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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)
- ·
HDL
- ·
Smoking
- ·
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
·
eat
·
weight
·
exercise
·
age
·
alcohol
·
stress
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.
- ·
LDL
- ·
HDL
- ·
Triglycerides
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.
lipoprotein
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)
http://www.americanheart.org
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
them.
National Heart, Lung, and Blood Institute
(NHLBI) Information Center
PO Box 30105
Bethesda MD 20824-0105
(301) 251-1222
http://www.nhlbi.nih.gov/nhlbi/nhlbi.htm
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
research.
American College of Cardiology (ACC)
http://www.acc.org
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
http://www.cardio.com
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
http://sln2.fi.edu/biosci/preview/heartpreview.html
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
http://www.heartinfo.org
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
http://www.medmatrix.org/Index.asp
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
"cardiology."
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
membership.
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