acute coronary artery lesions in sudden cardiac ischemic death, NEJM, 1984.  A blood clot (thrombus) forms where atherosclerotic plaque ruptures inside the wall of a coronary artery, which can obstruct oxygen-carrying blood flowing to the heart, thus reducing or cutting off its oxygen supply.
Each year, more than a million people in the U.S. have a heart attack, and about half of them die.  Of those who die, about half of them do so within 1 hour of the start of symptoms, and before reaching the hospital. The life quality and longevity of an MI survivor is mainly determined by the amount of damage done to the heart muscle.   If treatment is not started quickly, the affected area of heart muscle begins to die. If a person survives a heart attack, the injured area of the heart muscle is replaced by scar tissue, which weakens the pumping action of the heart and can lead to heart failure and other complications.
Thrombosis / Embolism
Thrombosis. The formation of a blood clot inside an artery (arterial thrombosis) or vein (veinous thrombosis) or heart chamber can cause a blockage to blood flow. Arterial thrombosis can reduce oxygen supply pumped from the heart and is the most common cause of heart attacks and strokes. Veinous thrombosis can block blood flow back the heart for oxygenation by the lungs, and is the most common cause of a pulmonary embolism (blood clot in the lung).
Embolism. Occurs when a clot / thrombus breaks off from where it was formed (now called an embolus) and travels in the blood to get stuck in a smaller vessel, where it can cause a blockage resulting in such as a stroke or pulmonary embolism.. Â
Stroke
A stroke occurs when the blood supply to part of the brain is interrupted or reduced.   Causing brain cells to die as oxygen and glucose delivery is disrupted. Sensation, movement or function controlled by the damaged part of the brain is impaired. Stroke kills one third of its victims. There are 3 types of strokes:
Hemorrhagic Stroke.    Leakage or rupture of a blood vessel in or around the brain, as a consequence of a weakened vessel wall (brain aneurism) and/or increased blood pressure; the leaking blood damages brain cells by putting pressure on them;
Ischaemic Stroke.   A clot in the large-sized internal carotid or vertebral arteries supplying the blood to the brain, usually as a consequence of;
Thrombosis (clot) in the large-sized internal carotid or vertebral arteries.    These arteries supply the blood to the brain;
Embolism.    When a small clot, originating either from a large artery (E.g. carotid artery) or from the heart, travels (embolizes) to the brain’s supply arteries causing (a) Blockage of an arteriole in the brain affecting just a small part of the brain, or even (b) Blockage of the larger arteries supplying the brain.
Mini-stroke /Transient Ischaemic Attack (TIA)
Angina
Angina is felt as a heavy, tight squeezing pain in the chest.   Caused by low blood flow yielding a poor oxygen supply to the heart; generally occurs when the heart is working hard and thus requiring more oxygen soon after a meal.
