Amy Lovern, RN, BSN
It is a condition occurring when the blood and
oxygen supply to the heart diminish due to
narrowing blood vessels. Coronary artery and
arteriosclerotic heart disease are two other
names for coronary heart disease.
Coronary heart disease affects 12.6 million
people in the United States and causes more
than 500,000 deaths annually.
Coronary heart disease is cause
by impaired blood flow to the
Atherosclerosis is the usual
cause of coronary heart disease.
This condition occurs when plaque builds up on
artery walls causing them to narrow.
Coronary heart disease may be
asymptomatic or may lead to angina
pectoris (chest pains), myocardial
infarction (heart attack), dysrhythmias,
heart failure, and even sudden death.
The highest incidence of CHD is in the Western
world, mainly in white males age 45 and older.
Both men and women are affected by coronary
heart disease; in women the onset is about 10
years later than men due to the heart-protective
effects of estrogen.
After menopause, women’s risk is equal to that
Risk factors for CHD are frequently classified as
non-modifiable, or factors that cannot change,
and modifiable, those factors that can be
Age – over 50% of heart attack victims are 65 or
Gender- men are affected at an earlier age than
Race- African Americans have a higher incidence
of hypertension, which contributes to more rapid
development of atherosclerosis.
Modifiable risk factors include lifestyle factors
and pathologic conditions that predispose the
person to developing CHD.
Pathologic conditions which contribute to CHD
include hypertension, diabetes mellitus, and
Hypertension is consistent blood pressure
readings greater than 140 mmHg systolic or 90
Hypertension is common, affecting more than
one-third of people over the age of 50 in the
Diabetes mellitus contributes to CHD in several
Diabetes is associated with hyperlipidemia,
hypertension, and obesity, all risk factors in their
Diabetes affects blood vessels, contributing to
the process of atherosclerosis.
Hyperlipidemia is an abnormally high level of
blood lipids and lipoproteins. Lipoproteins carry
cholesterol in the blood.
Low-density lipoproteins (Less Desirable
Lipoproteins) are the primary carriers of
High-density lipoproteins (Highly Desirable
Lipoproteins) help clear cholesterol from the
arteries, transporting it to the liver for excretion.
Cigarette smoking is an independent risk factor
for CHD, responsible for more deaths from CHD
than from lung cancer or pulmonary disease.
Obesity (body weight greater than 30% over
ideal body weight) , increased BMI (body mass
index), and fat distribution affect the risk of CHD.
Physical Inactivity is associated with higher risk
Diet may be a risk factor for CHD.
The male cigarette smoker has 2 to 3 times the risk
of developing heart disease than the nonsmoker.
The female who smokes has up to 4 times the risk.
For both men and women who
stop smoking, the risk of mortality
from CHD is reduced by half.
Second-hand smoke increases the
risk of death from CHD by as much as 30%.
Eat a variety of nutritious foods
from all food groups.
Eat fish at least twice a week.
Recent research shows that eating
oily fish containing omega-3 fatty
acids (salmon, herring, and trout)
may help lower your risk of death
from coronary artery disease.
Eat unrefined whole-grain foods,
which contain fiber that can help
lower blood cholesterol.
partially hydrogenated vegetable oils to reduce
beverages and foods with added sugars.
foods high in dietary cholesterol. Aim to eat
less than 300 milligrams of cholesterol each day.
foods high in sodium. Aim for less than
2,300 milligrams of sodium per day.
Research indicates that people who maintain a
regular program of physical activity are less
prone to developing CHD than sedentary people.
Cardiovascular benefits of exercise
include increased availability of oxygen
to the heart muscle, decreased oxygen
demand and cardiac workload, and
decreased blood pressure.
The normal heart is a strong, muscular pump,
about the size of a fist.
Each day the average heart beats (expands
and contracts) 100,000 times and pumps
about 2,000 gallons of blood.
In a 70-year lifetime, the average human heart
will beat approximately 2.5 billion times.
The heart has four chambers:
two on the right and two on the left.
The two upper chambers are
called the atria.
The two lower chambers are