Coronary atherosclerosis – the hidden killer among us

An unexpectedly high number of people have a hidden risk of heart attack, a new study reveals. They have no family history of heart disease and remain free of symptoms. But the research shows they have coronary atherosclerosis that has reached the ‘obstructive’ stage and are at risk of heart attack, and even death.

News of a friend or family member suffering a heart attack often comes as somewhat of a shock. In many cases, though, that shock is more a result of the timing of the attack rather than its occurrence.

In most cases, symptoms will be present, or the patient will be aware of pre-existing risk factors such as poor diet or being overweight. However, a Danish study indicates that as many 10 per cent of heart attack victims have no symptoms at all.

The study examined over 9500 people aged 40 or over who had no known symptoms of cardiovascular disease. They were assessed using computed tomography angiography (CTA) to look for any previously undiagnosed obstructive coronary atherosclerosis.

Of the group, 54 per cent were free of atherosclerosis, and 36 per cent had what is known as unobstructive coronary atherosclerosis. Those at risk were the remaining 10 per cent. These participants were revealed as having obstructive coronary atherosclerosis.

Lead author of the study Dr Klaus Fuglsang Kofoed, clinical associate professor in the department of clinical medicine at the University of Copenhagen, said such a high rate had not been expected.

“The greatest surprise was that as high as 10 per cent had obstructive diseases yet without having symptoms,” he said, adding that it is an important enough finding to warrant further analysis.

What is atherosclerosis?

In simple terms, coronary atherosclerosis is the build-up of plaque inside the arteries that take blood to the heart. The plaque in this case is made of cholesterol deposits. In time this build-up can narrow the arteries, restricting blood flow to the heart. This can result in the symptoms commonly associated with coronary risk, including chest pain and shortness of breath.

Dr Kofoed’s study indicates, however, that a number of those who have reached the obstructive stage do not display any such symptoms.

The advent of CTA technology has made diagnoses of diseases such obstructive coronary atherosclerosis more readily accessible. Until the late 1990s, a far more invasive technique of coronary angiography was used. As well as having its own risks, it was a technique most patients would prefer to avoid.

With CTAs, the risks and inconvenience are greatly reduced. Further advances in technology since their introduction have delivered CTA images of much higher resolution. This has made it easier for specialists to identify any plaque build-up.

What do the results of this new study mean for the asymptomatic people out there? Should we be rushing to our GPs and demanding a CTA? While tempting, the practical implications of everyone making such requests would place undue pressure on an already straining healthcare system.

A common sense approach is required here, as it is with most aspects of health and wellbeing. Try to limit your intake of high cholesterol foods and talk to your GP about any concerns you may have about the health of your heart.

Are you careful with your diet? Are you tempted to ask your GP for a precautionary scan? Share your thoughts in the comments section below.

Also read: Coronary heart disease is the biggest killer of women worldwide

Andrew Gigacz
Andrew Gigacz
Andrew has developed knowledge of the retirement landscape, including retirement income and government entitlements, as well as issues affecting older Australians moving into or living in retirement. He's an accomplished writer with a passion for health and human stories.
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