We have all heard of this threat. It has most likely affected someone in our family or amongst our friends. Unfortunately it started its stealthy incursion many years before it manifested itself with chest pain, temporary weakness on one side of the body, painful leg muscles on walking, a stroke, or sudden death from a massive heart attack. Because the problem began with very gradual narrowing of arteries, due to the build-up of plaque just under the surface of the arterial lumen, it is very difficult to discover without very invasive and costly procedures.
Atherosclerosis is the most common cause of death globally. According to the WHO, 17,9 million die annually from cardio-vascular disease, of which 80% are caused by atherosclerosis.
The early changes to major arteries have been identified at younger and younger ages. Already back in the early 1950s, up to 70% of young American soldiers who died in the Korean War, were found to have evidence of atherosclerosis, their average age being just 22 years. Studies done recently on young children who died in motor vehicle accidents in the US have found high incidences of atherosclerotic streaks, and early plaques.
Although there are well-known genetic conditions causing high blood cholesterol, the main underlying factor causing atherosclerosis, very few people can blame their genes. Having worked in rural Africa as a young doctor, I never saw a patient with a heart attack or stroke from atherosclerosis. But now, 40 years later, at that same hospital in Lesotho, manifestations of atherosclerosis are quite common. Certainly genetics has not changed in the population. So what has changed?
The most important factor is diet. Thanks to globalisation and marketing, people all around the world are eating far more highly- or ultra-processed foods, far more meat and chicken, and far more sugar and saturated fats, than our ancestors. Another important factor is a more sedentary lifestyle, associated with modern gadgets, office work, sitting in front of the computer, and being entertained for hours on end in front of the TV.
There is a way to stop this number one enemy from invading our lives, which we will discuss in the next few articles.
Dr Dave Glass
MBChB, FCOG(SA), DipIBLM
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