Coronary Heart Disease (CHD)

Coronary Heart Disease (CHD)• Seven million Americans effected• Caused by narrowing of the coronary arteries• No. 1 killer of men and women in U.S.

>500,000 each year

• > 60 million Americans have some form of coronary vascular disease (CVD)

• >2,600 Americans die each day of CVD, i.e., 1 death/33 sec

• ~ $299 billion cost to the U.S.

Risk factors

• High blood pressure (hypertension)

• High blood cholesterol

• Smoking

• Obesity

• Diabetes

• StressControllable

Major Risk Factors:The Big Three

• Hypertension

• High cholesterol

• Cigarette smoking

All three increase risk factor eight times

AND…. we should add LACK OF EXERCISE

Hypertension

• Commonly called high blood pressure

• Systolic and diastolic measurements

• Normal systolic - 110-130 mmHg

• Normal diastolic - 70-90 mm Hg

Symptoms of CHD

• Chest pain (angina)

• Shortness of breath

• Heaviness, tightness, pain, pressure or squeezingbehind the breastbone or in the arms,

neck, or jaws

• Pain may vary

• Perhaps no pain

Cause & Consequencess of CHD• Lack of oxyge

• Narrowing of coronary arteries

• Heart responds with angina

• Finally, heart attack Possible permanent damage

Treatment for CHD

• Lifestyle changes

• Medication

• Surgery

Lifestyle Changes

• Change of habits

• Low fat diet

• Lower weight

• Increase exercise

• Stop smoking

Effects of Smoking

• For adult males, smoking has declined from 53 % to 38%

• For women, remains at 30%

• Has increased for younger and teenaged women

• Heavy smoker = 20- 30 cigs/day

Effects of Smoking (cont’d)• Cigs contain about 2000 compounds

• Main harmful are tar, nicotine and COTar contains hydrocarbons and other carcinogenic

substancesNicotine causes release of epinephrine and

norepinephrine resulting in increased HR, BP, cardiac output, stroke volume, contractility, oxygen consumption, and coronary blood flow

CO reduces oxygen carrying capacity of the blood; can precipitate angina

Effects of Smoking (cont’d)

• Contributes to development of atherosclerosis

• Lowers levels of HDLcauses deterioration of elasticity of

vesselsResponsible for 20% of all deaths from

heart disease

• Female smokers have a higher risk than male smokers

HDL• High density lipoproteins seem to have

protective effect against development of atherosclerosis (a form or arteriosclerosis in which deposits of yellowish plaque containing cholesterol, lipoid substances and lipophages are formed within large and medium-sized arteries)

• Women have higher concentrations than men• Most important of all lipid risk factors• Below 35 mg/dl----- 8X incidence of CAD

compared to those with 65 mg/dl• Moderate alcohol intake may have + effect• Exercise has + effect• Greater weight has a negative effect

DIET

• Reduce saturated fats

• Increase polyunsaturated fats

• Higher protein to fat ratio

• Count calories