Heart Disease - Is it anybody's fault?

Sarah Hussain 12CH

Heart Disease – Is it anybody’s fault?

There are many different types of heart disease. The most common forms are stroke and coronary heart disease. Stroke is when there is a problem in the brain. It occurs when a blood vessel supplying blood to the brain bursts. This type of heart disease tends to be more severe and harmful of the rest of the body as it is affecting the brain. This may cause loss of vision in one eye or paralysis on one side of the body. This is only the circumstance of major stroke. In the case of a minor stroke the recovering process is much easier and the effects only last for a short period of time. (1)

Coronary heart disease (CHD) is to do with the narrowing of the coronary arteries. Due to this the muscle is unable to receive enough oxygen-rich blood. Within coronary heart disease there are different types such as myocardial infarction and arrhythmia, which are to do with the damaging of the muscle cells, and the irregular beat of the heart. (1)

So why do people suffer from heart disease? Is it anybody’s fault?

There are a number of factors, which affect the risk of a person’s chance to suffer from the disease. Some diseases are straightforward in the sense that they arise from only one risk factor. For example cystic fibrosis is caused by the homozygous genotype for the cystic fibrosis gene. CHD is a cause of several risk factors, which include heredity, stress, weight, age, gender, cholesterol, the environment and society and also smoking and alcohol. These are the major and contributing factors to CHD, the more of them you have, the greater chance of developing the disease.

I am going to explain each factor, some factors can be modified, treated or controlled, ad some cannot.

A major risk factor that cannot be changed it your age. Usually as your age increases the risk of suffering from CHD becomes more likely. About four out of five people who die from CHD are 65 or older (2). This is a factor that cannot be controlled. However it is not the main risk factor.

Another factor is gender. Men tend to have a higher risk level than men and they have attacks earlier in life. Even after menopause when women’s death rate from CHD increases it is not as high as the men’s death rate.

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Heredity and race is another major factor involved in the risk of CHD. If your parent or parents have suffered from CHD it is more likely that you will suffer from it too. There is not a faulty allele but there are several genes that can affect your likelihood of developing CHD (1). Most people with a strong history of CHD have one or ore of the other factors contributing to the risk of heart disease. Just as you cannot control your age, sex or race your family history cannot be controlled. Therefore it is essential for these people to control the other risk factors such as weight. African Americans have a more severe high blood pressure than Caucasians and a higher risk of CHD (2).

High Blood pressure is a major risk that can be controlled or modified. High blood pressure increases the heart’s workload. This is known as hypertension. This is seen as one of the most significant factors in the development of CHD. Blood pressure is a measure of the pressure of the blood against the walls of a blood vessel. The pressure in an artery is highest during a ventricular systole of the heart (1). This is called a systolic pressure. High blood pressure makes the heart thicken and become stiffer. The risk of a stroke, heart attack, kidney failure and congestive heart failure increases (2).

Another major factor that we can choose to control are our weight and cholesterol. People who are obese have excess amounts of fat especially if it around the waist are more likely to develop heart disease and stroke even is they do not have the other factors. In the UK it is estimate that around 60% often and 40% of women are either overweight or obese (1). Obesity increases your blood pressure and your cholesterol levels and can in turn increase the risk of coronary heart disease and stroke. Obesity also raises your blood lipid levels, which is also a risk factor of CHD. It has been proven that cholesterol is a major factor affecting the risk of CHD, 10% of deaths from CHD in the UK could be avoided if everyone had a blood cholesterol level of less than 6.5 mmol per 1, generally. If we have a high blood cholesterol level it is our own fault because we can control it by monitoring our diet.

We can also control whether we smoke or not. Smokers risk f heart attack is more than twice the risk of a non-smoker. Smoking introduces a vast range of toxins including nicotine into the blood, which can damage arterial walls and trigger atherosclerosis (1). Cigarette smoking is the biggest risk factor for sudden cardiac death. It also acts with other risk factors to greatly increase the risk for CHD. Even exposure to other people’s smoke increases the risk of heart disease even non-smokers (2).

Physical inactivity is another factor for CHD. Physical activity such as moderate exercise helps prevent heart and blood vessel disease (2). The more vigorous the activity the greater your benefits. Exercise can help control blood cholesterol, diabetes and obesity as well as help maintain a lower blood pressure. Exercise strengthens heart muscle so that it does not have to work so hard to pump blood around the body. It also reduces the influence of other risk factors such as diabetes. As you can see exercise has many benefits and it is up to the individual if they want to keep healthy and reduce their chances of CHD however most people are not ready to exercise due to lack of time in their daily lifestyles.

Stress is also a contributory factor of CHD. Some people cannot help this, for instance, those with a genetic predisposition to anxiety. This can also contribute to the effect of other risk factors. For example stress may result in the individual overeating or start smoking.

Heavy drinkers are also very much at risk for CHD as it raises blood pressure, contributes to obesity and can cause an irregular heartbeat. Excess alcohol intake can result in direct tissue damage, including the heart. Drinking can also lead to other diseases such as lung cancer. Drinking too much alcohol can contribute to high triglycerides and produce irregular heartbeats.

A factor, which only applies on some people, is drugs. This is also the choice of the individual. Drugs affect synapses within the brain. Alcohol is an inhibitory drug as is cannabis and have the effects I have mentioned above.

Salt also affects the risk of CHD. A high salt diet causes the kidneys to retain water. This can mean higher blood pressure because of the high levels of fluid.

Diabetes is a major risk of developing cardiovascular disease. Even when glucose levels are in control the individual is at risk of CHD or a stroke but if the blood sugar levels are high the risk is much greater. About three-quarters of people with diabetes die of some form of heart or blood vessel disease (2).

There are many factors involved in the risk of CHD; some are major and some minor. I have explained most of them in detail. Most of the major factors can be controlled and the consequence of CHD would therefore be our fault if we overeating, obese, smoking, taking drugs, stress and so on. However there are also factors, which cannot be controlled such as gender, age, and heredity. Therefore we cannot say that heart diseases it totally our fault but we can increase or decrease the risk if we wanted. For example we could watch our diet and weight, exercise and reduce the intake of alcohol. This way we are reducing the effect of the other factors, which we don not have control over. The most common risk of cardiovascular disease tends to be, leading a sedentary lifestyle i.e. smoking, hypertension, raised blood cholesterol or obesity. These things can be controlled and modified. As these are the main factors, IT would be the individual’s fault if they had not had a healthy diet, smoked, had high cholesterol levels and were obese because of this. Physically inactive people in Great Britain have a double risk of stroke compared with those who are moderately, to vigorously active. These higher levels of activity are also associated with a50% reduction in the likelihood of dying after the hear attack (3). Physical inactivity plays a critical role in the development of obesity and non-insulin dependant diabetes mellitus and there is important links with blood pressure, thombogenesis, mobility and possibly lung function. As you can see being physically active, at any age is incredibly important and plays a key role in the factors that affect the risk of CHD.

On the whole we can say that the risk of CHD is affected by many factors. Some that is our own choice and others that are not.