When discussing cardiac risk, one key term often arises: Atherosclerotic Cardiovascular Disease (ASCVD). Cardiac risk refers to the likelihood of developing heart-related conditions, and ASCVD plays a central role in this risk.
In simple terms, ASCVD refers to a group of conditions caused by the build-up of fatty deposits (known as plaque) in the walls of arteries. This build-up (atherosclerosis) can restrict blood flow, leading to a range of serious health problems.
What is ASCVD?
At its core, ASCVD describes conditions that arise when atherosclerosis affects different parts of the body. These conditions can lead to complications such as heart attacks and strokes. The narrowing of arteries caused by plaque not only limits blood flow but can also trigger clot formation, causing blockages that may lead to severe outcomes.
ASCVD is not a single disease but an umbrella term encompassing several cardiovascular and systemic conditions. Recognising it as a broad category helps healthcare providers assess and manage risks more comprehensively.
Conditions Associated with ASCVD
ASCVD includes a wide variety of conditions, each with unique impacts on health:
Stroke and Transient Ischaemic Attacks (TIAs):
Stroke occurs when blood supply to the brain is interrupted, often due to a clot or a burst artery. TIAs, or “mini-strokes,” are temporary episodes of reduced blood flow to the brain. Both are commonly linked to atherosclerosis in the blood vessels supplying the brain.
Chronic Kidney Disease (CKD):
Peripheral Artery Disease (PAD):
Carotid Artery Disease:
Abdominal Aortic Disease:
Common Risk Factors
Cardiac risk, as discussed in Understanding Cardiac Risk, is influenced by various conditions or risk factors. Some of these can be controlled, while others, like age and genetics, cannot. These factors, when left unmanaged, can lead to serious complications, such as atherosclerotic cardiovascular disease (ASCVD).
Here are some of the common risk factors:
- High Blood Pressure (Hypertension): Excessive pressure on artery walls can damage them over time, promoting plaque formation.
- High Cholesterol: Elevated levels of “bad” cholesterol (LDL) can contribute to plaque build-up, while low levels of “good” cholesterol (HDL) reduce the body’s ability to clear fats from the blood.
- Smoking: Tobacco use damages blood vessels, accelerates plaque build-up, and reduces oxygen in the blood, raising cardiovascular risk significantly.
- Diabetes: High blood sugar levels can damage arteries and increase the risk of atherosclerosis. Diabetes is a major enhancer of ASCVD risk.
- Obesity and Physical Inactivity: Excess weight, particularly around the waist, and a lack of exercise contribute to high blood pressure, unhealthy cholesterol levels, and diabetes—all of which increase ASCVD risk.
- Chronic Kidney Disease: As CKD and ASCVD are closely interconnected, one condition can worsen the other, creating a vicious cycle of risk.
Prevention and Management
As we explored in the article: Mitigating Cardiac Risk, focusing on primary prevention, early detection, and effective intervention can help significantly reduce our risk of heart problems and help us live healthier, longer lives.
Recommended Screenings by Age and Health Condition
| Recommended For | Screen For | Screening Test | Frequency |
|---|---|---|---|
|
Individual aged 18 years and above |
Obesity |
Body Mass Index (BMI) and Waist Circumference |
Once a year |
|
Hypertension |
Blood Pressure Measurement |
Once every 2 years; annually for individuals with higher readings |
|
|
Individuals aged 40 years and above |
Diabetes Mellitus |
Blood Glucose Level, Fasting Blood Glucose or HbA1c |
Once every 3 years; annually for those with risk factors or prediabetes |
|
Cholesterol/Hyperlipidemia |
Blood Lipid Level |
Once every 3 years; annually for high-risk individual |
Based on the Report of the Screening Test Review Committee, Academy of Medicine Singapore, 2019.
Advanced Assessments
Advanced assessments like Carotid Intimal Media Thickness (CIMT) and Carotid-Femoral Pulse Wave Velocity (cfPWV) are also often used to help evaluate the condition of the arteries.
Based on the Report of the Screening Test Review Committee, Academy of Medicine Singapore, 2019.
| Test | Purpose | Normal Range | When to Consider |
|---|---|---|---|
|
Carotid Intimal Media Thickness (CIMT) |
Measures the thickness of the carotid artery walls to check for early signs of atherosclerosis (narrowing of the arteries) |
Normal CIMT: < 0.8 mm Increased CIMT: ≥ 1.0 mm |
Recommended for people with risk factors like high blood pressure, diabetes, or a family history of heart disease. |
|
Carotid-Femoral Pulse Wave Velocity (cfPWV) |
Measures the stiffness of your arteries, which can help predict heart disease |
Normal cfPWV: < 8 m/s Increased cfPWV: > 10 m/s |
Recommended for people with high blood pressure, diabetes, or other signs of cardiovascular disease. |
Values are based on clinical data and studies conducted from NCBI and the American Heart Association (AHA).
Conclusion
ASCVD is a complex but preventable group of conditions linked to the build-up of plaque in the arteries. By understanding the associated conditions and their shared risk factors, you can take meaningful steps toward prevention and better management. Small changes, like adopting a healthier lifestyle and working closely with your healthcare provider, can significantly reduce your risk and improve your overall quality of life.
At Nobel Heart Centre, we prioritise your heart and overall health—book an appointment with us today and take the first step towards a healthier future!
