What are the primary causes of Irritable Bowel Syndrome. How does IBS affect the digestive system. What are the most common symptoms of IBS. Can IBS be effectively managed through lifestyle changes. Are there specific triggers that exacerbate IBS symptoms. How is IBS diagnosed and treated by medical professionals. What role does stress play in the development and progression of IBS.

Understanding Irritable Bowel Syndrome: A Complex Digestive Disorder

Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder that affects millions of people worldwide. Despite its prevalence, the exact cause of IBS remains elusive, with researchers believing it to be a result of various interacting factors. This article delves into the intricacies of IBS, exploring its potential causes, symptoms, and management strategies.

The Multifaceted Nature of IBS: Exploring Potential Causes

While the precise etiology of IBS is not fully understood, several factors have been identified as potential contributors to its development:

• Brain-gut interaction: Dysfunction in the communication between the brain and the digestive system may play a crucial role in IBS.
• Gastrointestinal motility: Abnormal muscle contractions in the intestines can lead to changes in bowel habits.
• Visceral hypersensitivity: Increased sensitivity to pain in the gut may contribute to IBS symptoms.
• Stress and psychological factors: Emotional stress and mental health conditions are closely linked to IBS.
• Gut microbiota imbalance: Alterations in the gut’s bacterial composition may influence IBS development.
• Post-infectious IBS: Some individuals develop IBS following a gastrointestinal infection.
• Genetic predisposition: Certain genetic factors may increase susceptibility to IBS.

Is there a single definitive cause of IBS? No, IBS is considered a multifactorial disorder, meaning it likely results from a combination of these factors rather than a single cause.

Recognizing the Symptoms: Hallmarks of Irritable Bowel Syndrome

IBS manifests through a range of symptoms that can vary in intensity and duration among individuals. The most common symptoms include:

1. Abdominal pain or discomfort, often related to bowel movements
2. Changes in bowel habits (diarrhea, constipation, or alternating between both)
3. Bloating and abdominal distension
4. Excessive gas
5. Mucus in the stool
6. Feeling of incomplete bowel evacuation

Do IBS symptoms remain constant over time? IBS is characterized by its chronic nature, but symptoms often fluctuate, with periods of exacerbation and remission.

IBS Subtypes: Understanding the Different Manifestations

IBS is typically classified into three main subtypes based on predominant bowel habits:

• IBS-D: Diarrhea-predominant
• IBS-C: Constipation-predominant
• IBS-M: Mixed type (alternating diarrhea and constipation)

Can an individual’s IBS subtype change over time? Yes, some people may experience shifts in their predominant symptoms, potentially moving between subtypes.

The Brain-Gut Axis: A Key Player in IBS Pathophysiology

The intricate connection between the brain and the digestive system, known as the brain-gut axis, plays a pivotal role in IBS. This bidirectional communication network involves the central nervous system, enteric nervous system, and gut microbiota.

How does the brain-gut axis influence IBS symptoms? Disruptions in this complex interplay can lead to altered gut motility, increased visceral sensitivity, and changes in intestinal permeability, all of which contribute to IBS symptoms.

The Role of Stress and Psychological Factors

Stress and psychological factors have a significant impact on IBS. Many individuals with IBS report symptom exacerbation during periods of increased stress or emotional distress. This connection is believed to be mediated through the brain-gut axis.

Can managing stress improve IBS symptoms? Yes, stress management techniques such as cognitive-behavioral therapy, mindfulness, and relaxation exercises have shown promise in reducing IBS symptom severity.

Gut Microbiota: The Microbial Ecosystem’s Influence on IBS

The human gut hosts trillions of microorganisms collectively known as the gut microbiota. This complex ecosystem plays a crucial role in digestive health, immune function, and overall well-being. Research has shown that individuals with IBS often have alterations in their gut microbiota composition compared to healthy individuals.

How does gut microbiota dysbiosis contribute to IBS? Imbalances in gut bacteria can lead to changes in intestinal permeability, inflammation, and altered gut motility, all of which may contribute to IBS symptoms.

The Potential of Probiotics and Prebiotics

Given the role of gut microbiota in IBS, there has been growing interest in the use of probiotics and prebiotics as potential therapeutic options:

• Probiotics: Live beneficial bacteria that may help restore balance to the gut microbiota
• Prebiotics: Non-digestible fibers that serve as food for beneficial gut bacteria

Are probiotics effective for all IBS patients? The effectiveness of probiotics can vary among individuals, and more research is needed to determine which specific strains are most beneficial for different IBS subtypes.

