Which disease starts first?
Ask the doctor
Q. In the April 2021 issue you said that atherosclerosis, obesity, high blood pressure, high cholesterol, and diabetes all were related, and affected each other. Which of them starts first?
A. It is true that these conditions often occur together. Not only that, but having some of them can increase the risk of getting the others. For example, being obese increases your risk of developing type 2 diabetes and high blood pressure. And having either of these conditions, or high blood levels of cholesterol, increases your risk of heart disease and stroke caused by atherosclerosis (in which cholesterol deposits form in the walls of arteries).
How does one condition affect another? As one example, blood banging at high pressure against the walls of arteries injures them, making them more likely to develop cholesterol deposits — and to increase the size of any deposits that already are present. And, as you'd expect, high levels of blood cholesterol also increase the risk for and size of cholesterol deposits.
Which comes first? Cholesterol starts building up in artery walls in childhood. Although it usually takes decades for the atherosclerosis to become significant enough to cause heart attacks and stroke, the disease starts early. That's why, increasingly, cholesterol and blood pressure — long thought of as adult health problems — also are measured and treated in children, not just in adults.
About the Author
Anthony L. Komaroff, MD, Editor in Chief, 天博体育 Letter; Editorial Advisory Board Member, 天博体育 Publishing
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