Coronary heart disease (CHD) affects over 7 million Americans and is the leading cause of death in the US, killing over 500,000 people each year. It is caused by a narrowing of the coronary arteries due to atherosclerosis. Major risk factors include high blood pressure, high cholesterol, smoking, obesity, diabetes, and stress. Smoking significantly increases the risk of CHD by damaging blood vessels and lowering HDL cholesterol levels. Maintaining a healthy lifestyle through diet, exercise, weight control, and avoiding smoking can help prevent and manage CHD.

1. Coronary Heart
Disease (CHD)

3. Coronary Heart Disease (CHD)
• Seven million Americans effected
• Caused by narrowing of the coronary arteries
• No. 1 killer of men and women in U.S.
>500,000 each year
• > 60 million Americans have some form of
coronary vascular disease (CVD)
• >2,600 Americans die each day of CVD, i.e.,
1 death/33 sec
• ~ $299 billion cost to the U.S.

4. Risk factors
• High blood pressure (hypertension)
• High blood cholesterol
• Smoking
• Obesity
• Diabetes
• Stress
Controllable

5. Major Risk Factors:
The Big Three
• Hypertension
• High cholesterol
• Cigarette smoking
All three increase risk
factor eight times
AND…. we should add LACK OF EXERCISE

7. Hypertension
• Commonly called high blood pressure
• Systolic and diastolic measurements
• Normal systolic - 110-130 mmHg
• Normal diastolic - 70-90 mm Hg

8. Symptoms of CHD
• Chest pain (angina)
• Shortness of breath
• Heaviness, tightness, pain, pressure
or squeezing
behind the breastbone or in the arms,
neck, or jaws
• Pain may vary
• Perhaps no pain

9. Cause & Consequencess of CHD
• Lack of oxyge
• Narrowing of coronary arteries
• Heart responds with angina
• Finally, heart attack Possible
permanent damage

10. Treatment for CHD
• Lifestyle changes
• Medication
• Surgery

11. Lifestyle Changes
• Change of habits
• Low fat diet
• Lower weight
• Increase exercise
• Stop smoking

12. Effects of Smoking
• For adult males, smoking has
declined from 53 % to 38%
• For women, remains at 30%
• Has increased for younger and
teenaged women
• Heavy smoker = 20- 30 cigs/day

13. Effects of Smoking (cont’d)
• Cigs contain about 2000 compounds
• Main harmful are tar, nicotine and CO
Tar contains hydrocarbons and other carcinogenic
substances
Nicotine causes release of epinephrine and
norepinephrine resulting in increased HR, BP,
cardiac output, stroke volume, contractility, oxygen
consumption, and coronary blood flow
CO reduces oxygen carrying capacity of the blood;
can precipitate angina

14. Effects of Smoking (cont’d)
• Contributes to development of
atherosclerosis
• Lowers levels of HDL
causes deterioration of elasticity of
vessels
Responsible for 20% of all deaths from
heart disease
• Female smokers have a higher risk
than male smokers

17. HDL
• High density lipoproteins seem to have
protective effect against development of
atherosclerosis (a form or arteriosclerosis in which
deposits of yellowish plaque containing cholesterol, lipoid
substances and lipophages are formed within large and
medium-sized arteries)
• Women have higher concentrations than men
• Most important of all lipid risk factors
• Below 35 mg/dl----- 8X incidence of CAD
compared to those with 65 mg/dl
• Moderate alcohol intake may have + effect
• Exercise has + effect
• Greater weight has a negative effect

18. DIET
• Reduce saturated fats
• Increase polyunsaturated fats
• Higher protein to fat ratio
• Count calories