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Prevention of Cardiovascular Diseases

Prevention of heart disease

What is coronary heart Disease

What does choloesterol have to do with heart disease?
Risk Factors and Heart Disease
What your LDL-Cholesterol Means to You?
What Make Your Cholesterol High or Low?
Do you know

Organizations and Links

What is coronary heart Disease

Heart disease is caused by narrowing of the coronary arteries that feed the heart. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by cholesterol and fat deposits--a process called atherosclerosis--and cannot supply enough blood to the heart, the result is coronary heart disease (CHD). If not enough oxygen-carrying blood reaches the heart, you may experience chest pain called angina. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.
Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body and that your body needs to function normally. It is present in cell walls or membranes everywhere in the body, including the brain, nerves, muscle, skin, liver, intestines, and heart. Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If you have too much cholesterol in your bloodstream, the excess is deposited in arteries, including the coronary arteries, where it contributes to the narrowing and blockages that cause the signs and symptoms of heart disease.

What does cholesterol have to do with heart disease?

The Framingham Heart Study established that high blood cholesterol is a risk factor for coronary heart disease (CHD). Results of the Framingham study showed that the higher the cholesterol level, the greater the CHD risk. On the other end of the spectrum, CHD is uncommon at total cholesterol levels below 150 milligrams per deciliter (mg/dL). A direct link between high blood cholesterol and CHD has been confirmed by the Lipid Research Clinics-Coronary Primary Prevention Trial (1984) which showed that lowering total and LDL ("bad") cholesterol levels significantly reduces CHD. A series of more recent trials of cholesterol lowering using statin drugs have demonstrated conclusively that lowering total cholesterol and LDL-cholesterol reduces the chance of having a heart attack, needing bypass surgery or angioplasty, and dying of CHD-related causes.

In addition to high cholesterol, there are other risk factors that can increase your chance of developing heart disease. To learn more about risk factors, click below.

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Risk Factors and Heart Disease

Risk factors are conditions that increase your risk for developing heart disease. Some risk factors can be changed and others cannot. In general, the more risk factors you have, the greater your chance of developing heart disease. Fortunately, there are things you can do to address most of the risk factors for heart disease.
The risk factors that you cannot control include:
   Age (45 years or older for men; 55 years or older for women)
   Family history of early heart disease (father or brother affected before age 55; mother or sister affected before age 65).
The known risk factors for heart disease that you can do something about include:
    High blood cholesterol (total and low)
   High blood pressure
   Diabetes -- if you have diabetes, your risk for developing heart disease is high, as high as a heart disease patient's risk for having a heart attack. You will need to lower your cholesterol under medical supervision, in much the same way as a heart disease patient, in order to reduce your high risk of getting
If you have not had your cholesterol level checked, talk to your doctor about getting it checked

What your LDL-Cholesterol Means to You?

Your LDL level is a good indicator of your risk for heart disease. Lowering LDL is the main aim of treatment if you have high cholesterol. In general, the higher your LDL level, the greater your chance of developing heart disease.  In addition to LDL, you will need to know what risk factors you have that influence your LDL-lowering treatment.

What Make Your Cholesterol High or Low?

Your blood cholesterol level is affected not only by what you eat but also by how  quickly your body makes LDL ("bad") cholesterol and disposes of it. In fact, your body makes all the cholesterol it needs, and it is not necessary to take in any additional cholesterol from the foods you eat.

Many factors help determine whether your LDL-cholesterol level is high or low. The following factors are the most important 


Heredity. Your genes influence how high your LDL ("bad") cholesterol is by affecting how fast LDL is made and removed from the blood. One specific form of inherited high cholesterol that affects 1 in 500 people is familial hypercholesterolemia, which often leads to early heart disease. But even if you do not have a specific genetic form of high cholesterol, genes play a role in influencing your LDL-cholesterol level. 

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What you eat. Two main nutrients in the foods you eat make your LDL ("bad") cholesterol level go up: saturated fat, a type of fat found mostly in foods that come from animals; and cholesterol, which comes only from animal products. Saturated fat raises your LDL-cholesterol level more than anything else in the diet. Eating too much saturated fat and cholesterol is the main reason for high levels of cholesterol and a high rate of heart attacks in the United States. Reducing the amount of saturated fat and cholesterol you eat is a very important step in reducing your blood cholesterol levels.

