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Coronary Heart Disease. by Amy Lovern, RN, BSN. What is coronary heart disease?. It is a condition occurring when the blood and oxygen supply to the heart diminish due to narrowing blood vessels. Coronary artery and arteriosclerotic heart disease are two other names for coronary heart disease.
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Coronary Heart Disease by Amy Lovern, RN, BSN
What is coronary heart disease? • It is a condition occurring when the blood and oxygen supply to the heart diminish due to narrowing blood vessels. Coronary artery and arteriosclerotic heart disease are two other names for coronary heart disease. • Coronary heart disease affects 12.6 million people in the United States and causes more than 500,000 deaths annually.
Causes of Coronary Heart Disease • Coronary heart disease is cause by impaired blood flow to the myocardium (heart). • Atherosclerosis is the usual cause of coronary heart disease. This condition occurs when plaque builds up on artery walls causing them to narrow.
Symptoms of Coronary heart disease • Coronary heart disease may be asymptomatic or may lead to angina pectoris (chest pains), myocardial infarction (heart attack), dysrhythmias, heart failure, and even sudden death.
Who is at risk? • The highest incidence of CHD is in the Western world, mainly in white males age 45 and older. • Both men and women are affected by coronary heart disease; in women the onset is about 10 years later than men due to the heart-protective effects of estrogen. • After menopause, women’s risk is equal to that of men.
Risk Factors • Risk factors for CHD are frequently classified as non-modifiable, or factors that cannot change, and modifiable, those factors that can be changed.
Non-modifiable risk factors • Age – over 50% of heart attack victims are 65 or older. • Gender- men are affected at an earlier age than women. • Race- African Americans have a higher incidence of hypertension, which contributes to more rapid development of atherosclerosis.
Modifiable risk factors • Modifiable risk factors include lifestyle factors and pathologic conditions that predispose the person to developing CHD. • Pathologic conditions which contribute to CHD include hypertension, diabetes mellitus, and hyperlipidemia.
Hypertension • Hypertension is consistent blood pressure readings greater than 140 mmHg systolic or 90 mmHg diastolic. • Hypertension is common, affecting more than one-third of people over the age of 50 in the United States.
Diabetes Mellitus • Diabetes mellitus contributes to CHD in several ways. • Diabetes is associated with hyperlipidemia, hypertension, and obesity, all risk factors in their own right. • Diabetes affects blood vessels, contributing to the process of atherosclerosis.
Hyperlipidemia • Hyperlipidemia is an abnormally high level of blood lipids and lipoproteins. Lipoproteins carry cholesterol in the blood. • Low-density lipoproteins (Less Desirable Lipoproteins) are the primary carriers of cholesterol. • High-density lipoproteins (Highly Desirable Lipoproteins) help clear cholesterol from the arteries, transporting it to the liver for excretion.
Lifestyle Factors • Cigarette smoking is an independent risk factor for CHD, responsible for more deaths from CHD than from lung cancer or pulmonary disease. • Obesity (body weight greater than 30% over ideal body weight) , increased BMI (body mass index), and fat distribution affect the risk of CHD. • Physical Inactivity is associated with higher risk for CHD. • Diet may be a risk factor for CHD.
Cigarette Smoking • The male cigarette smoker has 2 to 3 times the risk of developing heart disease than the nonsmoker. The female who smokes has up to 4 times the risk. • For both men and women who stop smoking, the risk of mortality from CHD is reduced by half. • Second-hand smoke increases the risk of death from CHD by as much as 30%.
Dietary Recommendations • Eat a variety of nutritious foods from all food groups. • Eat fish at least twice a week. Recent research shows that eating oily fish containing omega-3 fatty acids (salmon, herring, and trout) may help lower your risk of death from coronary artery disease. • Eat unrefined whole-grain foods, which contain fiber that can help lower blood cholesterol.
Cut back on foods containing: • partially hydrogenated vegetable oils to reduce trans fats. • beverages and foods with added sugars. • foods high in dietary cholesterol. Aim to eat less than 300 milligrams of cholesterol each day. • foods high in sodium. Aim for less than 2,300 milligrams of sodium per day.
Get physical! • Research indicates that people who maintain a regular program of physical activity are less prone to developing CHD than sedentary people. • Cardiovascular benefits of exercise include increased availability of oxygen to the heart muscle, decreased oxygen demand and cardiac workload, and decreased blood pressure.
Facts about the heart • The normal heart is a strong, muscular pump, about the size of a fist. • Each day the average heart beats (expands and contracts) 100,000 times and pumps about 2,000 gallons of blood. • In a 70-year lifetime, the average human heart will beat approximately 2.5 billion times.
Structure of the Heart • The heart has four chambers: two on the right and two on the left. • The two upper chambers are called the atria. • The two lower chambers are called ventricles.
