Coronary Artery Disease
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Coronary Artery Disease
NIH - Medical Encyclopedia Coronary heart disease "Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease. Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and a substance called plaque builds up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain (stable angina), shortness of breath, heart attack, and other symptoms. Coronary heart disease (CHD) is the leading cause of death in the United States for men and women. … Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.
There are two main types of chest pain:
• Atypical chest pain -- often sharp and comes and goes. You can feel it in your left chest, abdomen, back, or arm. It is unrelated to exercise and not relieved by rest or a medicine called nitroglycerin. Atypical chest pain is more common in women.
• Typical chest pain -- feels heavy or like someone is squeezing you. You feel it under your breast bone (sternum). The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin. Adults with typical chest pain have a higher risk of CHD than those with atypical chest pain.
Other symptoms include: • Shortness of breath • Heart attack -- in some cases, the first sign of CHD is a heart attack…
Tips for preventing CHD or lowering your risk of the disease: • Avoid or reduce stress as best as you can. • Don't smoke. • Eat well-balanced meals that are low in fat and cholesterol and include several daily servings of fruits and vegetables. • Get regular exercise. If your weight is considered normal, get at least 30 minutes of exercise every day. If you are overweight or obese, experts say you should get 60 to 90 minutes of exercise every day. • Keep your blood pressure, blood sugar, and cholesterol under control"
NHS – Coronary Heart Disease (Videos) “The main symptom of coronary heart disease is angina. Angina can be a mild, uncomfortable feeling similar to indigestion. In severe cases, it causes a feeling of extreme pressure on the chest, breathlessness, trapped air and belching. It is usually triggered by physical exercise or stressful situations, and tends to go away when you stop what you're doing, when you rest or when you take medication. Other symptoms include: Heart palpitations When you become aware of your heart beating irregularly or harder than normal. Heart attack If your arteries become completely blocked, you will have a heart attack. … Heart failure Heart failure occurs when the heart gradually gets too weak to pump blood around the body. This can cause fluid to build up in the lungs, making it increasingly difficult to breathe. Heart failure can happen suddenly (acute heart failure) or over a period of time (chronic heart failure).”
Highlighted Articles
Positive and negative affect and risk of coronary heart disease: Whitehall II prospective cohort study. (BMJ. 2008) “Smoking, hypertension, hypercholesterolaemia, and diabetes are established risk factors for coronary heart disease, a leading cause of morbidity and mortality in Western industrialised countries.1 2 However, psychological factors, such as emotions, may also have a role in the development of coronary heart disease.3 4 Several prospective studies have found anxiety, hostility/anger, and depression to be associated with an increased risk of coronary heart disease in healthy participants.3 5 As the relative importance of these three negative emotions on risk of coronary heart disease remains largely undefined,6 7 they have been hypothesised to be the components of a single underlying factor, labelled negative affect. Negative affect refers to “stable and pervasive individual differences in mood and self-concept characterised by a general disposition to experience a variety of aversive emotional states.”5 8 High negative affect has been described as a general tendency to report “distress, discomfort, dissatisfaction, and feelings of hopelessness over time and regardless of the situation,” and low negative affect is characterised by “calmness and serenity.”8 9 Supporting this conceptualisation, a considerable neurobiological and psychological overlap between anxiety, hostility/anger, and depression has previously been shown.10 11 As attempts to link psychological factors to heart disease have focused on negative emotions, mostly depression,7 whether positive emotions might also have a role in the development of coronary heart disease remains unclear.“
[Heart disease and stroke] (Tidsskr Nor Laegeforen. 2007)"Most cases of heart disease and stroke are caused by atherosclerosis, and the two diseases have much in common with regards to risk factors, treatment and prognosis. Heart disease may also be a direct cause of stroke. About one in four cerebral infarctions are due to embolism from the heart to the brain, mainly because of atrial fibrillation, but also because of diseases such as acute myocardial infarction, dilated cardiomyopathy and prosthetic heart valves (cardioembolic stroke). Stroke can also be caused by a cardiogenic fall in blood pressure in patients with stenoses in pre- or intracerebral arteries (haemodynamic stroke). Patients with symptoms of atherosclerosis in one artery system should be treated as if they have a high risk of developing symptoms from other artery systems. The possibility of a cardiac embolic source should always be considered in patients with acute brain infarctions."
