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Cardiovascular System

Atherosclerosis is a disease affecting the arteries. It is a type of arteriosclerosis which is commonly called “hardening of the arteries.” It consists of structural disorders (lesions) called “atheroma” or “plaque” seen in medium and large arteries.

Atheroma may rupture over time and particles enter into the flowing blood stream blocking the narrower blood vessels (thrombosis).

Even if atheroma does not rupture, its enlargement may lead to narrowing of the blood vessels (stenosis). In both cases, insufficient blood is carried to the organ supplied by the blood vessel.

Heart attack, acute stroke, heart failure and in general the most heart diseases are caused by atherosclerosis.

1. High Risk Group:
• Patients in this group have either coroner heart disease or risk factors equal to coroner heart disease (diabetes, peripheral artery disease ...)

2. Medium-High Risk Group: These patients have two or more risk factors.
• Blood LDL-cholesterol levels of these patients must be < 130 mg/dL. To achieve this level, it is recommended to change lifestyle if LDL-cholesterol is > 130 mg/dL, or drug therapy if LDL-cholesterol is > 160 mg/dL.

• If the patient also has obesity, sedentary lifestyle, high triglyceride levels or low HDL-cholesterol levels, the risk for atherosclerosis-related artery disease risk is higher.

3. Low Risk Group: These patients have no or one risk factor.
• LDL-cholesterol levels must be < 160 mg/dL. If the blood LDL-cholesterol level is > 160 mg/dL the lifestyle must be changed, if it is > 190 mg/dL drug therapy must be initiated.

Atherosclerosis is a pathological process which occurs via accumulation of lipid particles on the blood vessel wall and prevents normal blood flow by blocking the blood vessel lumen. The disease that develops with the occurrence of atherosclerosis in coronary arteries is called Coronary Artery Disease.

Individual and environmental factors play a role in development of atherosclerosis. Individual factors are coronary artery diseases in first degree relatives, hypertension, high cholesterol levels, diabetes, age and unclear genetic factors. Environmental or acquired risk factors include smoking, diet high in cholesterol, a stressful and passive lifestyle.

The most common symptom is Angina pectoris (chest pain), it can also cause pressure, tightness and burning in chest.


Hyperlipidemia is the scientific determination of an increase of lipid amount in the blood circulation. Lipid term covers cholesterol, phospholipids and triglycerides.

Angina Pectoris

Heart tissue, is supplied with blood by the coronary arteries surrounding it. Any problem which may decrease the blood flow in the coronary arteries: vasospasms in the coronary arteries (self-narrowing of the artery) or lipid accumulation (atherosclerosis), decrease the blood supply to the heart tissue and compromises the maintenance of vitality. The insufficient blood supply to the tissue in patients causes oxygen deficiency and “ischemia” develops. Severe pain in the chest and arms caused by this ischemic clinical picture is called “angina pectoris”. A process leading to heart attack (myocardiial infarction) develops if not treated.

To recover blood supply to the heart tissue, products which can widen coronary arteries (vasodilators), and products which block sympathetic nervous system having a artery narrowing (vasospastic) effect are used. Invasive  methods are another option. 


Blood pressure:

Blood pressure is the pressure within the arteries in the circulation system and is needed for the circulation of blood in the body. The condition in which this pressure is higher than normal is called “hypertension”.

Blood pressure is expressed in two types of terms.

Systolic blood pressure (contraction pressure)

Diastolic blood pressure (relaxation pressure)

Hypertension (High blood pressure):

Although normal blood pressure varies among individuals, systolic blood pressure value of 140 mmHg and diastolic blood pressure value of 80 mmHg are considered to be normal. Persistant values above 140/90 mmHg are considered as hypertension and require treatment.

Symptoms of hypertension:

Throbbing headache felt at the nape of the neck, palpitation, fatigue, shortness of breath, nose bleeding, having difficulty in walking or stair climbing, frewuent urination without a cause, blurry vision, tinnitus and swelling of feet/legs. There are hypertensive patients without these symptoms. Diagnosis in these patients can only be done with routine blood pressure monitoring. Therefore, individuals under risk who have relatives with hypertension, overweight individuals, diabetics, pregnant women and people older than 40 should have their blood plessure measured more often.

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