Coronary Heart Disease Overview

Introduction

Coronary heart disease (CHD), also known as coronary artery disease or ischaemic heart disease, is a condition which results from a decrease or complete loss of the supply of oxygen-containing blood to the muscles of the heart. 

In this article, we will look at the risk factors for CHD and practical things you can do to reduce your risk of developing it.

What is coronary heart disease?

The blood vessels that supply the heart are called coronary arteries - where the disease gets its name from. Deposits of fat within these vessels accumulate over time and lead to their narrowing or complete blockage. The parts of the heart supplied by these diseased vessels consequently fail to function correctly because they are deprived of oxygen-rich blood.

When the narrowing is severe enough, it can lead to a heart attack, resulting in extended hospital stays or death. Coronary heart disease was responsible for 16% of all deaths in 2019; making it the leading cause of death worldwide.¹

Symptoms

CHD could be silent, producing no symptoms in some cases. It could also result in:

• Chest pain or pressure which is often in the center of the chest. This pain may be triggered by physical activity or emotional stress but could occur without either.
• Pain in other parts of the body like the arms, the neck, the jaw, or the back
• Difficulty in breathing
• Nausea or vomiting
• Dizziness or lightheadedness
• Weakness

Causes

The leading cause of CHD is atherosclerosis. This is a fancy word used to describe the process where cholesterol is gradually deposited in the coronary arteries leading to their progressive narrowing.

Risk factors

Several interrelated factors are known to increase the risk of CHD.²

These include:

• Smoking - Cigarette smoking and exposure to secondhand smoke increases the risk of developing atherosclerosis and, consequently, CHD.²
• High blood pressure - One’s risk of developing atherosclerosis and coronary heart disease is 2-3 times higher if one has high blood pressure.³
• Diabetes also makes you at least twice as likely to develop atherosclerosis.⁴
• High cholesterol - Particularly high levels of bad cholesterol (low-density lipoproteins, also known as LDL) and low levels of normal cholesterol (high-density lipoproteins or HDL).^2,5
• Obesity - Being overweight puts strain on the heart and raises your risk of developing CHD.⁶
• Sedentary lifestyle - Physical inactivity also significantly increases your chances of getting CHD.⁷
• Increasing age - The risk of CHD is generally higher in men older than 45 and women above 55.²
• Family history - Having a male relative under 55 years or a female relative under the age of 65 with a history of CHD elevates your risk of developing it.²
• Stress - Intense and/or persistent psychological stress can also predispose one to develop CHD.

You can reduce your risk of coronary heart disease by making a few changes to your lifestyle.

The following lifestyle factors have the greatest impact on your risk of coronary heart disease. We will also look at what you can do to reduce your risk from today.

Nutrition

A healthy diet can significantly decrease your risk of developing CHD by helping to keep your weight, blood pressure, blood sugar and cholesterol within normal limits. Recommended dietary measures include:

• A high fibre diet that is rich in fresh fruits and vegetables as well as whole grains.
• Limit salt intake to less than 6 grams (one teaspoon) daily. Salt significantly increases the risk of developing high blood pressure; therefore, limiting it in the diet reduces this risk.
• A low sugar diet to decrease your risk of developing diabetes.
• A diet that is low in saturated fats and rich in unsaturated fats because the former can raise bad cholesterol while the latter raises healthy cholesterol. Examples of foods high in fats to avoid (saturated fats) include butter, cream, hard cheeses, cakes, coconut oil, and palm oil. Foods rich in heart-healthy (unsaturated) fats include nuts, avocados, oily fish, olive oil, and sunflower oil.

Physical activity

Regular exercise (at least 5 days a week), especially when combined with a healthy diet, helps with weight loss and in the maintenance of normal weight. Exercise also helps to reduce stress, blood pressure and blood sugar in addition to lowering bad cholesterol while increasing good cholesterol. This ensures a reduced risk of CHD.

Aerobic exercise such as walking, running, cycling, or swimming is most effective.⁸

Obesity

Eating a balanced diet in combination with regular physical activity will help you maintain an average weight. This, in turn will reduce the strain on your heart and your risk of CHD.

Alcohol

Keeping your alcohol consumption to a minimum and avoiding binge drinking significantly decreases your risk of developing CHD.

Smoking

The risk of CHD associated with smoking begins to fall immediately after one gives up smoking; however, it takes about 20 years to reverse the risk entirely. Therefore, smokers are advised to quit smoking as soon as possible. Speak to your doctor about smoking cessation aids and drugs available to help you stop.²

Hydration

Drinking adequate amounts of water prevents dehydration, and decreases your risk of CHD. As a healthy adult, you need about 2-3 litres of water daily.⁹

Sleep

An adequate amount of quality sleep reduces stress levels, improves overall health and decreases your CHD risk. Healthy adults need about 7 to 9 hours of sleep per day. You should aim to get these recommended hours of sleep each night for optimal heart health.¹⁰

Mental health

Severe mental illnesses such as schizophrenia, depression, anxiety, extreme stress, and post-traumatic stress disorder have been linked to the development of CHD. It is therefore imperative that you find effective ways of coping with stress if you are under a lot of it, and seek professional help if you believe you are suffering from any mental health disorder.^11,12

Wellness

Keeping your emotional health balanced is necessary for your physical health. Self-care is essential for overall good health.

Consequently, it is vital that you set aside time to relax and do things that you truly enjoy. Also, avoid turning to unhealthy habits such as excessive caffeine or alcohol consumption as a way to deal with stress.

If you have diabetes or have been diagnosed with high cholesterol levels or high blood pressure, focus on maintaining your blood pressure, blood sugar and cholesterol levels within normal limits. You can achieve this by taking any prescribed drugs regularly and adhering to your healthcare provider’s medical advice.

Conclusion

Coronary heart disease is a potentially deadly condition which occurs all too commonly and leads to many deaths. There are several risk factors for CHD which can be modified to reduce your risk of developing the disease. A healthy lifestyle with a holistic approach toward preserving your overall health ensures you maintain a healthy heart and live your best life!

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