Factors leading to Coronary Heart disease
Factors leading to Coronary Heart disease
Coronary heart disease is the leading single cause of death. It took the lives of over 135,000 people in the UK, in 1998. One in four men and one in five women die from the disease. Coronary heart disease by itself is the most common cause of death in Europe: accounting for nearly two million deaths in Europe each year. Over one in five women (22%) and men (21%) die from the disease. In the European Union, coronary heart disease is also the most common single cause of death, with over 600,000 deaths every year.
The narrowing of the coronary arteries (in the heart) that feed the heart causes coronary Heart disease. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by cholesterol and fat deposits a process called atherosclerosis. And are not able to supply enough blood to the heart, the result is coronary heart disease (CHD). If not enough oxygen-carrying blood reaches the heart, you may experience chest pain called angina. Sometimes this inadequate blood supply may cause no symptoms this is a condition called silent angina. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing. The blockage of the coronary heart disease begins to occur at an early age, a little bit of blockage is generally harmless. If the coronary artery becomes 50% blocked there is less blood flow than needed at periods of increased e.g. exercise which will cause shortness of breath. When the artery is 90% blocked there is generally a lack of blood supply at rest. When the artery is 100% blocked a heart attack occurs the part of the heart that does not receive oxygen begins to die, and some of the heart muscle may be permanently damaged. The diagram shows how the coronary arteries look, when they are normal, half blocked and totally blocked.
Risk factors are conditions that increase your risk for developing coronary heart disease. Some of these factors can be changed (controllable) and some cannot be changed (uncontrollable).
The risk factors that you cannot control are:
* Age (45 years or older for men, 55 years or older for women)
* Family history
In this case people are unable to control their chance of developing coronary heart disease. Fortunately, there are things you can to address most of the risk factors for coronary heart disease.
The know risk factors that you can control include:
* High blood cholesterol (high total cholesterol) and high LDL cholesterol
* Low HDL cholesterol
* Smoking
* High blood pressure
* Diabetes
* Obesity
* Stress
* Physical inactivity
Cholesterol
Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body and that your body needs to function normally. It is present in cell walls or membranes everywhere in the body, including the brain, nerves, muscle, skin, liver, intestines, and heart. Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest ...
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* Low HDL cholesterol
* Smoking
* High blood pressure
* Diabetes
* Obesity
* Stress
* Physical inactivity
Cholesterol
Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body and that your body needs to function normally. It is present in cell walls or membranes everywhere in the body, including the brain, nerves, muscle, skin, liver, intestines, and heart. Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If you have too much cholesterol in your bloodstream, the excess is deposited in arteries, including the coronary arteries, where it contributes to the narrowing and blockages that cause the signs and symptoms of heart disease.
Total cholesterol is the sum of all the cholesterol in your blood, the higher this amounts the greater the risk for coronary heart disease. The values that matter are shown in the table below:
Amount of Cholesterol in body Resulting Condition
Less than 200 mg/dL
"Desirable" level that puts you at lower risk for heart disease. Cholesterol level of 200 mg/dL or greater increases your risk.
200 to 239 mg/dL
"Borderline-high."
240 mg/dL and above
"High" blood cholesterol. A person with this level has more than twice the risk of heart disease compared to someone whose cholesterol is below 200 mg/dL.
Cholesterol travels in the blood in packages called lipoproteins. Cholesterol, which is fatty, and blood, which is watery, does not mix. In order to be able to travel in the bloodstream, the cholesterol made in the liver is combined with protein, making a lipoprotein. This lipoprotein then carries the cholesterol through the bloodstream. There are specific kinds of lipoproteins that contain cholesterol in your blood, and each affects your heart disease risk in a different way.
* Low density lipoproteins (LDL)
This is the bad cholesterol. LDL carries most of the cholesterol in the blood, and the cholesterol from LDL is the main source of damaging build up and blockage in the arteries. Therefore, the more LDL-cholesterol you have in your blood, the greater your risk of heart disease. Reducing your LDL cholesterol is the main goal of cholesterol lowering treatment. The values are shown below in a table:
Amount of LDL Resulting Condition
Less than 100 mg/dL
Optimal condition
00 to 129 mg/dL
Near Optimal/Above Optimal
30 to 159 mg/dL
Borderline High
60 to 189 mg/dL
High
90 mg/dL and above
Very High
* High density lipoproteins (HDL)
This is the good cholesterol in the blood from other parts of the body back to the liver, which leads to its removal from the body. So HDL helps keep cholesterol from building up in the walls of the arteries. Again the table shows the important figures for this.
Amount of HDL Resulting condition
Less than 40 mg/dL
A major risk factor for heart disease
40 to 59 mg/dL
The higher your HDL, the better
60 mg/dL and above
An HDL of 60 mg/dL and above is considered protective against heart disease
* Triglycerides
This is a form of fat carried through the bloodstream. Most of your body's fat is in the form of triglycerides stored in fat tissue. Only a small portion of your triglycerides is found in the bloodstream. High blood triglyceride levels alone do not necessarily cause atherosclerosis. But some lipoproteins that are rich in triglycerides also contain cholesterol, which causes atherosclerosis in some people with high triglycerides and high triglycerides are often accompanied by other factors (such as low HDL or a tendency toward diabetes) that raise heart disease risk. So high triglycerides may be a sign of a lipoprotein problem that contributes to heart disease.
