Attempts aiming at prevention of coronary heart diseases

Coronary heart diseases (CHD) are the diseases of the heart that result from inadequate blood flow to the heart muscles compared to its needs. This may be caused by obstructive changes in the coronary blood vessels of the heart. Atherosclerosis of coronary arteries is the underlying pathology of coronary heart disease.

Manifestations of coronary heart diseases:

Coronary heart diseases may manifest in many ways, such as Angina pectoris, Unstable angina, Cardiac arrhythmias, Heart failure, Myocardial infarction and Sudden death.

Risk factors for developing coronary heart diseases:

There are many risk factors for developing coronary heart diseases. Some of them are not modifiable but many are modifiable.  

Non-modifiable risk factors-

Gender: Males are more affected then females.

Age: Increasing age is a risk factor for coronary heart disease.

Family history: Persons having family history of coronary heart diseases are at more risk of developing coronary heart disease.

 

Modifiable risk factors-

Smoking: Smoking accelerates narrowing of the arterial walls which favours heart attack.

Fatty diet: Increases the chance of CHD.

High blood pressure: Uncontrolled high blood pressure increases the risk of developing CHD.

High level of LDL cholesterol and low level of HDL cholesterol: LDL cholesterol is bad and HDL cholesterol is good. Long term high levels of LDL cholesterol and low level of HDL cholesterols are favourable for CHD.

Diabetes mellitus: Uncontrolled diabetes mellitus markedly increases the chances of CHD.

Obesity: Obese persons are prone to develop CHD.

Physical inactivity or sedentary habits: Persons with more sedentary lifestyles or having no physical activity are also prone to develop CHD.

Stress: Stressful life is a risk factor for CHD.

Alcoholic drinks: These also increases the chance of CHD.

Prevention of coronary heart diseases:

Prevention of coronary heart disease includes primordial prevention, primary prevention and secondary prevention.

Primordial prevention:

Primordial prevention involves prevention of emergence of risk factors among the whole population. This includes healthy dietary habits and healthy lifestyles of the whole population from their early childhood.

Healthy dietary habits like reduction of fat intake to 20-30% of total calorie intake, saturated fat less than 10% of total calorie intake, dietary cholesterol to below 100 mg per 100 kcal per day and an increase consumption of fruits, vegetables and whole grins, avoidance of alcohol consumption are very important.

Regular physical activity, reduction of average blood pressure of the whole population and avoidance of smoking are also interventions of population strategy.

Primary prevention:

Besides primordial prevention, it is important to identify the persons having the risk factors for coronary heart disease and then bring them under preventive care by motivating them to take positive actions against the identified risk factors so that they can modify the risk factors. That is, coronary heart disease can be prevented by modifying the modifiable risk factors.

Smoking should be stopped. Blood pressure should be screened regularly at least once every two years if blood pressure is normal.

But if there is hypertension or pre-hypertension, then it should be checked more often and the blood pressure should be kept under control by medications, dietary changes and physical activities.

Dietary approaches to stop hypertension, in short called DASH, are a unique way to prevent high blood pressure. Eating more fruits and vegetables is very essential in this regard. Blood glucose levels should be measured every 3 years. May also measure A1c levels.

If there is diabetes mellitus, it is also to be kept under control by medications, dietary changes and physical activities. Similarly, blood cholesterol is also to be routinely checked every 4 years.

If there is a rise in bad cholesterol levels, then it should be controlled again by medications, dietary changes and physical activities. Body weight should be kept at normal range.

If obese, the weight should be reduced. Physical activity should be a regular practice.

Secondary prevention

Secondary prevention aims at prevention of recurrences and progression of coronary heart disease. Persons once suffered from CHD should stop smoking, must control their diabetes mellitus and hypertension, should consume healthy diet and should perform permissible regular physical exercise.

Attempts aiming at prevention of coronary heart diseases

Coronary heart diseases (CHD) are the diseases of the heart that result from inadequate blood flow to the heart muscles compared to its needs. This may be caused by obstructive changes in the coronary blood vessels of the heart. Atherosclerosis of coronary arteries is the underlying pathology of coronary heart disease. Manifestations of coronary heart diseases: Coronary heart diseases may manifest in many ways, such as Angina pectoris, Unstable angina, Cardiac arrhythmias, Heart failure, Myocardial infarction and Sudden death. Risk factors for developing coronary heart diseases: There are many risk factors for developing coronary heart diseases. Some of them are not modifiable but many are modifiable. Non-modifiable risk factors- Gender: Males are more affected then females. Age: Increasing age is a risk factor for coronary heart disease. Family history: Persons having family history of coronary heart diseases are at more risk of developing coronary heart disease. Modifiable risk factors- Smoking: Smoking accelerates narrowing of the arterial walls which favours heart attack. Fatty diet: Increases the chance of CHD. High blood pressure: Uncontrolled high blood pressure increases the risk of developing CHD. High level of LDL cholesterol and low level of HDL cholesterol: LDL cholesterol is bad and HDL cholesterol is good. Long term high levels of LDL cholesterol and low level of HDL cholesterols are favourable for CHD. Diabetes mellitus: Uncontrolled diabetes mellitus markedly increases the chances of CHD. Obesity: Obese persons are prone to develop CHD. Physical inactivity or sedentary habits: Persons with more sedentary lifestyles or having no physical activity are also prone to develop CHD. Stress: Stressful life is a risk factor for CHD. Alcoholic drinks: These also increases the chance of CHD. Prevention of coronary heart diseases: Prevention of coronary heart disease includes primordial prevention, primary prevention and secondary prevention. Primordial prevention: Primordial prevention involves prevention of emergence of risk factors among the whole population. This includes healthy dietary habits and healthy lifestyles of the whole population from their early childhood. Healthy dietary habits like reduction of fat intake to 20-30% of total calorie intake, saturated fat less than 10% of total calorie intake, dietary cholesterol to below 100 mg per 100 kcal per day and an increase consumption of fruits, vegetables and whole grins, avoidance of alcohol consumption are very important. Regular physical activity, reduction of average blood pressure of the whole population and avoidance of smoking are also interventions of population strategy. Primary prevention: Besides primordial prevention, it is important to identify the persons having the risk factors for coronary heart disease and then bring them under preventive care by motivating them to take positive actions against the identified risk factors so that they can modify the risk factors. That is, coronary heart disease can be prevented by modifying the modifiable risk factors. Smoking should be stopped. Blood pressure should be screened regularly at least once every two years if blood pressure is normal. But if there is hypertension or pre-hypertension, then it should be checked more often and the blood pressure should be kept under control by medications, dietary changes and physical activities. Dietary approaches to stop hypertension, in short called DASH, are a unique way to prevent high blood pressure. Eating more fruits and vegetables is very essential in this regard. Blood glucose levels should be measured every 3 years. May also measure A1c levels. If there is diabetes mellitus, it is also to be kept under control by medications, dietary changes and physical activities. Similarly, blood cholesterol is also to be routinely checked every 4 years. If there is a rise in bad cholesterol levels, then it should be controlled again by medications, dietary changes and physical activities. Body weight should be kept at normal range. If obese, the weight should be reduced. Physical activity should be a regular practice. Secondary prevention Secondary prevention aims at prevention of recurrences and progression of coronary heart disease. Persons once suffered from CHD should stop smoking, must control their diabetes mellitus and hypertension, should consume healthy diet and should perform permissible regular physical exercise.