Cardiovascular Diseases

The Epidemiology of Coronary Heart Disease

CHD, the most common type of heart disease, is caused by the failure of the blood vessels supplying the heart muscle due to fatty acid deposition, calcification, and subsequent plaque formation within the linings of the coronary arteries. This plaque leads to narrowing of the artery opening, thus reducing the amount of blood flow to the myocardium, followed by symptoms of chest pain and angina.

Culture determines the prevalence of individuals with elevated blood lipids, the total outcome of risk frequency, and the potential for prevention of coronary heart disease. People with diets composed of significant fatty acids, vegetable protein, cholesterol, complex carbohydrates, caloric excess, and a high intake of sodium are at the greatest risk for [Page 86]heart disease. Tobacco use also is associated with the increased risk of heart disease. Excessive caloric intake also can influence human health by metabolic maladaptations of obesity, hyperlipidemia, hyperinsulinemia, and hyperuricemia (gout).

Atherosclerosis (colloquially called “hardening of the arteries”) is four times more frequent in males than in females. The risk of sudden death will vary with the extent of the disease present along with the degree of impairment of ventricular function. Death will probably result from ventricular fibrillation. The most common complication of coronary disease is myocardial infarction. Within the United States, 3 million people will have an infarction, with most deaths occurring within 30 to 60 minutes after the start of symptoms.

Coronary artery disease (CAD) is responsible for nearly half of all deaths, and one-third of all deaths in people between the ages of 35 and 65 within the United States. The coronary heart, or ischemic heart disease, patient suffers from what is called pump failure, which is a decline in the contraction force of the ventricles. Associated risk factors include hypertension, hyperlipidemia, diabetes mellitus type 2, smoking, alcohol consumption (very heavy), obesity, sedentary lifestyle, hormone replacement therapy, and psychosocial factors. Typical risk factors for coronary heart disease that are nonmodifiable are genetics, race (blacks more than whites), age, male gender, and diabetes type 2.

Chronic Heart Failure

The initial loss of function of the myocardial cells places an abnormal burden on the left ventricle, causing an overload that may, over time, not be tolerated by the remaining normal myocardial cells. In these patients, this scenario can lead to acute or chronic heart failure (CHF).

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