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CORONARY HEART DISEASE
Clinical studies,
laboratory investigations and a number of surveys
show certain personal characteristics and
life-styles pointing to increased danger of heart
attack (coronary heart disease). These danger
signs are called "risk factors". The
well established risk factors are high blood
pressure, high blood cholesterol, cigarette
smoking and diabetes mellitus. Other factors that
may increase or affect the risk for heart attach
are obesity, a sedentary life-style, an
aggressive response to stress, and certain drugs.
In the past two decades, millions of Americans
have learned about these risk factors and have
tried to modify them favorable by seeking medical
attention and by changing life-style. Many adults
have stopped smoking. The medical control of high
blood pressure has greatly improved. The average
cholesterol level of the population has decreased
continually over the last two decades, probably
due to changes in dietary habits and increased
exercise.
This attempt to modify risk factors almost
certainly has contributed to the declining death
rate from heart disease in the United States.
During the 1960's, U.S. death rates from heart
disease were still rising, but today the
incidence from diseases of the cardiovascular
system (including coronary heart disease) has
fallen dramatically. Overall, heart-related
problems have declined about 25 percent in the
last decade. Some of this decrease undoubtedly is
due to better medical care of heart attack
victims, but it is likely that a sizable
percentage is related to modification of risk
factors.
The entire population has become more aware of
the seriousness of heart disease and coronary
heart problems. CPR training is offered in
schools, places of business, and church and
community functions, and everyone seems to
recognize that prevention of coronary heart
disease is a partnership between the public and
the medical community. These are a number of
factors implicated in coronary heart disease.
Some of these may raise coronary risk by
accentuating the major risk factors already
discussed. Others may act in ways not understood.
Still others may be linked mistakenly to coronary
risk.
Obesity predisposes individuals to coronary heart
disease. Some of the reasons for this are known,
but others are not. The major causes of obesity
in Americans are excessive intake of calories and
inadequate exercise. When caloric intake is
excessive, some of the excess frequently is
saturated fat, which further raises the blood
cholesterol. Thus, obesity contributes to higher
coronary risk in a variety of ways.
Most of the major risk factors are silent. They
must be sought actively, and much of the
responsibility for their detection lies with each
of us as individuals. Regular checkups are
particularly necessary if there is a family
history of heart disease, high blood pressure,
high cholesterol levels or diabetes.
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