Dietary Factors and IBS: Navigating the Complex Relationship

Diet plays a crucial role in IBS management, with many patients reporting that certain foods can trigger or exacerbate their symptoms. While dietary triggers can vary widely among individuals, some common culprits include:

• FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols)
• Caffeine and alcohol
• Spicy or fatty foods
• Dairy products (in lactose-intolerant individuals)
• Gluten (in some cases)

Can a low FODMAP diet help manage IBS symptoms? Many studies have shown that a low FODMAP diet can be effective in reducing IBS symptoms for some patients, particularly those with IBS-D.

The Importance of Individualized Dietary Approaches

Given the heterogeneous nature of IBS, there is no one-size-fits-all dietary solution. Working with a registered dietitian can help individuals identify their specific dietary triggers and develop a personalized nutrition plan.

Should all IBS patients follow a restrictive diet? No, overly restrictive diets can lead to nutritional deficiencies and may not be necessary for all IBS patients. A balanced approach, focusing on identifying individual triggers, is often more sustainable and effective.

Diagnosis and Treatment: Navigating the Medical Landscape of IBS

Diagnosing IBS can be challenging due to the lack of specific biomarkers. Physicians typically rely on symptom-based criteria, such as the Rome IV criteria, and the exclusion of other gastrointestinal disorders.

What tests are used to diagnose IBS? While there is no definitive test for IBS, doctors may perform blood tests, stool analyses, and imaging studies to rule out other conditions that can mimic IBS symptoms.

Treatment Strategies: A Multifaceted Approach

IBS treatment often involves a combination of approaches tailored to the individual’s specific symptoms and needs:

1. Dietary modifications
2. Stress management techniques
3. Medications (e.g., antispasmodics, laxatives, antidiarrheal agents)
4. Psychological therapies (e.g., cognitive-behavioral therapy, hypnotherapy)
5. Probiotics and supplements
6. Regular exercise

Is there a cure for IBS? While there is no cure for IBS, many patients can effectively manage their symptoms through a combination of these treatment strategies.

The Role of Genetics in IBS: Unraveling Hereditary Factors

Research suggests that genetic factors may contribute to an individual’s susceptibility to IBS. While no single “IBS gene” has been identified, studies have shown that IBS tends to run in families, indicating a potential genetic component.

How significant is the genetic influence on IBS development? The exact contribution of genetics to IBS risk is still being studied, but it’s likely that genetic factors interact with environmental influences to determine an individual’s susceptibility.

Epigenetics and IBS: Beyond DNA Sequence

Epigenetic modifications, which affect gene expression without altering the DNA sequence, may also play a role in IBS. These modifications can be influenced by factors such as diet, stress, and environmental exposures.

Can epigenetic changes be reversed to alleviate IBS symptoms? While research in this area is still in its early stages, understanding epigenetic influences on IBS could potentially lead to new therapeutic approaches in the future.

The Impact of IBS on Quality of Life: Beyond Physical Symptoms

IBS can significantly impact an individual’s quality of life, affecting various aspects of daily functioning:

• Work productivity and absenteeism
• Social relationships and activities
• Mental health and emotional well-being
• Sleep quality
• Dietary choices and eating habits

How can individuals with IBS improve their quality of life? Adopting a holistic approach to management, including addressing both physical symptoms and psychological well-being, can help improve overall quality of life for IBS patients.

The Importance of Support Systems

Having a strong support system can be invaluable for individuals living with IBS. This may include family, friends, support groups, and healthcare professionals who understand the challenges of managing a chronic condition.

Are there online resources available for IBS patients? Yes, numerous online support groups, forums, and educational resources are available to help individuals with IBS connect with others and stay informed about the latest management strategies.

In conclusion, Irritable Bowel Syndrome is a complex and multifaceted disorder that requires a comprehensive approach to understanding and management. By addressing the various factors that contribute to IBS, including gut-brain interactions, microbiota imbalances, dietary influences, and psychological factors, individuals can work towards effectively managing their symptoms and improving their overall quality of life. As research in this field continues to evolve, new insights and treatment strategies are likely to emerge, offering hope for better outcomes for those living with IBS.

