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
attach 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
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