Your blood cholesterol level is affected not only by what you eat but also by how quickly your body makes LDL-cholesterol and disposes of it. In fact, your body makes all the cholesterol it needs, and it is not necessary to take in any additional cholesterol from the foods you eat. Patients with heart disease or those who are at high risk for developing it typically have too much LDL-cholesterol in their blood. Many factors help determine whether your LDL-cholesterol level is high or low. The following factors are the most important:
Heredity. Your genes influence how high your LDL-cholesterol is by affecting how fast LDL is made and removed from the blood. One specific form of inherited high cholesterol that affects 1 in 500 people is familial hypercholesterolemia, which often leads to early heart disease. But even if you do not have a specific genetic form of high cholesterol, genes play a role in influencing your LDL-cholesterol level.
What you eat. Two main nutrients in the foods you eat make your LDL-cholesterol level go up: saturated fat, a type of fat found mostly in foods that come from animals; and cholesterol, which comes only from animal products. Saturated fat raises your LDL-cholesterol level more than anything else in the diet. Eating too much saturated fat and cholesterol is the main reason for high levels of cholesterol and a high rate of heart attacks in the United States. Reducing the amount of saturated fat and cholesterol you eat is a very important step in reducing your blood cholesterol levels.
Age and sex. Before menopause, women usually have total cholesterol levels that are lower than those of men the same age do. As women and men get older, their blood cholesterol levels rise until about 60 to 65 years of age. In women, menopause often causes an increase in their LDL-cholesterol and a decrease in their HDL- cholesterol level, and after the age of 50, women often have higher total cholesterol levels than men of the same age.
Alcohol. Alcohol intake increases HDL-cholesterol but does not lower LDL-cholesterol. Doctors don't know for certain whether alcohol also reduces the risk of heart disease. Drinking too much alcohol can damage the liver and heart muscle, lead to high blood pressure, and raise triglycerides. Because of the risks, alcoholic beverages should not be used as a way to prevent heart disease.
Apart from cholesterol below are some other factors in some detail:
Weight.
Excess weight tends to increase your LDL-cholesterol level. If you are overweight and have a high LDL-cholesterol level, losing weight may help you lower it. Weight loss also helps to lower triglycerides and raise HDL.
Physical activity/exercise
Being physically active also helps improve blood cholesterol levels because it can raise HDL cholesterol and lower LDL cholesterol, as well as help you lose weight, lower your blood pressure, and improve the fitness of your heart and blood vessels. Whereas lack of physical activity will mean higher LDL cholesterol, giving you more chance of developing coronary heart disease.
Diabetes
Having diabetes is a strong risk factor for developing heart disease. Because your risk for having a heart attack is typically as high as that of a person with heart disease, your LDL goal and cholesterol-lowering treatment are the same as for someone who has heart disease. As is the case for people with heart disease, your LDL goal is less than 100 mg/dL. The main aim of cholesterol-lowering treatment is to get your LDL down to less than 100 mg/dL. High triglyceride and low HDL levels are often present in people who have diabetes. After your LDL goal has been reached, attention may have to be paid to the high triglyceride and low HDL levels.
Stress
Stress over the long term has been shown in several studies to raise blood cholesterol levels. One way that stress may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating fatty foods. The saturated fat and cholesterol in these foods contribute to higher levels of blood cholesterol, causing more chance of coronary heart disease.
High blood pressure
When blood pressure is elevated for an extended period of time, the inner linings of the coronary arteries become damaged. This leaves them sensitive to the build up of fatty deposits that can narrow or block the arteries and reduce blood flow to the body's organs, causing heart disease.
Smoking
Smoking has several harmful effects on cholesterol. Smoking reduces HDL cholesterol and in all likelihood changes LDL cholesterol to a form that promotes the build up of deposits in the walls of the coronary arteries. In addition, smoking has harmful effects on the heart and blood vessels. In these ways, smoking substantially raises the risk for coronary heart disease if you are healthy and multiplies that risk many more times if you have other risk factors such as high blood cholesterol. All in all, smoking is the leading preventable cause of death.
It is estimated that 30% of deaths from coronary heart disease are due to unhealthy diets. Only a small proportion of adults and children eat the recommended daily intake of five fruit and vegetables. It is also estimated that 36% of deaths is due to lack of physical activity, which could be avoided if people who are not exercising enough or not at all increased it to a moderate level. Inactivity, together with a poor diet, is leading to rising rates of overweight and obesity, increasing the risk of chronic diseases in later life, including coronary heart disease. The advantage of getting high blood pressure and diabetes is three times higher among overweight people, than among those of normal body weight.
Bibliography
Human Biology- Mike Boyle, Bill Indge, Kathryn Senior
www. Britishheartfoundation.com
Advanced Biology- W R Pickering
WWW.wellnessweb.com
Controllable
* High blood pressure
* Diabetes
* Smoking
* Stress
* High blood cholesterol
* Obesity
* Physical inactivity
Uncontrollable
* Male sex or women who are past their menopause
* Family history
It is estimated that 30% of deaths from coronary heart disease are due to unhealthy diets. Only a small proportion of adults and children eat the recommended daily intake of five fruit and vegetables. It is also estimated that 36% of deaths is due to lack of physical activity, which could be avoided if people who are not exercising enough or not at all increased it to a moderate level. Inactivity, together with a poor diet, is leading to rising rates of overweight and obesity, increasing the risk of chronic diseases in later life, including coronary heart disease. The advantage of getting high blood pressure and diabetes is three times higher among overweight people, than among those of normal body weight.
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