The most common symptoms of coronary heart disease are angina, a shortness of breath and pain in the arms, neck and jaws. However a person is able to have a heart attack without ever coming across these symptoms. ‘There is no one simple test, the only certain way to diagnose and assess the extent of CHD is coronary angiography.’ (CHD –The Facts, National Heart, Lung and Blood Institute, 2002)
There are many risk factors for CHD. The major factors that a person is unable to change are increasing age, gender, diabetes and heredity. Obviously we are unable to control increasing age. ‘Four out of five people who are sufferers from coronary heart disease are at least 65 or older.’ (, 2003) This is because as you become older your arteries become weaker. We cannot change our sex unfortunately men are at a greater risk of contracting CHD than women. They can also contract the disease at an earlier age than women. If relatives have CHD or there is a history of the disease in your family, then you are most likely to be at risk of developing it. This is due to the fact that parents pass their genes onto their children that may render them more liable to suffer from high blood pressure, high cholesterol levels or contracting diabetes mellitus. ‘Heart disease risk is also higher amongst Mexican Americans, American Indians, native Hawaiians and some Asian Americans.’ (, 1999) About two thirds of people who suffer from diabetes die of some form of heart disease. You are unable to control getting diabetes. When blood glucose levels are low, not enough is provided for the cardiac muscle; therefore cellular respiration cannot take place to the maximum effect. Also people that suffer from diabetes tend to have high blood lipid levels so they are more likely to develop plaques from the fat deposits in the blood.
There are several other risk factors that we can modify or control. These are exercise, smoking, stress, diet, socio-economic class and alcohol intake. Exercising is one of the most effective ways of losing weight, which can help lower blood cholesterol levels and is helpful in reducing high blood pressure. Without exercising you will become overweight, which increases the strain on the heart. Being overweight raises blood pressure, blood cholesterol and triglyceride levels, and lowers HDL cholesterol levels. ‘At least 30 minutes of steady activity five days a week, or 20 minutes of higher intensity activity three days a week is recommended.’ (, 1998)
Smoking drastically increases your chance of developing CHD. It encourages the formation of blockages and decreases the amount of oxygen in the blood. Nicotine in the tobacco smoke is a vasoconstrictor – this narrows the arteries and increase blood pressure. Carbon monoxide from the tobacco smoke makes the red blood cells inefficient in carrying oxygen to the endothelial cells in the heart. ‘Cigarette smokers are about four times more likely to develop CHD than non-smokers and are more likely to die of a hearty attack when they have one.’ (Human Biology, page 207, 2000) Chemicals that are found in cigarettes cause platelets to become stickier which increases the chances of a blood clot forming.
Having a stressful life can increase blood pressure; it can also have other affects such as overeating, smoking and the consumption of alcohol. It is important for a person to relax every so often. When a person has high blood pressure their cardiac output is higher than normal because their heart has to work at a faster rate in order to pump blood around the body. When blood pressure becomes constantly high the arteries respond by increasing the smooth muscle layer amount, this makes the lumen become narrower and hypertension occurs which causes an increased risk of contracting CHD.
A high fat diet can increase the risk of CHD because cholesterol combine with proteins found in the blood to form lipoproteins; low-density lipoproteins contribute to an atheroma forming. Their deposits are left in the arteries causing blockages as explained previously. People with a cholesterol level above 240mg per 100cm³ of blood are at risk of developing CHD later in life. Without a healthy diet you could become overweight so the heart has extra strain to cope with. If you are overweight you are more likely to have high blood pressure, diabetes and high blood fats. People in higher classes tend to eat richer foods like red meat, which increase fat and cholesterol levels. Lower class people may not have adequate personal hygiene, which may affect chances.
Your alcohol intake can contribute to high triglycerides. It can damage cardiac muscle directly and can cause irregular beating; it can also damage the liver. Alcohol contributes to high blood pressure – increasing chances of CHD. ‘Men are encouraged to drink no more than 28 units per week and women no more than 21 units.’ (Coronary Heart Disease, page 24, 1996)
