Heart disease 1: Risk factors you need to watchout for.

In the United States, 1 in 4 women dies from heart disease. In fact, coronary heart disease (CHD)—the most common type of heart disease—is the #1 killer of both men and women in the United States. Women tend to have CHD about 10 years later than men. However, CHD remains the #1 killer of women in the United States.

 Other types of heart disease, such as coronary microvascular disease (MVD) and broken heart syndrome, also pose a risk for women. In this article we would be focusing on CHD and its complications. However, general information about coronary MVD and broken heart syndrome would be given.

• ·        Coronary Heart Disease

CHD is a disease in which plaque (usually made up fat, cholesterol, calcium, and other substances found in the blood) builds up on the inner walls of your coronary arteries. Over time, this plaque can harden or rupture. Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina.

If the plaque ruptures, a blood clot can form on its surface. A large blood clot can partially or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries. When plaque builds up in the arteries, the condition is called atherosclerosis.

CHD may lead to heart failure, irregular heartbeats called arrhythmias, and sudden cardiac arrest (SCA).

·        Coronary Microvascular Disease

Coronary MVD is heart disease that affects the heart's tiny arteries. In coronary MVD, the walls of the heart's tiny arteries are damaged or diseased.

Women are more likely than men to have coronary MVD. It is believed that a drop in estrogen levels during menopause combined with other heart disease risk factors causes coronary MVD. Although death rates from heart disease have dropped in the last 30 years, they haven't dropped as much in women as in men. This may be the result of coronary MVD.

·        Broken Heart Syndrome

Broken heart syndrome is also called stress-induced cardiomyopathy or takotsubo cardiomyopathy. In this recently recognized heart problem, extreme emotional stress can lead to severe (but often short-term) heart muscle failure. Women are also more likely than men to have a condition called broken heart syndrome.

Broken heart syndrome may easily be misdiagnosed as a heart attack because it has similar symptoms and test results. However, there's no evidence of blocked heart arteries in broken heart syndrome, and most people have a full and quick recovery. Researchers are just starting to explore what causes this disorder and how to diagnose and treat it.

Having seen the types of heart disease, let us focus on the CHD which is the number 1 killer heart disease. The good news is that you can control many CHD risk factors. CHD risk factors are conditions or habits that raise your risk for CHD and heart attack. These risk factors also can increase the chance that existing CHD will worsen.

Major CHD Risk Factors

• Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called “bad” cholesterol) and low HDL cholesterol (sometimes called “good” cholesterol).
• High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)
• Smoking. Smoking can damage and tighten blood vessels, lead to unhealthy cholesterol levels, and raise blood pressure. Smoking also can limit how much oxygen reaches the body's tissues.
• Insulin resistance. This condition occurs if the body can't use its own insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used for energy. Insulin resistance may lead to diabetes.
• Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly.
• Overweight or obesity. The terms “overweight” and “obesity” refer to body weight that’s greater than what is considered healthy for a certain height.
• Metabolic syndrome. Metabolic syndrome is the name for a group of risk factors that raises your risk for CHD and other health problems, such as diabetes and stroke.
• Lack of physical activity. Being physically inactive can worsen other risk factors for CHD, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight or obesity.
• Unhealthy diet. An unhealthy diet can raise your risk for CHD. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other risk factors for CHD.
• Older age. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk for CHD increases after age 45. In women, the risk for CHD increases after age 55.
• Family history of early heart disease. Your risk increases if your father or a brother was diagnosed with CHD before 55 years of age, or if your mother or a sister was diagnosed with CHD before 65 years of age.

Although older age and a family history of early heart disease are risk factors, it doesn't mean that you’ll develop CHD if you have one or both. Controlling other risk factors often can lessen genetic influences and help prevent CHD, even in older adults.
Other conditions and factors also may contribute to CHD, including:

• Sleep apnea. Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can increase your risk for high blood pressure, diabetes, and even a heart attack or stroke.
• Stress. Research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event, especially one involving anger.
• Alcohol. Heavy drinking can damage the heart muscle and worsen other CHD risk factors. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day.
• Preeclampsia. This condition can occur during pregnancy. The two main signs of preeclampsia are a rise in blood pressure and excess protein in the urine. Preeclampsia is linked to an increased lifetime risk of heart disease, including CHD, heart attack, heart failure, and high blood pressure.

Signs and Symptoms of Coronary Heart Disease

·          ANGINA: This refers to chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain.

·         SHORTNESS OF BREATH: This symptom occurs if CHD causes heart failure. When you have heart failure, your heart can't pump enough blood to meet your body’s needs. Fluid builds up in your lungs, making it hard to breathe.

The severity of these symptoms varies. They may get more severe as the buildup of plaque continues to narrow the coronary arteries. Some people who have CHD have no signs or symptoms—a condition called silent CHD. The disease might not be diagnosed until a person has signs or symptoms of a heart attack (flow of oxygen-rich blood to a section of heart muscle is cut off), heart failure (heart can't pump enough blood to meet your body’s needs), or an arrhythmia (an irregular heartbeat). 

What Causes Coronary Heart Disease?

Research suggests that coronary heart disease (CHD) starts when certain factors damage the inner layers of the coronary arteries. These factors include:

• Smoking
• High levels of certain fats and cholesterol in the blood
• High blood pressure
• High levels of sugar in the blood due to insulin resistance or diabetes
• Blood vessel inflammation

Plaque might begin to build up where the arteries are damaged. The buildup of plaque in the coronary arteries may start in childhood.
Over time, plaque can harden or rupture (break open). If the plaque ruptures, blood cell fragments called platelets stick to the site of the injury. They may clump together to form blood clots. Blood clots can further narrow the coronary arteries and worsen angina. If a clot becomes large enough, it can mostly or completely block a coronary artery and cause a heart attack.

  click to see how CHD is diagnosed and treated.



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