Weight. Excess weight tends to increase your LDL ("bad") cholesterol level. 
If You are overweight and have a high LDL-cholesterol level, losing weight may help you lower it. Weight loss also helps to lower triglycerides and raise HDL ("good") cholesterol levels.

Physical activity/exercise. Regular physical activity may lower LDL ("bad") cholesterol and raise HDL ("good") cholesterol levels.

Age and sex. Before the age of menopause, women usually have total cholesterol levels that are lower than those of men the same age. As women and men get older, their blood cholesterol levels rise until about 60 to 65 years of age. After the age of about 50, women often have higher total cholesterol levels than men of the same age.

Alcohol. Alcohol intake increases HDL ("good") cholesterol but does not lower LDL ("bad") cholesterol. Doctors don't know for certain whether alcohol also reduces the risk of heart disease. Drinking too much alcohol can damage the liver and heart muscle, lead to high blood pressure, and raise triglycerides. Because of the risks, alcoholic beverages should not be used as a way to prevent heart disease.

Stress. Stress over the long term has been shown in several studies to raise blood cholesterol levels. One way that stress may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating fatty foods. The saturated fat and cholesterol in these foods contribute to higher levels of blood cholesterol. 

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Cholesterol travels in the blood in packages called lipoproteins. Just like oil and water, cholesterol, which is fatty, and blood, which is watery, do not mix. In order to be able to travel in the bloodstream, the cholesterol made in the liver is combined with protein, making a lipoprotein. This lipoprotein then carries the cholesterol through the bloodstream.

There are specific kinds of lipoproteins that contain cholesterol in your blood, and each affects your heart disease risk in a different way.


Low density lipoproteins (LDL): the "bad" cholesterol. LDL carry most of the cholesterol in the blood, and the cholesterol from LDL is the main source of damaging buildup and blockage in the arteries. Thus, the more LDL-cholesterol you have in your blood, the greater your risk of heart disease. If you have heart disease or are at high risk for developing it and your LDL is 100 mg/dLor higher, your cholesterol may well be too high for you.

High density lipoproteins (HDL): the "good" cholesterol. HDL carry cholesterol in the blood from other parts of the body back to the liver, which leads to its removal from the body. So HDL help keep cholesterol from building up in the walls of the arteries. If your level of HDL-cholesterol is below 40 mg/dL, you are at substantially higher risk for heart disease. The higher your HDL-cholesterol, the better. The average HDL-cholesterol for men is about 45 mg/dL, and for women it is about 55 mg/dL. 


Triglycerides: a form of fat carried through the bloodstream. Most of your body's fat is in the form of triglycerides stored in fat tissue. Only a small portion of your triglycerides is found in the bloodstream. High blood triglyceride levels alone do not necessarily cause atherosclerosis. But some lipoproteins that are rich in triglycerides also contain cholesterol, which causes atherosclerosis in some people with high triglycerides and high triglycerides are often accompanied by other factors (such as low HDL or a tendency toward diabetes) that raise heart disease risk. So high triglycerides may be a sign of a lipoprotein problem that contributes to heart disease.

Cholesterol is a major ingredient of the plaque that builds up in the coronary arteries and causes heart disease, so it is important to understand how plaques develop. Excess cholesterol is deposited in the artery walls as it travels through the bloodstream. Then, special cells in the artery wall gobble up this excess cholesterol, creating a "bump" in the artery wall. This cholesterol-rich "bump" then is covered by a scar that produces a hard coat or shell over the cholesterol and cell mixture. It is this collection of cholesterol covered by a scar that is called plaque. 

unstable plaque

The plaque buildup narrows the space in the coronary arteries through which blood can flow, decreasing the supply of oxygen and nutrients to the heart. If not enough oxygen- carrying blood can pass through the narrowed arteries to reach the heart muscle, the heart may respond with a pain called angina. The pain usually happens with exercise when the heart needs more oxygen. It is typically felt in the chest or sometimes in other places like the left arm and shoulder. However, this same inadequate blood supply may cause no symptoms.
Plaques come in various sizes and shapes. Throughout the coronary arteries many small plaques build themselves into the walls of the arteries, blocking less than half of the artery opening.


