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Risk factors
By Mayo Clinic staffRisk factors for small vessel disease include:
- Tobacco smoking
- Total blood cholesterol over 240 mg/dL (6.2 mmol/L)
- Systolic blood pressure over 140 millimeters of mercury (mm Hg) or diastolic blood pressure over 90 mm Hg
- Obesity (body mass index of 30 or higher)
- Inactive lifestyle
- Diabetes
- Insulin resistance
- Being female
- An estrogen deficiency, in women
- Increasing age, over 45 in men and over 55 in women
It's not clear why the same risk factors, such as obesity or an inactive lifestyle, cause some people to develop small vessel disease instead of large vessel coronary artery disease. Because women are more likely to develop small vessel disease than are men, the following conditions, which occur more commonly in women, may play a role in the development of small vessel disease:
- Polycystic ovarian syndrome
- Inflammation due to an autoimmune disease, such as rheumatoid arthritis or lupus
- Migraine with aura
- Lanza GA, et al. Primary coronary microvascular dysfunction: Clinical presentation, pathophysiology, and management. Circulation. 2010;121:2317.
- What is coronary microvascular disease? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cmd/cmd_all.html. Accessed July 10, 2010.
- Beltrame JF, et al. Advances in coronary microvascular dysfunction. Heart, Lung and Circulation. 2009;18:19.
- Camici PC, et al. Coronary microvascular dysfunction. New England Journal of Medicine. 2007;356:830.
- Lakhani K, et al. Microvascular dysfunction in women with polycystic ovary syndrome. Human Reproduction. 2005;20:3219.
- Topcu S, et al. Metformin therapy improves coronary microvascular function in patients with polycystic ovary syndrome and insulin resistance. Clinical Endocrinology. 2006;65:75.
- Foster W, et al. Inflammation and microvascular and macrovascular endothelial dysfunction in rheumatoid arthritis: Effect of treatment. The Journal of Rheumatology. 2010;37:711.
- Kurth T, et al. Migraine and ischaemic vascular events. Cephalalgia. 2007;27:965.
- Coenzyme Q10. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed July 11, 2010.
- Littarru GP, et al. Clinical aspects of coenzyme Q10: An update. Nutrition. 2010;26:250.
- Hamilton SJ, et al. Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients. Diabetes Care. 2009;32:810.
- L-arginine. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed July 11, 2010.
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