Symptoms & Causes of Irritable Bowel Syndrome

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What are the symptoms of IBS?

The most common symptoms of irritable bowel syndrome (IBS) are pain in your abdomen, often related to your bowel movements, and changes in your bowel movements. These changes may be diarrhea, constipation, or both, depending on what type of IBS you have.

Other symptoms of IBS may include

• bloating
• the feeling that you haven’t finished a bowel movement
• whitish mucus in your stool

Women with IBS often have more symptoms during their periods.

IBS can be painful but doesn’t lead to other health problems or damage your digestive tract.

To diagnose IBS, you doctor will look for a certain pattern in your symptoms over time. IBS is a chronic disorder, meaning it lasts a long time, often years. However, the symptoms may come and go.

What causes IBS?

Doctors aren’t sure what causes IBS. Experts think that a combination of problems may lead to IBS. Different factors may cause IBS in different people.

Functional gastrointestinal (GI) disorders such as IBS are problems with brain-gut interaction—how your brain and gut work together. Experts think that problems with brain-gut interaction may affect how your body works and cause IBS symptoms. For example, in some people with IBS, food may move too slowly or too quickly through the digestive tract, causing changes in bowel movements. Some people with IBS may feel pain when a normal amount of gas or stool is in the gut.

Certain problems are more common in people with IBS. Experts think these problems may play a role in causing IBS. These problems include

• stressful or difficult early life events, such as physical or sexual abuse
• certain mental disorders, such as depression, anxiety, and somatic symptom disorder
• bacterial infections in your digestive tract
• small intestinal bacterial overgrowth, an increase in the number or a change in the type of bacteria in your small intestine
• food intolerances or sensitivities, in which certain foods cause digestive symptoms

Research suggests that genes may make some people more likely to develop IBS.

Last Reviewed November 2017

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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Lin Chang, M.D., David Geffen School of Medicine, University of California Los Angeles

What’s causing your IBS – Harvard Health

While the exact cause of irritable bowel syndrome, or IBS, is unknown, studies have suggested that IBS might be related to a few specific changes in the body. Some symptoms may be caused by spasms, uncontrolled contractions in the muscles of the colon. The nerve endings in the intestines also may become unusually sensitive, magnifying pain. The reasons for these changes are not always known, but factors that have been linked with IBS include bacterial overgrowth, use of antibiotics, and stress, among others.

Psychological factors. The brain and gut are intimately connected. Your thoughts and emotions can trigger symptoms in the gut, and the health of your gut can shape your mental well-being. Stress can cause more contractions in the intestines and increase sensitivity. It’s not clear whether stress or other psychological factors may be a cause of IBS or vice versa. However, we do know that people with IBS often have higher levels of stress and anxiety and that this distress also can make IBS symptoms worse. A 2017 study in the Journal of Neurogastroenterology and Motility found that people with IBS have higher levels of depression and anxiety compared with those who don’t have the disorder. IBS also is more common among people who experienced psychological trauma as children.

Antibiotics. The human digestive tract contains trillions of bacteria, viruses, and fungi known collectively as the gut microbiota or gut flora. These microorganisms play several critical roles in our health, including digestion and immune system function. When we take antibiotics to combat bacterial infections, the drugs also kill helpful bacteria in the gut. Repeated treatments or long-term use of antibiotics may alter the gut flora in a way that disrupts the colon’s normal function. Some animal and human research suggests that this disruption may lead to IBS in some cases. However, studies have not had consistent results, so more research is needed.

Bacterial overgrowth. Some people with IBS also have a surplus of bacteria in the small intestines, a condition called small intestinal bacterial overgrowth (SIBO). It’s unclear whether SIBO can be a cause of IBS, but people with IBS are more likely than others to test positive for SIBO. In addition, some research has found that IBS symptoms often decrease after antibiotic treatment that focuses on bacteria in the small intestine.

SIBO occurs when extra bacteria in the colon back up into the small intestine. In this situation, people often have symptoms typical of IBS such as bloating, constipation, abdominal pain, and diarrhea. Estimates vary about how many people diagnosed with IBS also have SIBO, but research in the March 2017 issue of Gut and Liver suggested it may be between 19% and 37%. Most studies diagnose SIBO with a breath test that measures gases released by the body’s breakdown of sugars such as glucose and lactulose. There is a debate, however, about the reliability of the test results.

