CORONARY HEART DISEASE (CHD)
(Syn.: ISCHAEMIC HEART DISEASE)
“Impairment of heart function due to inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation of the heart” is the definition of Coronary heart disease. [Source: WHO (1982). Techn Rep. Ser. No. 678].
Symptoms
$ Pain in the centre of the chest with sweating in full body.
$ Pain in the neck or pain in left hand arm pit or pain above the stomach.
$ About 20% of the people are attacked by Coronary heart disease without any pain.
Risk Factors
Some habits and activities which make the occurrence of the disease more probable is known as risk factors.
Some of the Risk factors are modifiable, while others are not modifiable. The below table show the same.
| Modifiable | Non – Modifiable |
| 1. Cigarette smoking | 1. Age |
| 2. High BP | 2. Sex |
| 3. Elevated Serum Cholesterol | 3. Family History |
| 4. Diabetes | 4. Genetic Factors |
| 5. Obesity | 5. Personality |
| 6. Sedentary habits | |
| 7. Stress |
The principal risk factors are given below,
1. Smoking
Cigarette smoking is the major reason for Coronary heart disease. If the person quits the habit of smoking, the risk of death from coronary heart disease is decreased. The risk decreases quite substantially within one year of stopping smoking. After 10-20 years, it is same as that of non-smokers. [Source: WHO (1979) Tech. Rep. Ser. No.636].
2. Serum Cholesterol
Excess amount of cholesterol in blood is known as Hyperlipidemia [also known as hyperlipoproteinemia, or hyperlipidaemia (British English)]. Cholesterol should be less than 200mg/dl in blood. Low density lipoprotein (LDL) cholesterol is directly associated with Coronary heart disease and should be less than 100mg/dl. High density lipoprotein (HDL) cholesterol is protective against the development of coronary heart disease and should be more than 30mg/dl.
“With newer techniques, HDL and LDL have been further subdivided into sub-fractions. Recent evidence indicates that levels of plasma apolipoprotein-A-I (the major HDL protein) and apolipoprotein-B (the major LDL protein) are better predictors of coronary heart disease than HDL cholesterol or LDL cholesterol respectively. Therefore measurement of apolipoproteins may replace lipoprotein cholesterol determinations in assessing the risk of coronary heart disease.” (Source: Park’s text book of Preventive and social medicine by K.Park).
3. Hyper Tension
For some persons due to hyper tension, there will be no symptoms of coronary heart disease. So it is better to check blood pressure every 6 months. Those who have blood pressure should take salt in lesser quantity. Also they should avoid taking pickles, pappad, chips, canned foods, salt biscuits and dried fish.
4. Diabetes
Diabetes patients should keep their blood sugar level in control. The risk of coronary heart disease is 2-3 times higher in diabetes patients than in non-diabetics patients. Diabetic patients should keep their blood sugar level at 100mg to 126mg before taking any food and 2 hours after taking food at 140mg to 180mg. Daily exercise is also very important.
5. Obesity
Obesity is also a reason for coronary heart disease. Exercise is good to control obesity.
Other reasons include
1. Genetic factors – family history of coronary heart disease
2. Physical activity, without any exercise.
3. Hormones
4. Alcohol
5. Oral contraceptives
Advices for Heart patients
1. Take 30 minutes rest after taking food.
2. Do your jobs patiently and calmly.
3. Do not eat heavy meals.
4. Avoid alcohol.
5. Avoid egg yellow, liver, brain, crab, prawn, pork, beef, coconut, coconut oil, palm oil, butter, ghee, cream.
6. Avoid smoking.
More Articles on CHD will be published later with more details and medical advices………
