Atherothrombosis

Atherothrombosis (AT) is the underlying condition responsible for the greatest number of deaths in Singapore. AT causes heart attack, stroke, and peripheral artery disease (narrowing or obstruction caused by cholesterol affecting the arteries that supply blood flow to the legs).

The risk factors of AT are high blood pressure, cholesterol, and obesity. AT is the common link between all these diseases and risk factors, however, this silent killer goes largely unrecognised by the man on the street.

Atherothrombosis is a global disease, meaning that if a person has atherothrombosis affecting their heart (e.g. if they have had a previous heart attack), they are likely to have atherothrombosis affecting their brain and limbs, predisposing them to a stroke or peripheral artery disease.

AT starts when deposits such as cholesterol builds up in the walls of our arteries. Over time these deposits, known as plaque, restricts the flow of oxygen-rich blood throughout the body. This is a gradual process, which takes place over years.

As blood flows over the plaque, stress forces are exerted on the plaque surface. Eventually, the plaque may rupture. This acute event causes platelets in the blood to stick to the plaque and to other platelets forming a blood clot.

This clot (or thrombus) can limit or completely stop the flow of blood to part of the heart or brain, giving rise to a heart attack or stroke. That’s why it’s critical to treat atherothrombosis and reduce the risk of a life-threatening clot forming.

Heart Patients – Being AT Aware

Heart patients need to be aware that, if they have suffered from a heart attack, they also have a condition that may affect the whole body including the brain and legs as well.

Understanding this, patients can take active steps to reduce their AT risk factors, such as seeking appropriate treatment and making lifestyle changes. Statistics show that heart attack patients are not only 5 times more likely to suffer a repeat heart attack than the general population, but their risk of having a stroke is tripled. Heart attack patients are also at an increased risk of developing PAD – peripheral arterial disease.

Statistics from the Reach Registry – a worldwide survey of atherothrombosis patients – suggest that on average, around one in eight outpatients with stable atherothrombosis, will die, have a heart attack or stroke, or be hospitalised for a complication arising from atherothrombosis within a year.

How many heart patients realise these risks of recurring events exist? How many of these patients are aware they can reduce their risk through lifestyle changes and medication?

Only with increased awareness of the prevalence, prevention and treatment of AT – among both the general public and the medical profession – can we begin to take the first steps to win the battle against the silent killer that is atherothrombosis.

  • Reducing your AT risk
  • Regular gentle exercise
  • Eating healthily
  • Maintain an ideal weight
  • Avoid excessive alcohol intake
  • Go for screening
  • Prevent stress
  • Avoid smoking

It is vital to adequately control various risk factors, including the need to use medications to control diabetes, hypertension and high cholesterol, as well as medications to reduce stickiness of platelets such as aspirin and clopidogrel

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