People with the inherited disease homocystinuria develop extensive atheroma formation, particularly at a young age. The disease affects many arteries but doesn't primarily affect the coronary arteries, which supply the heart. In contrast, in the inherited disease familial hypercholesterolemia, extremely high levels of blood cholesterol cause atheromas to form in the coronary arteries much more than in other arteries. Fortunately, taking steps to achieve some of these goals helps achieve others. For instance, starting an exercise program helps a person lose weight, which in turn helps lower cholesterol levels and blood pressure.
Quitting smoking helps lower cholesterol levels and blood pressure.
In people who already have a high risk of heart disease, smoking is particularly dangerous. Smoking also raises the level of carbon monoxide in the blood, which may increase the risk of injury to the lining of the arterial wall, and smoking constricts arteries already narrowed by atherosclerosis, further decreasing the amount of blood reaching the tissues. Plus, smoking increases the blood's tendency to clot, so it increases the risk of peripheral arterial disease, coronary artery disease, stroke, and obstruction of an arterial graft after surgery. A smoker's risk of coronary artery disease is directly related to the number of cigarettes smoked daily. Quitting also decreases the risk of death after coronary artery bypass surgery or a heart attack.