Coronary Artery Disease (CAD) Pathophysiology of CAD

Coronary artery disease is when the heart muscle is weakened and cannot pump the oxygen and nutrition’s needed efficiently (Huether & McCance, 2017; Hammer & McPhee, 2019). CAD decreased myocardial blood supply causing ischemia (Huether & McCance, 2017). Ischemia is defined as a temporary loss of blood supply to the cell, which becomes damaged and cannot function normally (Huether & MCCance, 2017). Ischemia occurs two ways when there is an increasing demand for oxygen related to the supply, or a decrease in oxygen supply (Hammer & McPhee, 2019). The leading cause of CAD is atherosclerosis, which is fatty streaks in the vessels that cause narrowing of arteries (Hammer & McPhee, 2019).

Aging and CAD

The normal aging process will increase the thicken and stiffness of vessels and arteries in the heart (American Heart Association, [AHA], 2019). Thinking and stiffening of veins will increase the need for the blood to pump harder, which increases blood pressure. Coronary artery disease is common amongst the elderly population (Madhavan, Gersh, Alexander, Granger, & Stone, 2018).  29.9% of patients ages 75-84 develop CAD compared to 3.9% in ages 45-54 (Madhavan et al., 2018). Men have a slightly high prevalence than women to develop CAD (Madhavan et al., 2018).

Effects of Hypertension for CAD

High blood pressures cause strain on the heart to forcefully push blood out into the arteries and vessels (American Heart Association [AHA], 2019). The forcefully push of blood causes damage to the lining (AHA, 2019). These tears in the lining allow a build-up of fat, and cholesterol called plaque (AHA, 2019). When the plaque forms, it slows the flow of blood back, and the more plaque, the more the vessels and arteries get blocked, eventually causing myocardial infarction or heath attack (AHA, 2019). Hypertension increases the risk for CAD for all age’s groups, and both genders (Rosendorff et al., 2015) Hypertension increases the risk of CAD 2 or 3 times (Hammer & McPhee, 2019). 

Other Risk Factors

Family history can increase the risk of developing CAD (Huether & McCance, 2017). Modifiable risks include smoking, obesity, diabetes, and dyslipidemia (Huether & McCance, 2017).

Reducing the risk by making healthy lifestyle modification can reduce the risk of CAD. Controlling high blood pressure can also reduce risk.

Reference

American Heart Association [AHA]. (2019). HBP and the cardiovascular system. Retrieved from: https://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=highbp

Madhavan, M. V., Gersh, B. J., Alexander, K. P., Granger, C. B., & Stone, G. W. (2018). Coronary artery disease in patients ≥80 years of age. Journal of the American College of Cardiology, 71(18), 2015–2040. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jacc.2017.12.068

Rosendorff, C., Lackland, D. T., Allison, M., Aronow, W. S., Black, H. R., Blumenthal, R. S., … White, W. B. (2015). Treatment of hypertension in patients with coronary artery disease: A scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Journal of the A