HEARTS AT RISK
Know the major risk factors associated with heart disease.
Prevention of heart attacks is critical because, according to authoritative estimates, almost half of all heart fatalities occur in the midst of the first heart attack. That's why knowing what the risk factors are and controlling them, where possible, is vital.
Risk factors have been defined as phenomena that are often observed to be associated with a given disease in larger populations and are considered to indicate risk - in our context, of coronary disease. There are gradations among risk factors. On the American Heart Association's (AHA) list of "well-established" risk factors are high blood pressure, cholesterol "and related abnormalities," smoking, and Diabetes Mellitus. "Others" listed on the AHA roster include obesity, stress, hormonal factors, genetic history, and the immoderate consumption of alcoholic beverages.
Heart attacks are the result of atherosclerosis, a raised plaque on the artery wall that contains cholesterol and scar tissue. This plaque narrows the coronary arteries, cutting off the necessary blood supply to the heart muscle. Partial narrowing of the artery may produce chest pain (angina pectoris). Complete blockage causes heart attack (myorcardial infarction). The plaque itself may grow enough to produce complete blockage, or a blood clot (coronary thrombosis) may form on a smaller plaque and choke off the blood supply.
Major Risk Factors
What are the dangers associated with risk factors, and what can be done to mitigate their potentially harmful effects?
Let's begin with those widely regarded by medical scientists as major risk factors:
High blood pressure is defined in the United States as a blood pressure greater than 140 systolic pressure or 90 diastolic pressure. Many doctors are now advising that even those adults with normal blood pressure have it checked every two to two-and-one-half years. Those who are susceptible to hypertension are advised to get their blood pressure checked even more frequently. This group would include the middle-aged and elderly, blacks, people who are more than 30 percent overweight, those who drink too much alcohol or eat lots of high-sodium foods, people with certain kinds of kidney disease, and women who take oral contraceptives.
Blood pressure can be controlled through a combination of diet, exercise, and drugs. In some cases, drug medications, which have side effects, can be dispensed with if diet and exercise lower blood pressure levels sufficiently.
Smoking has been linked to deaths from lung disease (14.6 percent); cancer (35.3 percent); and cardiovascular disease (36.2 percent), according to the Centers for Disease Control, U.S. Department of Health and Human Services. Smoking keeps turning up in one manifestation or another of heart disease. AHA reports that smoking is blamed for increasing atherosclerosis, "possibly by damaging the artery wall and allowing more cholesterol deposit." Some medical scientists suspect that smoking causes coronary thrombosis and disturbances to the hearth rhythm that may prove fatal to those who have angina pectoris or who have had a previous heart attack. Moreover, AHA has concluded that smoking increases the likehood of developing atherosclerosis in the abdominal aorta and the arteries to the legs as well as to the coronary arteries.
In the American Council on Science and Health's (ACSH) report on coronary heart disease, "The Facts and Myths about Coronary Heart Disease," the author, Agnes Heinz, Ph.D., ACSH's director of nutrition and biochemistry, said of smoking, "Cigarette smoking is the most significant risk factor. Smokers have a much higher rate of heart disease and more severe atherosclerosis than nonsmokers. They run two to four times the risk of nonsmokers of sudden cardiac death, which is death from a heart attack in a very short time. …