Optimal Medical Therapy with or without PCI for Stable Coronary Disease (NEJM 2007) "Background In patients with stable coronary artery disease, it remains unclear whether an initial management strategy of percutaneous coronary intervention (PCI) with intensive pharmacologic therapy and lifestyle intervention (optimal medical therapy) is superior to optimal medical therapy alone in reducing the risk of cardiovascular events. … Conclusions As an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy."
Visit InfoMedSearch's Home Page for all InfoMedLinks Cardiovascular Topics: Atherosclerosis, Atrial Fibrillation, Coronary Artery Disease, Cholesterol - Lipids, General Cardiovascular, Heart Failure, Hypertension, Myocardial Infarction (Heart Attack), Peripheral Artery Disease, and Stroke.
Coronary Artery Disease
Risk Factors
NEWS:
Heart disease risk soars with obesity, diabetes “Researchers found that of more than 3,400 adults in a long-running U.S. heart study, women who were obese and diabetic had a nearly 80 percent chance of developing heart disease at some point. For their male counterparts, that figure was nearly 90 percent.”
Low vitamin D linked to sudden cardiac death “Vitamin D deficiency is associated with heart dysfunction, sudden cardiac death, and death due to heart failure, German researchers report. An association between vitamin D deficiency and heart trouble is physiologically plausible, the researchers note. For example, vitamin D is known to affect contractility of the heart.“
Statement from Elizabeth G. Nabel, M.D., Director, National Heart, Lung, and Blood Institute on New Findings on the Role of Inflammation in Prevention of Coronary Heart Disease “These studies expand our understanding of the role of inflammation in detecting early signs of cardiovascular disease and identifying adults who are at risk for heart attack or stroke. These findings suggest that adding hsCRP levels to traditional risk factors could identify millions more adults for whom treatment with statins appears to lower the risk of heart attack.”
Too Little Vitamin D Puts Heart at Risk “Getting too little vitamin D may be an underappreciated heart disease risk factor that's actually easy to fix. Researchers say a growing body of evidence suggests that vitamin D deficiency increases the risk of heart disease and is linked to other, well-known heart disease risk factors such as high blood pressure, obesity, and diabetes. For example, several large studies have shown that people with low vitamin D levels were twice as likely to have a heart attack, stroke, or other heart-related event during follow-up, compared with those with higher vitamin D levels. “
'Western' Diet Is a Global Heart Risk “The INTERHEART study, funded by the Canadian Institutes of Health Research, shows that the risk of heart attack crosses geographic boundaries and correlates strongly to the so-called Western diet that favors salty snacks and fried foods, and to a lesser extent, meat. The risk, spread over five continents, is 30% higher for those who eat a Western diet, the study shows, than for those who adhere to a "prudent diet," or one rich in fruits and vegetables. An Oriental diet, which is high in tofu and other soy products, doesn't seem to lower or raise heart attack risk overall, according to the study.”
White bread linked to heart disease “EATING white bread and sugary breakfast cereals can increase the risk of diabetes, heart disease and even cancer, new Australian research suggests. A world-first study by Sydney scientists has found conclusive evidence that a high GI diet, generally rich in food that is burnt by the body quickly, leads to a higher risk of common lifestyle diseases. The Glycemic Index (GI) is a measure of how different foods affect your blood glucose levels, with those that are “low GI” released more slowly and deemed better for health. “
ARTICLES:
JOURNAL ARTICLES:
Chronic Particulate Exposure, Mortality, and Coronary Heart Disease in the Nurses’ Health Study (American Journal of Epidemiology 2008) “In this population, increases in such exposures were associated with increases in all-cause and CHD mortality. Never smokers with higher body mass indexes were at greatest risk of fatal CHD.”
Obesity, Behavioral Lifestyle Factors, and Risk of Acute Coronary Events. (Circulation. 2008) “Conclusions-Obesity confers an elevated risk of ACS in both healthy and less healthy subgroups of lifestyle behaviors. Adherence to healthy lifestyle behaviors was associated with a lower risk even among obese individuals.”
Prediction of First Events of Coronary Heart Disease and Stroke With Consideration of Adiposity (Circulation. 2008) “Conclusions— Greater BMI, higher systolic blood pressure, higher ratio of cholesterol to high-density lipoprotein cholesterol, and presence of DM were all predictive of first CHD events, and all but the presence of DM were predictive of first CeVD events. These results suggest that common pathophysiological mechanisms underlie the roles of BMI, DM, and systolic blood pressure as predictors for first CHD and CeVD events.”
The omega-3 index as a risk factor for coronary heart disease. (Am J Clin Nutr. 2008)
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