Heart disease (also called coronary heart disease or atherosclerotic coronary artery disease) is a serious condition that affects about 16 million people in the United States. It is the number one cause of death in America, and is responsible for over 600,000 deaths every year. Several risk factors for coronary heart disease have been identified; some are able to be modified (e.g., smoking) while others are not (e.g., family history).
Smoking
Smoking has been, and continues to be, the number one modifiable risk factor in the development of atherosclerotic coronary artery disease (CAD). A modifiable risk factor is unlike, for instance, one's gender, the risk factor is something that can be controlled by the person. While gender is not considered modifiable, the decision to smoke or not, as well as the decision to quit or to continue, is a choice that can be made. According to the World Health Organization, the risk of dying from heart disease is two to three times higher in people who smoke. However, one year after a person quits smoking, his risk of coronary heart disease decreases by 50 percent.
High Levels of Cholesterol
Hypercholesterolemia is a term that refers to the high levels of cholesterol in the blood, and it is another risk factor for heart disease. Similar to smoking, cholesterol level is a risk factor that is at least somewhat in the control of the patient. There are two main types of cholesterol in the blood: low-density lipoprotein (LDL) ("bad"cholesterol) and high-density lipoprotein (HDL) ("good" cholesterol). The higher the levels of LDL in the blood, the higher the risk for developing heart disease.
Several components may impact cholesterol levels. Living an active life with regular exercise will often decrease levels of LDL and increase levels of HDL. A diet that is lower in saturated fats (often found in fried foods and fast foods) can help bring LDL levels down. According to Drs. Mahley and Bersot, writing in "Goodman and Gilman's Pharmacological Basis of Therapeutics," these lifestyle modifications are the best way to decrease the risk of coronary heart disease. However, if changes to diet and exercise are made, with no change in cholesterol levels (or not enough of a change is seen), certain medications, such as the statins (e.g., atorvastatin [Lipitor]), may be used.
Family History
A family history of heart disease has been well-established in the medical community as an independent risk factor for heart disease. In 2001, a long-term study of over 60,000 men and women was published by the Brigham and Women's Hospital in Boston. The authors of the study found that men whose parents both had heart disease (compared with only their mother having disease or only their father) had the highest risk of developing heart disease. The risk for women who had two parents with heart disease was even higher than for men. In general, the earlier the age at which a parent has heart disease, the higher the risk for developing the disease.
High Blood Pressure
Hypertension is another well-established risk factor for developing heart disease. Both systolic (the top number in a blood pressure measurement) and diastolic (the bottom number) blood pressure are potential risk factors. Because of this, it is important to maintain normal blood pressure levels throughout life. If a diagnosis of high blood pressure is made, getting correct treatment is a valuable step toward reducing the risk of heart disease.
References
- "Maternal and paternal history of myocardial infarction and risk of cardiovascular disease in men and women"; Circulation; H.D. Sesso et. al.; July 2001
- "Goodman and Gilman's Pharmacological Basis of Therapeutics"; Laurence Brunton et. al.; 2005
- "UpToDate"; Denise S. Basow; 2010
- World Health Organization: CVD prevention and control: missed opportunities
