The most common form of cardiovascular disease is called atherosclerosis, a disease of the arteries that can strike at any age, although it is not a serious threat until we reach our fifth or sixth decades. This is due in part to cellular changes that make the blood vessels less elastic (hardening of the arteries) and weaken the heart muscles, but it is largely due to poor diet and lack of exercise. This disease is characterized by a narrowing of the arteries, caused by the formation of plaques (deposits) containing dead cells and cholesterol. Several factors influence the appearance of plaques, including high levels of cholesterol (and cholesterol precursors, such as triglyceride) in the blood, high blood pressure, and cigarette smoke. The body removes excess cholesterol from the blood using a protein called apolipoprotein E (ApoE). ApoE, encoded by a gene on chromosome 19, binds to cholesterol and delivers it to liver cells, which store it for later use. Mutant ApoE loses the ability to bind to liver receptors, resulting in a buildup of cholesterol in the blood.
A second form of cardiovascular disease affects the coronary arteries, the blood vessels that carry blood to the cardiomyocytes, or heart muscle cells. If coronary arteries become blocked or otherwise damaged, the cardiomyocytes die from lack of oxygen. In serious cases, this can lead to a massive heart attack and death of the patient. In milder cases, damage to the heart is minimal but coronary circulation is insufficient to allow the patient a normal lifestyle. Many treatments are available for cardiovascular disease, including surgical intervention, angioplasty, and gene therapy. But this disease, like diabetes, is largely the result of lifestyle and is not an inevitable consequence of age. A combination of adequate exercise and a healthy diet begun at an early age is the best treatment.
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