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Coronary heart disease and its treatment

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Introduction

Coronary heart disease and its treatment Over 270 000 people suffer heart attacks every year, in the UK. What causes coronary heart disease? How can it be treated and prevented and what are the risk factors? Coronary heart disease (CHD) is caused by atherosclerosis occurring in the coronary arteries that supply blood to the myocardium. Restriction of blood-flow to this tissue reduces its ability to function; failure of the myocardium can have catastrophic consequences. CHD is multi-factorial; teenagers may start smoking to be accepted by people. British people are more likely to suffer CHD then Japanese people because of the diet based around rice, fish, and potatoes. High blood pressure (BP) causes tears to the endothelium, fats are laid down and form atheroma. Nicotine in cigarettes increases the BP, causing tears in the endothelium. Carbon Monoxide reduces the amount of oxygen transported in the blood, the heart works faster to maintain the blood supply to body tissues and increases the blood pressure. High saturated fats and cholesterol in the blood cause the release of low-density lipoproteins (LDL), which are lipids combined with proteins that are laid down in the arteries forming atheroma. High salt levels in the bloodstream raise the HR, causing atherosclerosis. ...read more.

Middle

'Statins are a class of drugs that lowers the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Statins block the enzyme in the liver that is responsible for making cholesterol. This enzyme is called hydroxyl-methyl glutaryl-coenzyme a reductase (HMG-CoA reductase for short)'. (1) 'Inhibition of the enzyme stimulates LDL receptors, resulting in an increased clearance (LDL) from the bloodstream and a decrease in blood cholesterol levels'. (2) 'Scientifically, statins are referred to as HMG-CoA reductase inhibitors'. (1) The decrease in cholesterol level means that the body has a greater chance of burning up saturated fats in the blood. The drop in saturated fats in the blood prevents atheroma forming and clogging the arteries, which would lead onto CHD. This reduces stress on the heart and keeps BP and HR lower. If CHD becomes has developed too far for statins, exercise or diet change to have a significant effect on their own to solve the problem, various surgical options are available to tackle CHD. The treatment used to combat CHD depends on the symptoms and how far the CHD has developed. If the CHD does not cause symptoms, it can be treated with either medicine or angioplasty. ...read more.

Conclusion

Economic The cost of treating CHD is high but 1 in 4 males and 1 in 5 females die from CHD. Early detection and treatment of CHD avoids costly procedures i.e. bypass surgery. Meaning tax payers pay less into the NHS. Ethnical The availability of drugs can vary throughout the UK. In some parts of the UK, statins are more widely available; therefore, patients have to wait or travel to receive treatments in a different area, meaning that death rates can vary from area to area. E.g. people in the south west of England may have more access to clot busting drugs and statins and therefore more are treated for CHD then in the North East. Statistics would then show that the southwest is a healthier area than the north east, which is not completely accurate. Environmental There needs to be a greater emphasis on exercise and sport to prevent CHD forming in the population before it starts. Education on diets and eating healthily comes too late to have an impact. A bigger push needs to be made on healthy eating to children at primary school age and less fast foods and foods high in fat and sugar should not be served in schools to pupils or staff to set examples and ideas. This should stop too much sugary and fatty foods being eaten, improving the health of the UK in the long-term. ...read more.

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