Heart attack risks and biological mechanisms of cardiovascular disease

Heart attacks occur when coronary arteries are suddenly blocked, depriving the heart muscle of oxygen and nutrients. This can lead to heart failure or death. Risk factors include obesity, high blood pressure, smoking, diabetes, and elevated cholesterol.

While LDL cholesterol has been a central focus of heart health since the 1970s, recent discussions suggest that endothelial dysfunction and inflammation play critical roles. When the endothelium—the active cell layer lining blood vessels—becomes permeable due to dysfunction, LDL particles can enter the vessel wall, oxidize, and trigger inflammatory responses. This process contributes to plaque formation.

Research indicates a U-shaped relationship between cholesterol levels and mortality, where both extremely high and extremely low values are associated with increased risk. Additionally, symptoms of a heart attack can vary; women often experience different signs than men, which can lead to delayed recognition. Common symptoms include intense chest pain, pain radiating to the left arm or shoulder, fear of death, and weakness.