New Delhi: Coronary heart disease (CHD) or coronary artery disease (CAD) is the most common form of heart disease that causes impaired blood flow in the arteries supplying blood to the heart. This can lead to heart attacks, heart failure, and even death. Also known as ischemic heart disease (IHD), coronary artery disease has assumed epidemic proportions worldwide.
Globally, ischemic heart disease is the primary cause of death with a recognised set of risk factors. In contrast to developed countries, where mortality from coronary heart disease is rapidly declining, it is increasing in developing countries mainly driven by industrialisation, urbanisation, and related lifestyle changes.
The growing epidemic of coronary heart disease across the globe
This epidemic is mainly driven by an increase in the prevalence of major risk factors like obesity, high cholesterol, cigarette smoking, a sedentary lifestyle, diabetes mellitus, and hypertension. “These risk factors are interdependent and the presence of one predisposes to the occurrence of others. In combination, this leads to an exponential increase in the risk of developing coronary heart disease,” said Dr Gnanadev, consultant cardiologist, BGS Gleneagles Global Hospitals, Bangalore.
Coronary heart disease is predominantly a man-made disease caused by an unhealthy lifestyle. Some of these risk factors are modifiable, which means they can be controlled, unlike non-modifiable risk factors such as increasing age, male sex, family history of a heart attack, etc.
Risk factors for coronary heart disease
Obesity: Obesity, which is often a result of poor diet and lifestyle choices, is an independent risk factor for the development of coronary heart disease. Furthermore, obesity is associated with accelerated progression of CHD. Excess weight and obesity also predispose diabetes mellitus and hypertension which, in turn, accelerate the progression of CHD and worsening prognosis.
Smoking: Smoking is a major risk factor for coronary heart disease. The quantum of risk increases with the number of cigarettes. It doubles the risk of having a heart attack – the risk persists up to five years after quitting smoking. Passive smoking is also harmful. Research clearly shows that exposure to secondhand tobacco smoke is a cause of heart disease in non-smokers.
Diabetes: Diabetes is a serious risk factor for developing cardiovascular disease. Even if the glucose level is under control, diabetes increases the risk of heart disease and stroke. The risks are even greater if blood sugar is not controlled well. Around 68 per cent of people with diabetes over 65 years of age die of some form of heart disease. Among that same group of people, 16 per cent die of stroke.
High blood pressure: It increases the heart’s workload, causing the heart muscle to thicken and become stiffer eventually leading to a heart attack. This stiffening of the heart muscle is not normal and can further affect the heart to function normally. It also increases your risk of heart attack, stroke, kidney failure and congestive heart failure.
Additionally, stress and unhealthy eating habits are risk factors for heart disease, including heart attack. Individual response to stress may be a contributing factor for heart attacks. It has been noted that a relationship exists between coronary heart disease risk and stress in a person’s life, along with their health behaviours and socioeconomic status. For instance, people under stress may overeat, start smoking or smoke more than they otherwise would.
A dietary pattern consisting of more fried food, added fats, processed meats, and sugar-sweetened beverages increases the risk of a heart attack. These factors may affect other controllable risk factors, such as cholesterol, blood pressure, diabetes and being overweight.
Can the risk of getting a heart attack be reduced?
Yes, up to a large extent. There are a number of things you can do to reduce all of the modifiable risk factors for heart disease and heart attack. Perhaps, any measures to prevent heart attack should be initiated at a young age. Moreover, atherosclerosis which is deposition of cholesterol in blood vessels and a precursor of heart attack appears at a young age. Hence, its progression or regression depends on how healthy our lifestyle is, added Dr Gnanadev.
Lifestyle changes for a healthy heart
- Heart-healthy lifestyle practices include a healthy diet that emphasises the intake of vegetables, fruits, nuts, whole grains, lean protein, and fish while minimising the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages, etc.
- For overweight or obese adults, counselling and caloric restriction are recommended by the health experts/doctors for achieving and maintaining weight loss.
- People should engage in at least 150 minutes per week of moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.
- For adults with Type 2 diabetes mellitus, lifestyle changes – such as improving dietary habits and achieving exercise recommendations are crucial.
- Quitting smoking at the earliest is very important.
- Stress-reducing habits will help improve overall health. Physical activity or exercise is one way to reduce stress. Slowing down and performing relaxation exercises or breathing techniques, such as those used in yoga, is also helpful.
- Letting go of worries and spending more time with family and friends can also contribute to a healthier, more relaxed lifestyle.
- It’s also important to get enough sleep.
In conclusion, most cases of coronary heart disease are preventable. It is grown into an epidemic proportion globally largely because of our poor, unhealthy lifestyle. Inculcating healthy lifestyle measures from a young age is vital in preventing this epidemic. An age-old saying, “what we sow is what we reap”, aptly holds good for this particular disease. Making lifestyle changes can reduce the risk of coronary heart disease and other complications such as heart attack.