CORONARY HEART DISEASE
Clinical studies, laboratory investigations and a number of
surveys show certain personal characteristics and lifestyles
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
attach are obesity, a sedentary lifestyle, 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 lifestyle. 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, US 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.
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