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No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

causes, symptoms and treatment at the FSCC FMBA

General description

Ischemic heart disease (CHD) is the leading cause of death worldwide. According to experts, in 2030 more than 23 million people will die from CVD.

Coronary artery disease (CHD) is a disease caused by insufficient supply of oxygen and nutrients to the heart (myocardium), which occurs due to impaired blood supply to the myocardium due to damage to the coronary arteries. Clinical manifestations of coronary artery disease are diverse: from acute manifestations in the form of myocardial infarction or sudden cardiac death to long-term chronic diseases – angina pectoris (periodic retrosternal pain), postinfarction cardiosclerosis, chronic heart failure.

Causes

IHD occurs as a result of atherosclerosis of large (epicardial) coronary (cardiac) arteries of varying degrees: from a slight narrowing of the lumen in the vessel to its complete blockage by atheromic (cholesterol, fatty) masses or a thrombus that has developed at the site of a “vulnerable” (damaged) atherosclerotic plaque (ASP) . Other causes of coronary artery disease are spasm of the coronary arteries and damage to the microvasculature in the myocardium. In most cases, they also develop against the background of existing atherosclerosis.

It is possible to identify the most susceptible to the development of coronary heart disease (CHD) groups of the population: people suffering from high blood pressure; addicted to smoking; suffering from high cholesterol; diabetes mellitus; with chronic kidney disease. Male sex and advanced age are also powerful risk factors for developing coronary artery disease.

Symptoms of coronary heart disease

The main, but far from the only symptom of coronary artery disease is pressing or squeezing pain behind the sternum or in the region of the heart. In chronic coronary artery disease, pain occurs initially during exercise and causes a gradual decrease in its tolerance. In the acute form of coronary heart disease, myocardial infarction or a pre-infarction state (unstable angina pectoris) develops.

During an attack of coronary artery disease, the patient may also feel:

• pain or burning in the chest, under the shoulder blade, in the back, in the upper abdomen;
• feeling of heaviness in the chest;
• sensation of uneven heartbeat, irregular heartbeat, palpitations;
• feeling of sinking heart;
• shortness of breath;
• weakness;
• nausea;
• dizziness and fainting;
• sweating.

The discomfort may disappear or disappear completely after the completion of physical activity. With myocardial infarction or with unstable angina, the connection between complaints and physical activity is lost, and complaints can develop at rest and last for a long time (tens of minutes, hours). Usually, all of the above symptoms do not appear at the same time. In various forms of coronary heart disease, a certain feeling of discomfort dominates.

If you notice such sensations in yourself, contact your cardiologist as soon as possible. If chest pain or other symptoms described above do not disappear within 10 minutes at rest, call the ambulance team. IHD progression can develop slowly over years. At the same time, in some patients, coronary disease is asymptomatic or with erased or atypical symptoms.

To prevent disturbances in the work of the heart or the development of severe forms of coronary artery disease, undergo a comprehensive examination of the heart at our center of the Federal Research and Clinical Center of the Federal Medical and Biological Agency. Running coronary disease is very dangerous! At a later stage, it can lead to a fatal heart attack or severe heart failure with severe disability.

IHD diagnostics

Diagnosis of coronary artery disease is carried out by cardiologists in several stages. When questioning the patient, complaints are clarified, symptoms that may be characteristic of coronary heart disease are clarified. Examination of the patient helps to note visual changes – swelling and discoloration of the skin (cyanosis), listening to the heart reveals murmurs, rhythm disturbance.

Next, the patient passes laboratory tests for certain indicators in the blood, which may indicate a pathology. Also important is the standard biochemical analysis, as well as the determination of glucose and cholesterol levels.

But the most accurate method for diagnosing coronary disease is instrumental:

• ECG;
• ultrasound of the heart;
• stress tests with exercise or drug stimulation of the heart;
• Holter ECG monitoring;
• angiography of the coronary arteries (coronary angiography).

Timely examination helps to avoid serious consequences and the development of an irreversible form of coronary heart disease. Give your health a few hours, because this time will help preserve the quality of life in the future.

