The growing burden of atherothrombosis

Cardiovascular disease (CVD) is the leading cause of death in the Philippines. In 2001, according to the Department of Health, CVD was responsible for 28 percent of all deaths among Filipinos.

As a consequence, CVD exerts a huge and growing burden on the country’s limited resources for health services as well as on the patients and their families, many of whom pay medical services out-of-pocket.

Atherothrombosis, a progressive and life-threatening disease affecting the arteries throughout the body, is responsible for the majority of CVD cases.

The disease occurs over a period of several years when plaque, consisting of fatty acids and cholesterol, accumulate in the inner walls of the arteries, causing them to narrow and harden.

While this narrowing of the arteries, also known as atherosclerosis, can itself cause symptoms associated with ischemia (a condition in which the oxygen-rich blood flow to a part of the body is restricted), more serious, if not catastrophic, events occur when plaques rupture, activating platelets in the blood to form a clot, or thrombus, that can partially or completely block the blood vessel.

Depending on the location, atherothrombosis can result in a heart attack, stroke or peripheral artery disease (PAD).

Atherothrombotic process occurs over many years with the gradual development of atherosclerosis, which occurs when deposits referred to as plaque, consisting of fatty acids and cholesterol, calcium and other materials, accumulate in the inner walls of arteries, causing them to narrow and harden (i.e. hardening of the arteries).

Antiplatelet medicines such as aspirin and clopidogrel are prescribed to prevent fatal heart attacks among individuals with heart problems such as worsening chest pain. They are also used by those who suffered a stroke to prevent another stroke, which could be fatal from happening.

Clopidogrel has proven efficacy in the management of atherothrombosis as demonstrated in a number of studies.

The CAPRIE study demonstrated a significantly greater risk reduction with clopidogrel than with aspirin, while the CURE study reported that a combination of clopidogrel and aspirin was more effective than aspirin alone in reducing the risk of a heart attack or stroke in patients with symptoms of heart disease.

With a healthy lifestyle, regular visits to the doctor and medication, people at risk of death from cardiovascular disease can hope for better and longer days ahead of them.