Help Your Heart

By Gordon, Neil F. | The Saturday Evening Post, March 1988 | Go to article overview
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Help Your Heart

Gordon, Neil F., The Saturday Evening Post


Coronary heart disease has been described as the greatest sustained epidemic confronting mankind. But surprisingly, it was a medical rarity not so long ago. Indeed, not until 1912 did the first detailed clinical description of a heart attack appear in the medical literature. From then to the early 1960s, death rates from coronary heart disease increased relentlessly.

In the 1960s, death rates from coronary heart disease started to fall off. During the past two decades, death rates from this killer disease have decreased by almost 40 percent in the United States. However, despite its recent precipitous decline, coronary heart disease remains the major health problem in this and most other Western countries. Currently, an estimated 6 million Americans carry a clinical diagnosis of coronary heart disease. Nationally, more than 1 million heart attacks cause a half a million deaths per year, making coronary heart disease the leading cause of death in the United States. Unfortunately, of these deaths from coronary heart disease, many are instantaneous. Moreover, although the medical profession has made great strides in treating the clinical consequences of coronary heart disease, such as angina and heart attack, the survivors of a heart attack often remain at least partly disabled.

So considerable emphasis is now being placed on coronary heart disease prevention--that is, the prevention of a first or recurrent heart attack.

Coronary Heart Disease Risk Factors

Coronary heart disease most commonly results from the buildup of fatty deposits in the walls of the arteries that supply the heart with blood and oxygen. The precise cause of these deposits is still not completely understood. However, a number of major scientific studies have clearly demonstrated that coronary heart disease does not occur randomly in a given population. In fact, the risk of developing coronary heart disease is largely dependent on the presence or absence of certain factors, the so-called "coronary heart disease risk factors." Although some of these risk factors cannot be changed--for example, age, sex, and parental history of coronary heart disease--others are profoundly influenced by lifestyle and health habits, and they can, therefore, be modified. Modifiable risk factors include elevated blood cholesterol levels; cigarette smoking; high blood pressure; sedentary lifestyle; obesity; and type-A behavior. Of the modifiable risk factors, elevated blood cholesterol levels have recently attracted considerable attention, and the National Heart, Lung and blood Institute has launched a national cholesterol-education program to inform Americans about the need to lower blood-cholesterol levels.

Cholesterol Transport

Cholesterol, a fatlike substance, is an essential constituent of all cells in the body. It plays an important role in several metabolic processes. Of all the cholesterol in the body, only about 7 percent circulates in the blood. This circulating cholesterol, however, determines the risk of developing coronary heart disease. Because cholesterol is not soluble in water, it is transported in the blood in combination with proteins. These cholesterol-protein packages, called lipoproteins, are classified according to their density. Low-density lipoproteins (LDLs) contain the greatest percentage of cholesterol. They are responsible for depositing cholesterol in the walls of the coronary arteries; LDL-cholesterol is, therefore, often called "bad cholesterol." In contrast, high-density lipoproteins (HDLs) help remove cholesterol from the body. HDL-cholesterol is often referred to as "good cholesterol." High levels of LDL-cholesterol increase any predisposition toward coronary heart disease, whereas high levels of HDL-cholesterol provide partial protection against coronary heart disease.

Benefits of Cholesterol Lowering

Although the precise cause of coronary heart disease is unknown, recent studies have demonstrated that we can still deal with this disease quite effectively simply by modifying risk factors.

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