Prevention of coronary heart disease

Prevention of CVD is much easier than cure. To maintain healthy arteries and blood vessels, it is necessary to eliminate risk factors that negatively affect your health:

• Smoking cessation;
• Blood pressure monitoring
• Normalization of the level of “bad” cholesterol (low density lipoprotein)
• Combating stress and depression
• Minimizing alcohol intake;
• Refusal of smoked, fatty, fried and salty foods.

Give more time to an active lifestyle: moderate physical activity, therapeutic exercises, morning exercises, walking, swimming, dancing. Physical activity will help strengthen the walls of blood vessels and maintain normal weight, if necessary, reduce it.

The most important thing in the prevention of coronary artery disease is timely observation by a specialist. In order not to visit medical institutions several times to pass all the necessary tests and undergo research, contact our cardiology center. FSCC FMBA offers patients several programs for a comprehensive study of the heart. You can get acquainted with them here.

IHD treatment

When IHD is detected, the cardiologist determines the treatment model. Our clinic can offer you:

• drug therapy for coronary artery disease – a complex of modern medicines is prescribed, which allows you to control the symptoms and significantly improve the prognosis of the disease. The main drugs for the treatment of coronary artery disease are: antiplatelet agents (reduce the likelihood of blood clots in the coronary arteries), B-blockers, nitrates, calcium antagonists, enzyme inhibitors / angiotensin II receptor blockers (allow to prevent the development of pain, shortness of breath, edema) and statins (allow to reduce and control cholesterol). Treatment of coronary disease can take place on an outpatient basis or in the cardiology department of our center. When drug therapy for coronary artery disease does not help, they seek advice from a cardiac surgeon who will apply the following treatment methods:

  • surgical intervention aimed at myocardial revascularization (restoration of normal blood flow to the heart muscle):
  • stenting of affected arteries of the heart – intravascular surgery. Under local anesthesia, a catheter is inserted through the radial (on the forearm) or less often through the femoral (in the groin) artery, through which a special device is passed into the arteries of the heart. A special metal frame construction coated with drugs that suppress inflammation at the site of intervention is installed with the help of a balloon in the place of narrowing of the vessel. The balloon expands, as a result of which the stent presses the cholesterol plaque against the walls of the vessel and restores its patency;
  • coronary artery bypass surgery is an open heart surgery, the purpose of which is to restore a full blood supply. It is carried out by bypassing the place of narrowing of the vessel with the help of shunts (vascular prostheses), which redirect blood flow from the clogged areas of the arteries to healthy ones. The most commonly used coronary bypass grafts are the patient’s own arteries and veins. At the same time, arterial bypasses have a significant advantage in terms of long-term improvement in prognosis and pain relief as a result of surgery. In our Department of Cardiac Surgery, the operation is performed both with the help of cardiopulmonary bypass, and without (off pump).

The FSCC FMBA Cardiology Center is one of the few that performs coronary bypass surgery using mini-thoractomy. This method of surgery significantly speeds up postoperative rehabilitation and has no significant restrictions on physical activity within three months after the operation.

Our center employs highly qualified specialists who have confirmed their experience at the international level. Many years of experience and high-tech equipment allow us to achieve excellent results in surgical procedures.

In their daily practice, our doctors use the latest achievements of medical science and the most advanced medical technologies. Offering treatment to patients with coronary artery disease, our cardiologists, angiosurgeons and cardiac surgeons are always looking for the most effective, less traumatic and most appropriate way for each individual patient to carry it out.

It is important for us not only to save you from suffering, but also to ensure a long and comfortable life.

With care for you and your heart!

This article is an informational material and is not intended for self-diagnosis and self-treatment. If signs of discomfort appear, you should contact your doctor.

Causes, risk factors for CHD and social aspects

Coronary artery disease (CHD) is a common disease with severe complications. The incidence of coronary artery disease is associated with its multifactorial nature and the social characteristics of the environment in which patients are located. Why ischemia develops, who is at risk and how to assess this risk for yourself – we tell in the article.

Why ischemia occurs in the myocardium

The heart muscle is supplied with blood by the coronary, or coronary, vessels, which bring oxygenated (oxygenated) blood to the myocardium and carry away oxygen-deprived blood. If this process is disturbed and the inflow of oxygenated blood to the myocardium does not cover the oxygen demand of the heart muscle, ischemia develops in the heart.

