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The underlying pathology of cardiovascular diseases is arteriosclerosis, which is characterized by a multifactorial aetiology with different risk factors, many of them modifiable, thus allowing their prevention. These risk factors usually present themselves in association with each other, increasing cardiovascular risk.

The three most important modifiable risk factors are smoking, high blood pressure and hypercholesterolaemia. Nevertheless, we must also consider factors such as obesity, physical inactivity and diabetes.

There are also other unmodifiable risk factors, including age, sex and genetic makeup.

Dyslipidaemia

Dislipidemia or dislipemia is a series of pathological conditions whose only common element is an alteration of the lipid metabolism with a consequent alteration of the concentrations of lipids and lipoproteins in the blood

The study of this metabolic disorder takes on particular importance since the Framingham study showed that this is one of the main cardiac risk factors. This is because cholesterol tends to bind to the walls of arteries forming atheroma plaques, narrowing the arterial lumen until it is obstructed. Even though the most studied and discussed disease is that of the coronary arteries, which leads to acute myocardial infarction, in reality this condition may occur anywhere within the whole arterial tree and can affect various organs.

High blood pressure

High blood pressure is a medical condition characterised by blood pressure figures above 140/90 mmHg and considered one of the most important public health issues in developed countries, affecting close to one thousand million people throughout the world. Individuals with blood pressure between 130/80 and 139/89 have twice the risk of developing high blood pressure than individuals with lower values. Hypertension is an asymptomatic disease that is easy to detect, although it causes severe and lethal complications if not treated in time.

High blood pressure silently produces macro and microvascular haemodynamic change, caused in turn by dysfunction of the vascular endothelium and reshaping the walls of the resistance arterioles, responsible for maintaining peripheral vascular tone. These changes, which occur before the rise in blood pressure, produce specific organic lesions, some of which are clinically defined.

In 90% of cases the cause is unknown and so it is called ‘essential hypertension’ which has a strong hereditary influence. Likewise, in ‘secondary hypertension’ there are causes that are directly responsible for the increased blood pressure. On occasions this form of hypertension may not only be treated and disappear without requiring chronic treatment but, in addition, may be a warning sign for more severe conditions of which it is merely a clinical symptom.

Tobacco addiction

Tobacco addiction is addiction to tobacco mainly caused by one of its active components, nicotine; the action of this substance conditions abuse of its consumption.

According to the World Health Organisation, smoking is the world's number one cause of disease, invalidity and premature death. In Europe, tobacco addiction causes 1.2 million deaths every year. It is directly related to the appearance of 29 diseases, of which 10 are various types of cancer. It is the main cause of 95% of lung cancers, 90% of bronchitis and more than 50% of all cardiovascular diseases. More than 50,000 people die in Spain every year due to smoking, more than road accidents and the consumption of all illegal drugs combined.

Obesity

Obesity is the condition in which natural energy reserves, stored in adipose tissue, increase to a point where they are associated with certain health conditions or increased mortality. It is characterised by an increased body mass index (BMI) - 30 or higher.

Obesity is an important risk factor for chronic diseases such as heart disease, diabetes mellitus, high blood pressure, stroke and some forms of cancer. The evidence suggests that it is a disease with a multifactorial origin that includes genetic, environmental and psychological factors.

Heredity has an important role in the development of this disease; so important in fact that the children of obese parents have a risk of obesity 10 times higher than normal. In part it is due to a metabolic tendency to accumulate fat, but cultural eating habits and physical inactivity also contribute to the repetition of the obesity patterns of the parents.

Diabetes mellitus

Diabetes mellitus is a chronic multisystemic organic syndrome that is characterised by increased blood glucose levels, an effect known medically as hyperglycaemia. It is the result of low insulin levels or resistance to insulin by part of the body, which later leads to disorders in metabolizing carbohydrates, lipids and proteins.

This complaint causes various complications, frequently affecting the eyes, kidneys, peripheral nerves and blood vessels. Its acute complications generally include hypoglycaemia, ketoacidosis, hyperosmolar non-ketotic coma and, rarely, lactic acidosis if there is inadequate control of the disease. Furthermore, chronic complications lead to cardiovascular diseases, nephropathy, retinopathy, neuropathy and microvascular damage.

Given that close to 50% of subjects are unaware of their condition, it is very important to detect it in time. Among the symptoms of this illness are polyuria (excessive urine production), polydipsia (increased thirst), weight loss, occasional polyphagia (abnormal increase of the need to eat) and blurry vision.

Of the three types of diabetes mellitus recognised by the World Health Organisation - type 1, type 2 and gestational diabetes - apparently only diabetes mellitus type 1 has a genetic element.