An Overview Of Risk Factors For Coronary Heart Disease And Prevention Strategies

Abstract

In developed countries, coronary heart disease (CHD) accounts for 40-50% of all deaths, while 1 5-35% of all cardiac admissions in hospitals in our country are due to coronary heart disease¹. The prevalence of CHD in our country varies from 1.7% to 6.5%² and is rising, affecting young and middle aged persons in prime of their life and career ^3a and it is said that CHD will replace infectious diseases as the major killer in India by year 2015 A.D.^3b. Indian immigrants settled abroad have higher incidence and higher mortality as compared to native population. ^4jb. The famous cardiologist Paul Dudley White has said "Heart disease before the age 80 is not God's will but due to our own faults" and it is the same message as given by Charaka about 30 centuries back, in 1000 B.C., who emphasized the role of overeating, heavy and fatty meals , worries and sedentary habits in causation of heart disease⁵. The human and economic costs of such a situation are very heavy. Atherosclerosis, the term introduced by Marchand in 1904, is the lipid rich lesion in the innermost layer of the arteries which is responsible for the majority of cases of myocardial and cerebral infarction. The endothelial lining of the artery is in direct and continuous contact with blood and interaction of blood cells & other constituents with the endothelium gives rise to atherosclerosis. This lesion presents as either fatty streak which is made up of foam cells, lipids & T lymphocytes and occurs early, commonly in children or fibrous plaque consisting of dense connective tissue, lipid droplets, smooth muscle cells, macrophages & T lymphocytes. Platelets adhere and aggregate to ulcerated or fissured plaques.