RISK OF ANGINA AND CHANGES IN THE BLOOD VESSEL WALLS

April 2nd, 2009 by admin

So far I have listed elements within the circulating blood that can heighten your risk of angina, but changes in the blood vessel walls also play a part. If your blood vessels remain wide open and their lining is smooth, blood flow within them remains fast and adequate. If they become narrowed, then the flow through them slows down. The change can be dramatic. Halve the diameter of a blood vessel and the flow of blood through it decreases by nine-tenths! That may still provide enough oxygen and glucose for a heart at rest, but not when you are running or even walking briskly or climbing stairs.

I have already mentioned one cause of narrowing of these blood vessels—atheroma. However, an artery’s diameter is also governed by the tone in the muscles in its walls. Every artery has in its walls muscles that encircle it. When they contract, the artery narrows, and blood flow through it slows; when they relax, the artery opens up, and the flow increases. If your arteries are in a state of contraction, so that they are narrower than they should be, the blood flow through them is either less, or the pressure to keep the flow normal must rise. In the first instance, the supply of oxygen from that artery is diminished, and in the second, the demand on the heart is increased. Often, both occur together. Obviously, this is yet another set of circumstances that can promote angina.

The combination of a high level of fibrinogen, stiffened red cells, high cholesterol, high blood pressure, hyperactive aggregated platelets, and increased arterial muscle tone, all on top of atheroma in the coronary arteries, is a lethal one. Each element of that combination contributes either to lowering the supply of oxygen and glucose to the heart muscle or to increasing the demand of the heart for oxygen, and therefore to the onset of angina.

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