Do you know
Cholesterol lowering is important for young, middle-aged, and older adults. 1 out of every 2 men and 1 out of every 3 women will develop heart disease sometime in their life. Whether you have heart disease or want to prevent it, you can reduce your risk for having a heart attack by lowering your cholesterol level.  
In FDA's summary of the scientific evidence, it found that most human intervention trials in subjects with total cholesterol levels less than 300 mg/dL who received soy protein had reduced total and/or LDL-cholesterol levels to a clinically significant degree. Also, HDL-levels were unchanged or increased slightly. The hypocholesterolemic effects of soy protein were more consistent in individuals following a low-fat, low-cholesterol diet.

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American Heart Association (AHA)

7320 Greenville Avenue
Dallas TX 75231
(214) 373-6300)

The AHA Web site is a gold mine of
references, information, and news about
heart disease. There is a questionnaire that
will calculate your risk for heart disease, a
section on family heart health, information
about research and new professional
publications on heart disease, as well as an
A to Z listing of pamphlets or fact sheets on
the different types of heart disease. They will
also mail this information to you if you call

National Heart, Lung, and Blood Institute
(NHLBI) Information Center

PO Box 30105
Bethesda MD 20824-0105
(301) 251-1222

The NHLBI is the institute in the National
Institutes of Health that deals with
cardiovascular, pulmonary, and blood
diseases and disorders. They plan and
support education, prevention and treatment
of diseases in these areas. They also
develop basic research, clinical trials of
drugs and devices, and rehabilitation
programs. The NHLBI offers publications for
consumers and health care professionals
covering recent research, clinical trials and
their findings, prevention information, and
other areas. Many of these can be found on
their web site.

Coronary Club, Inc.

9500 Euclid Avenue
Cleveland OH 44106
(216) 444-3690

This group is made up of patients,
physicians, and other health care
professionals concerned with coronary care.
They publish a monthly newsletter, Heartline,
which aims to keep readers up to date on 
ssues such as medications, surgery, diet,
exercise, psychosocial factors, and new

American College of Cardiology (ACC) 

The ACC offers consumer level publications
on different types of heart disease, news and
updates from their journal The Journal of the
American College of Cardiology, as well as
descriptions of the roles of different types of
physicians that a heart patient will see. On
this site, you'll also find a database of web
site links and resources.

Cardiovascular Institute of the South 

This site contains material written by the
doctors at the Cardiovascular Institute of the
South. Through their practice, they identified
some common information deficits with their
patients, and wrote the information that they
felt was missing in the traditional patient
education materials. The site starts the user
off with a search box on the home page.
There is also an index of articles, a list of the
categories, biographies of the doctors, and
other information. The information is set up in
several different categories including disease
states, prevention, treatment, FAQs, and
issues for women with heart disease.

Heart Preview Gallery 

The Heart Preview allows the user to take a
walking tour of the heart. The tour consists of
different pages of information that textually
describe features and functions of different
parts of the cardiovascular system. There are
also some accompanying graphics and
sounds. Topics they cover include heart
development, structure, monitoring, and how
the heart interacts with other body systems.
This is a really nice example of the potential
uses of the World Wide Web. The site
consists of many interlinked pages that keep
the user "flowing" through the heart and
circulatory system.

Heart Information Network 

This site is an independent educational site
about heart disease designed to be used by
all levels of readers. Their mission is to
empower heart patients by opening the lines
of communication between patients and
doctors. They offer news, FAQs, articles
about different types of heart disease and
treatments, and several different directories
for clinics, products, and other cardiology
web sites that they have reviewed.

Medical Matrix: Cardiology

The Medical Matrix is an ever-growing index
of reviewed health and medical web sites.
They organize their sites by type of
information, format, and reading level. This is
a very exhaustive list: it can point users to
very specific pages within a large web site,
or to entire web sites dedicated to a single
topic. Because of its size and scope it can
be a bit overwhelming. It provides a good
view of the scope of cardiovascular
information available on the Internet, and with
some careful selection, you can probably
find what you're looking for. Start by
registering (it's free), and then click on

National Heart Savers Association (NHSA)

9140 W. Dodge Road
Omaha NE 68114
(402) 398-1993

This is a non-profit organization fully funded
by a heart attack survivor. The NHSA will
send out, free of charge, an information
packet containing information on heart
disease, cholesterol, exercise, diet, and
substitution suggestions for recipes.

National Well Spouse Foundation

PO Box 28876
San Diego CA 92198
(619) 673-9043

This is an organization for the families of the
chronically ill. They offer an emotional
support network and work to increase public
consciousness about the role and issues of
well family members. They establish local
support groups, and offer a variety of
information and materials. Their publications
include two newsletters that are free with

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