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

attack 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.

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.