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Sunday, 24 November 2013

Ischemic Heart Disease - The Causes and Risk Factors

Cardiovascular Disease
Cardiovascular diseas
e is defined as medical conditions affecting the cardiovascular system, including heart, blood vessels(arteries and veins).
II. Ischemic heart disease
 Ischemic heart disease is defined as a condition of  reduced blood supply of the heart muscle, as a result of  coronary artery disease caused by plague building up in the arteries.
Causes and Risk Factors
B.1. Causes
Cause of  Ischemic heart disease is a result of reduced blood supply of the heart muscle, due to coronary artery disease caused by plague building up in the arteries.

B.2. Risk Factors 
1. Diabetes 
Dr. Wentworth JM and the research team at the Royal Melbourne Hospital Department of Diabetes and Endocrinology, indicated that people with long-standing type 2 diabetes who attend a tertiary hospital outpatient clinic, ischemic heart disease, in contrast to other vascular complications, correlates robustly with BMI. These findings indicate that clinical trials of weight loss in type 2 diabetes should use cardiac endpoints as their primary outcomes(3).

2. High lever of blood cholesterol
In the study of the male population of Kaunas, aged 45-59 years, who were examined in 1972-1974, Among 2,034 men, who at the first examination were without signs of ischemic heart disease (IHD), there appeared after 7.4 years 75 cases of IHD as a result of increased high levels of blood cholesterol(4)

3. Hypertension
"Epidemiological surveys show the clear association of hypertension with an increased risk of developing ischemic heart disease. One method of quantifying atherosclerosis is to measure, at necropsy, the percentage of the intimal surface of the coronary arteries or aorta which is occupied by raised plaques" Dr. Davies MJ. and the team of researchers at St George's Hospital Medical School, University of Londo, said(5)

4. High blood triglycerides 
High blood triglycerides is associated to increased risk of  Ischemic heart disease. Dr. Chien KL, and the team at the National Taiwan University, indicated that low HDL-C was significantly associated with acute coronary events, and triglyceride levels as well as renal function were inversely related to all-cause deaths after the coronary event(6).

5. Obesity 
In the document of Concomitant ischemic heart disease (IHD), in 350 normotensives (4%) and in 119 hypertensives (13.8%). The prevalence of IHD was not significantly different in lean, overweight, moderate and severe obese hypertensives, also when sex and smoking habits were considered. Our data indicated a strong association between obesity and hypertension. In addition they may be consistent with the suggestion that obese hypertensives were not characterized by a lower risk of ischaemic heart disease (IHD), than lean hypertensives(7).

6. Lack of physical activity
In the study to investigate  the relative impact of physical fitness, physical demands at work, and physical activity during leisure time on ischemic heart disease (IHD) and all-cause mortality among employed men with pre-existing cardiovascular disease (CVD), showed that among gainfully employed men with pre-existing CVD, a high physical fitness was associated with a substantially reduced risk for IHD and all-cause mortality(8).

7. Smoking and other tobacco use
Some researchers suggested that there is a stronger association between smoking and peripheral arterial disease than ischemic heart disease does not appear to be influenced by the other risk factors(9)

8. Family history of heart disease
Literature suggests that inherited factors are important in the development of premature ischemic heart disease, but decline in importance with age(10)

9. Excessive drinking
In the study to investigate the relationship between alcohol consumption and the prevalence of the metabolic syndrome (MetS), type 2 diabetes mellitus (DM), coronary heart disease (CHD), stroke, peripheral arterial disease (PAD), and overall cardiovascular disease (CVD) in a Mediterranean cohort, showed that Heavy drinking was associated with an increase in the prevalence of all of these disease states(11)

10. Unhealthy diet
Diet high in saturated fat and trans fat can lead to cholesterol building up in the arterial wall of that can decrease blood flow and oxygen to the heart muscle.

11. Stress, coping, and social support as psychosocial factors
Data on stress (Stress Appraisal Scale), coping strategies (Ways of Coping Questionnaire), and social network/social support (Norbeck Social Support Questionnaire) were collected from 100 persons with the primary diagnosis of IHD prior to discharge from hospital, in the study ofStress, coping, and social support as psychosocial factors in readmissions for ischaemic heart disease, indicated that greater use of the coping strategy 'seeking social support' was associated with the readmission of persons who had had their first admission for IHD. Less use of the coping strategy 'accepting responsibility' was associated with the readmission of persons who had a history of prior admission for IHD(12).

12. Sickle-cell disease
Sickle cell disease (SCD) is an inherited chronic haemolytic anaemia whose clinical manifestations arise from the tendency of the haemoglobin to polymerize and deform red blood cells into the characteristic sickle shape due to a single nucleotide change in the β-globin. Sickle cell anaemia (SCA) is associated with recurrent multi-organ ischemia and infarction. Myocardial ischemia (MI) and infarction are increasingly recognised as features of SCA(13)

13. Shift work and metabolic syndrome
Other researchers suggested that Shift work and metabolic syndrome also associated to increased risk of  Ischemic heart disease(14).
I would like to summarize this section by quoting the study by Dr. Fowkes FG and the research team at University of Edinburgh, "Multiple regression of risk factors on measures of peripheral arterial disease showed associations with diabetes mellitus (but not impaired glucose tolerance), systolic blood pressure, and serum cholesterol; inverse association with high-density lipoprotein cholesterol; and only univariate association with triglycerides. In multiple logistic regressions of risk factors on six separate indicators of cardiovascular disease, the only consistent difference was that smoking increased the risk of peripheral arterial disease (range of odds ratios, 1.8-5.6) more than heart disease (range of odds ratios, 1.1-1.6)"(15).

14. Etc.

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