The blood supply to the myocardium can be disturbed both slowly and quickly – from several years to hours or even minutes. With prolonged chronic oxygen starvation, stable or progressive forms of angina pectoris develop. Postinfarction cardiosclerosis also belongs to the chronic form of coronary artery disease. In situations of rapid disruption of blood supply, acute forms of ischemic disease occur – sudden coronary death, unstable angina, or myocardial infarction.

The causes of insufficient myocardial oxygenation are divided into non-coronary – if the problem is located outside the vessels (a sharp jump in pressure, tachycardia or hypertrophy of the heart muscle) and coronarogenic, when the coronary vessels are to blame for oxygen starvation of the heart, in which the lumen narrows or spasm occurs.

Coronary causes of myocardial ischemia

• Atherosclerosis is a narrowing of the lumen of blood vessels due to the deposition of cholesterol in the form of plaques or uniform impregnation of the wall with lipid compounds. Without diet and other aspects of disease prevention, the lumen of the vessels will progressively narrow, annually increasing the risk of developing acute forms of coronary artery disease.

• Anatomical malformations of the coronary vessels (formed in utero, that is, during the development of the fetus during pregnancy).

• Coronaritis is an inflammatory process in the coronary vessels, caused by systemic pathologies of the connective tissue, autoimmune or general infectious diseases. Inflammatory processes in the walls of the coronary arteries lead to edema, a change in their structure and a decrease in the lumen, which leads to a deterioration in the blood supply to the myocardium.

• Dissection of an aortic aneurysm – tearing of the aorta is accompanied by blood flow into the space between the layers of its wall, which leads to progressive dissection of the latter and narrowing of its lumen.

• Coronary embolism of various origins is a complete or partial blockage of the lumen of the coronary arteries by foreign bodies, gases, tissue particles, including fatty tissue, and also by a thrombus. As a result, the blood supply to the heart is stopped, which causes a sharp oxygen starvation and subsequent necrosis of the myocardium.

Prolonged oxygen starvation of the myocardium can lead to the development of chronic forms of coronary artery disease, and a sharp one – to myocardial infarction.

IHD risk factors

Factors in the development of coronary heart disease are divided into two groups – deterministic, which cannot be influenced, and non-deterministic, amenable to adjustment.

Deterministic factors

Genetic:

• age – although coronary artery disease often develops in the elderly, at present this disease is “getting younger”;

• gender – men are more likely to suffer from myocardial ischemia, since the female body synthesizes estrogens that have a beneficial effect on blood vessels and the heart, however, during menopause, the vessels lose “estrogen protection”, which increases the incidence of coronary artery disease in women;

• obesity, diabetes mellitus, dyslipidemia and arterial hypertension in a family history.

Anatomical, physiological and biochemical:

• hypertonic disease;

• obesity;

• dyslipidemia;

• diabetes.

Non-deterministic (controllable) factors

• Low physical activity. The lack of regular exercise slows down blood flow, which creates conditions for thrombosis, and weak contractions of an untrained heart reduce myocardial oxygenation.

• Arterial hypertension. Vessels that are in tension for a long time pass less blood, leading to oxygen starvation of the heart muscle.

• Overweight (including metabolic syndrome). Obesity is accompanied by lipid degeneration of the heart, the deposition of fatty complexes in the walls of blood vessels and an increased content of lipids in the blood. All this together impedes the movement of blood and normal oxygenation of the myocardium.

• Dyslipidemia is a general group of diseases characterized by improper absorption of lipids and an abnormal ratio of their fractions. As a result of these violations, “bad” fats are deposited in the vessels, starting the process of their narrowing.

• Smoking. Increases the risk of atherosclerosis by increasing the concentration of low-density lipoproteins in the blood, which are the basis of cholesterol plaques. In addition, this bad habit provokes an increase in the level of fibrinogen, a protein that is the basis of blood clots.

• Diabetes. A persistent increase in blood glucose levels damages blood vessels, leading to the development of changes similar to those in atherosclerosis. Arteries and capillaries become rigid (stiff), narrow and lose their ability to expand.

Daily half-hour exercise normalizes myocardial oxygenation and body weight

Social aspects of coronary heart disease

Low awareness of the population about the causes of the disease, the mechanisms of its development and consequences, as well as a sedentary lifestyle and bad habits, lead to the fact that the disease “gets younger” and reaches middle age.

The above risk factors for the development of coronary artery disease are adjustable, they are also called behavioral, or behavioral.