Coronary Heart Disease
Coronary heart disease can define as "impairment of heart function due to inadequate blood flow to the heart compared to its needs cause by obstructive changes in coronary circulation to the heart."
Coronary Heart Disease (CHD) man manifests itself in many presentations:
A) angina pectoris of effort
B) myocardial infarction
C) irregularities of the heart
D) cardiac failure
E) sudden death
"Epidemic" of CHD began at different times in different countries.
In the United States, epidemics began in early 1920; in Britain in the 1930s.
👉 Risk factors of Coronary Heart Disease (CHD) | Heart Disease Causes
1. SMOKING
Smoking has been identified as a major Coronary Heart Disease (CHD) risk factor.
Carbon monoxide induced thermogenesis; nicotine stimulation of adrenergic drive raising blood pressure and myocardial oxygen demand; lipid metabolism with fall in "protect high-densitysity lipoprotein, etc.
2. Hypertension
Blood pressure is the single most useful test for identifying individuals at a high risk of developing CHD.
Hypertension accelerates the atherosclerotic process, especially if hyperlipidemia is also present.
3. Serum cholesterol
Elevation in serum cholesterol was one of the factors which carried an increased risk for the development of myocardinfarctiontion.
Low-density lipoprotein (LHD) Cholesterol is most directly associated with CHD.
4. DIABETES
The risk of CHD is 2-3 times higher in diabetic people than non-diabetic.
CHD is responsible for 30 to 40% of deaths in diabetic over the age of 40 years in industrialized countries.
5. GENETIC FACTORS
A family history of CHD is known to increase the risk of untimely death.
6. PHYSICAL ACTIVITY
Sedentary life is associated with an increased risk of CHD.
There is evidence that regular physical exercise is beneficial to cardiovascular health.
7. HORMONE
Ther is the difference in mortality rate between male and female subject suggest that the underlying factor may have a hormone basis.
It is a hypothesis that hyperestrogenemia may be the common underlying factor that leads both to atherosclerotic and its complications such as CHD, Stroke, Peripheral vascular disease.
8. TYPE A PERSONALITY
Type A behaviour is associated with competitive drive, restlessness, hostility, and a sense of urgency or impatience.
Type A individuals are more at risk of CHD than calmer type 2 individuals.
9. ALCOHOL
High alcohol into ake more than 75g per day is an independent risk factor for CHD, hyperten, soon, and all cardiovascular disease.
10. ORAL CONTRACEPTIVE
Women using Verbal contraceptives have higher systolic and diastolic blood pressure.
The risk of myocardinfarctiontion in women is increased by oral contraceptives.
Other factors like dietary fiber, sucrose, and soft water have been debated.
PREVENTION OF Coronary Heart Disease (CHD) | Heart Disease Treatment
(1) Primary Prevention | Primary Treatment
A mass approach focusing mainly on the control of underlying causes in the whole population, not merely in individuals.
ist si a very useful approach for primary prevention.
This strategy centaroundound the following key areas:
1. DIETARY CHANGES
- downgrading of fat intake to 20-30 percent
- consumption of saturated fats must be limited to less than 10% of total energy intake.
- a reduction of dietary cholesterol to o below 100mg per 1000 kcal per day.
- an increase in complex carbohydrates consumption ( vegetable, fruit, whole grain, legume )
- avoidance of alcohol consumption; downgrading of salt intake to 5g daily or less.
2. SMOKING
As far as CHD concern present evidence does not support the promotion of the so-called “safer cigarette”.
The goal should be to achieve a smoke-free society.
3. BLOOD PRESSURE
It has been estimated that even a small reduction in the average blood pressure of the whole population by a mere 2-3 mg would produce a large reduction in the incidence of cardiovascular complications.
4. PHYSICAL ACTIVITY
Regular physical exercise or activity should be part of a normal daily routine.
Physical exercise is the most important factor for decreasing the risk factor of Cardiovascular disease.
(2) SECONDARY PREVENTION | SECONDARY Treatment
First primary prevention should be continued with secondary prevention.
Cessation of a smoking, healthy lifestyle is most effective.
Revascularization procedures for patients with angina pectoris
The indication for coronary artery revascularization i.e. coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty ( PTCA )
(a) patients with unacceptable symptoms despite medical therapy to its tolerable limits.
(b) patients with left main coronary artery stenosis greater than 50 percent with or without symptoms.
(c) patients with three-vessel Illness with left ventricular dysfunction
(d) patients with unstable angina who after symptoms control by medical therapy continue to exhibit ischemia on exercise testing or monitoring
(e) post-myocardial infarction patients with continuing anginasevereever ischaemic or non-invasive testing
Here Name of some risk factors intervention trials for Coronary Heart Disease (CHD)
1. Stanford-three-community study
2. The North Karelia Project
3. MRFIT
4. OSLOW Diet/smoking intervention study
5. lipid Research Clinic study
 Condition | Symptoms | Risk Factors | Prevention in USA){kind=link}
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