- Coronary Heart Disease
Clinical studies, laboratory
investigations and a number of surveys show certain personal
characteristics and life-styles pointing to increased danger
of heart attack (coronary heart disease). These danger signs
are called "risk factors". The well established risk
factors are high blood pressure, high blood cholesterol, cigarette
smoking and diabetes mellitus. Other factors that may increase
or affect the risk for heart attach are obesity, a sedentary
life-style, an aggressive response to stress, and certain drugs.
In the past two decades, millions
of Americans have learned about these risk factors and have tried
to modify them favorable by seeking medical attention and by
changing life-style. Many adults have stopped smoking. The medical
control of high blood pressure has greatly improved. The average
cholesterol level of the population has decreased continually
over the last two decades, probably due to changes in dietary
habits and increased exercise.
This attempt to modify risk factors almost certainly has contributed
to the declining death rate from heart disease in the United
States. During the 1960's, U.S. death rates from heart disease
were still rising, but today the incidence from diseases of the
cardiovascular system (including coronary heart disease) has
fallen dramatically. Overall, heart-related problems have declined
about 25 percent in the last decade. Some of this decrease undoubtedly
is due to better medical care of heart attack victims, but it
is likely that a sizable percentage is related to modification
of risk factors. |
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The entire population has become
more aware of the seriousness of heart disease and coronary heart
problems. CPR training is offered in schools, places of business,
and church and community functions, and everyone seems to recognize
that prevention of coronary heart disease is a partnership between
the public and the medical community.
These are a number of factors implicated in coronary heart disease.
Some of these may raise coronary risk by accentuating the major
risk factors already discussed. Others may act in ways not understood.
Still others may be linked mistakenly to coronary risk.
Obesity predisposes individuals to coronary heart disease. Some
of the reasons for this are known, but others are not. The major
causes of obesity in Americans are excessive intake of calories
and inadequate exercise. When caloric intake is excessive, some
of the excess frequently is saturated fat, which further raises
the blood cholesterol. Thus, obesity contributes to higher coronary
risk in a variety of ways.
Most of the major risk factors are silent. They must be sought
actively, and much of the responsibility for their detection
lies with each of us as individuals. Regular checkups are particularly
necessary if there is a family history of heart disease, high
blood pressure, high cholesterol levels or diabetes.
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