Acquired heart disease (AHD) represents a spectrum of disorders affecting the heart and blood vessels that develop over the course of a person’s life. This illness is a major public health concern globally, accounting for a substantial portion of all cardiovascular-related morbidity and mortality. Unlike conditions present from birth, AHD refers to damage or dysfunction that manifests years later due to genetic predisposition and environmental factors.
Defining Acquired Heart Disease
Acquired heart disease is an umbrella term encompassing any disorder of the heart muscle, valves, or blood vessels that occurs after birth. AHD is the result of progressive damage or acute injury that affects the healthy heart over time. This group of diseases is significantly more prevalent in the adult population.
The conditions falling under the AHD umbrella are diverse, reflecting the various structures of the heart that can be affected. Coronary Artery Disease (CAD) is one of the most common forms, involving the narrowing of the arteries supplying the heart muscle. Other categories include valvular heart disease, where the heart’s four valves become damaged, and cardiomyopathy, a disease where heart muscle fibers become stiffened or enlarged. Heart failure, the heart’s inability to pump blood efficiently, is often the endpoint of various types of AHD.
AHD also includes conditions caused by infections or inflammatory processes. Examples include myocarditis (inflammation of the heart muscle) and endocarditis (typically an infection of the inner lining or valves). Rheumatic heart disease stems from untreated streptococcal infection, leading to an inflammatory response and permanent damage to the heart valves. The vast majority of AHD in adults is related to lifestyle-driven disorders like CAD.
Primary Contributors to AHD Development
The development of AHD is a gradual process driven by several interconnected biological mechanisms and persistent risk factors. The foundational process for many forms of AHD is atherosclerosis, the buildup of fatty plaque within the artery walls. This plaque is composed of cholesterol, fats, and other substances. Its accumulation causes the arteries to narrow and harden, restricting the flow of oxygen-rich blood to the heart muscle.
One major contributor to this damage is high blood pressure, or hypertension, where the force of blood against the artery walls is consistently too high. Uncontrolled hypertension causes the arteries to become thick and stiff, forcing the heart to pump harder and less efficiently. Over years, this excessive workload can lead to the thickening and eventual weakening of the heart muscle itself, a form of cardiomyopathy.
High levels of low-density lipoprotein (LDL) cholesterol, often termed “bad” cholesterol, directly contribute to the formation of atherosclerotic plaque. When the body has too much LDL, the excess cholesterol deposits into the arterial walls, initiating the hardening process. Conversely, high-density lipoprotein (HDL) cholesterol helps transport cholesterol away from the arteries, offering a protective effect.
The chronic metabolic disorder diabetes also significantly increases AHD risk by causing damage to the blood vessels. High blood sugar levels promote inflammation and accelerate atherosclerosis. Chronic inflammation, often associated with autoimmune conditions or persistent infections, is recognized as a standalone risk factor that damages the heart and blood vessel linings. A sudden rupture of an atherosclerotic plaque can trigger a blood clot, completely blocking the artery and resulting in an acute event like a heart attack.
Recognizable Signs and Symptoms
The physical manifestations of AHD can range from subtle discomfort to acute, life-threatening events. A common chronic symptom is chest pain, known as angina, which occurs when the heart muscle does not receive enough oxygen-rich blood. Angina is often felt as pressure or tightness and may radiate to the jaw, neck, throat, or down the arms.
Shortness of breath, or dyspnea, is another frequent sign, particularly during physical activity or even when lying flat, indicating a reduced capacity for the heart to pump blood effectively. This symptom is often associated with the fluid backup that occurs with heart failure. Fatigue and general weakness are also persistent symptoms, as the heart’s compromised pumping action fails to deliver adequate oxygen to the body’s tissues.
Other noticeable signs include palpitations, sensations of a racing, fluttering, or pounding heartbeat, often indicating an irregular heart rhythm (arrhythmia). Swelling (edema) in the legs, ankles, or feet is a consequence of fluid retention when the heart cannot manage fluid return efficiently. While chronic symptoms develop gradually, acute symptoms like sudden, severe chest pain or fainting require immediate medical attention.
Strategies for Prevention and Lifestyle Management
Adopting specific lifestyle changes represents the most effective means of reducing the risk of developing AHD and managing existing conditions. A heart-healthy eating pattern, such as the Mediterranean diet, emphasizes fruits, vegetables, whole grains, and lean proteins, while incorporating healthy fats like olive oil. It is important to actively reduce the intake of salt, saturated fats, trans fats, and added sugars, as these contribute directly to hypertension and high cholesterol.
Incorporating regular physical activity is another highly effective preventive measure, as it strengthens the heart muscle and improves the efficiency of the circulatory system. Adults should aim for at least 150 minutes of moderate aerobic exercise, such as brisk walking, or 75 minutes of vigorous activity each week. Consistent exercise helps maintain a healthy weight, which in turn reduces the strain placed on the heart and lowers the risk of developing diabetes and high blood pressure.
Cessation of tobacco use is one of the most impactful actions an individual can take to protect their heart. Chemicals in tobacco smoke damage the heart and blood vessels, and quitting significantly reduces heart disease risk, with benefits starting almost immediately. Managing psychological stress is also beneficial, as chronic stress can contribute to elevated blood pressure and unhealthy coping behaviors. Techniques such as meditation, yoga, or ensuring quality sleep help manage stress levels, contributing to overall cardiovascular health.