People with Cardiovascular Diseases
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Cardiovascular diseases
Cardiovascular pertains to cardio (heart) and vascular (blood vessels). Thus, cardiovascular disease (CVD) refers to dysfunctional conditions of the heart (heart disease) and vessels (particularly the arteries) that supply oxygen to organs and tissues throughout the body, including the brain, heart, and other vital organs. CVD includes arteriosclerosis, coronary artery disease, heart valve disease, arrhythmia, heart failure, hypertension, orthostatic hypotension, shock, endocarditis, disorders of the peripheral vascular system, and congenital heart disease and stroke. Blood vessels in humans, like those of other animals, have vascular "smooth muscles" that can alternatively relax and contract to accommodate fluctuations in blood flow and volume. A thin layer of "endothelial cells" in the vessels serves, in part, as a sensor mechanism to help regulate this process. The proper function of the endothelial cells, in turn, is driven by specific enzymes and signaling pathways.
Atherosclerosis, a disease of the large arteries, is the primary cause of heart disease and stroke. In westernized societies, it is the underlying cause of about 50% of all deaths. Epidemiological studies have revealed several important environmental and genetic risk factors associated with atherosclerosis. What has been known for some time is that blood vessels, as they age, lose much of their capacity to relax. If the vessels are narrowed by atherosclerotic lesions the problem is further exacerbated. High blood pressure is often the result, which in turn can lead to heart attacks, strokes, and death. We have learned that in older blood vessels, the cellular signaling process is breaking down. The vessels still have the ability to relax much as they did when they were younger, but they are not getting the message. A complex enzymatic process outlined in the new study explains how this "failure to communicate" occurs. An enzymatic reaction called "phosphorylation," which is essential to the signaling process, loses about half of its effectiveness in aging blood vessels.
Research done and progress so far
Two genes with effects on heart disease have been linked to human longevity. The (most well) best studied of these genes, called (apolipoprotein E (apoE)) ASPOE, produces a protein called apolipoprotein E that circulates in our blood. Researchers have found that those people who carry at least one copy of the E4 variant of the apoE gene have a higher risk of heart disease than those who carry an E2 variant. Statistically, people who survive to age 100 have been found to be about half as likely to carry the E4 gene and somewhat more likely to carry the E2. Interestingly, investigators have found that people possessing two copies of the apparently protective E2 (i.e., one from each parent) have an increased likelihood of high blood triglyceride levels, a predictor for heart disease. This would seem to negate its protective effect. A second gene with a known association with heart disease is the gene that produces a substance known as angiotensin converting enzyme (ACE). ACE affects blood pressure regulation. This research on both the apoE and ACE genes suggests some of the difficulty of untangling the effects of individual genes on complex disease and aging processes. Genes can have both positive and negative effects on specific diseases and aging in general. The researchers also discovered that ceramides, one type of lipid, or fat, are primarily responsible for the excessive activity of phosphates. And in laboratory experiments with blood vessels from rats, they were able to inhibit ceramide synthesis.
As is appropriate for many other disease concerns and health conditions, a diet that's heavy in fruits and vegetables seems to slow down the loss of blood vessel function. This overall process, the researchers said, is linked to a low-grade, chronic inflammation that occurs with aging, in blood vessels and probably many other metabolic functions. Efforts to understand and address these inflammatory processes are some of the most promising areas of chronic disease prevention and treatment. Scientists, for instance, have developed magnetic resonance imaging and other noninvasive ways to study the aging heart. Researchers have discovered a host of innovative drug treatments to help the ailing heart and arteries work better.
Future holds promise
Effective drugs for lowering cholesterol and high blood pressure have been developed. New weapons, particularly agents that block disease at the level of the vessel wall are needed. Over the past decade, a number of promising new targets have been identified. Preliminary studies in animals suggest that it may be possible not only to block the development of Atherosclerosis but also to achieve significant regression. The most critical clinical aspect of atherosclerosis is plaque rupture and thrombosis. In the future, interventions to slow accelerated aging of the heart and arteries in apparently healthy young and middle-age people could prevent or delay the onset of heart disease, stroke, and other cardiovascular disorders in later life. These interventions may take many forms. For instance, the more we understand about the changes that take place in cells and molecules during aging, the closer we get to the possibility of designing drugs targeted to those changes. Gene therapies can also target specific cellular changes and could potentially be a way to intervene in the aging process.
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