NUTRITION AND CORONARY HEART DISEASE
Atherosclerotic coronary heart disease (CHD) is the leading cause of death in the United States. During the past 40 years the age-adjusted death toll from CHD declined 40%. Although improved medical treatments have played a significant role, the favorable trend can also be related to lifestyle improvements and better control of modifiable risk factors such as smoking cessation and dietary changes.
CHD is a disease of the blood vessels of the heart known as the “coronary arteries”. When these coronary arteries become narrowed or clogged by cholesterol and fat deposits– a process called atherosclerosis – and cannot supply enough blood to the heart, the result is CHD. Chest pain (angina pectoris) and heart attacks result from CHD.
Angina pectoris can occur when blood flow to the heart is enough for normal needs but not enough when the heart’s needs increase. The disease becomes lethal when fatty deposits silently build up inside the tiny coronary arteries that nourish the heart muscle. A heart attack occurs when a blood clot suddenly forms and lodges against the deposits completely blocking the flow of blood to a portion of the heart. This often results from reaction to rupture or tearing of a plaque that has formed. If the blood supply is cut off severely or for a long time, muscle cells suffer irreversible injury and die. Disability or death can result, depending on how much heart muscle is damaged.
As the pathogenesis of CHD becomes better understood, it is evident that the process of atherosclerosis involves many factors, regulated by a variety of genes, and that these intrinsic factors in turn interact with a variety of environmental factors to cause CHD. While cholesterol is the main component of arterial plaque, some sort of damage to arterial walls must happen first for cholesterol to deposit there. Many experts believe that the underlying problem causing this damage is inflammation, perhaps due to hormone-like substances called prostaglandins or according to new research a bacterial infection with the organism Chlamydia pneumoniae.
Some of the known risk factors for heart disease are unmodifiable, such as having a family history of disease (genetic predisposition), being male, and aging. However, there are risk factors that can be modified: dyslipidemia, diabetes, physical inactivity, obesity, hypertension, psychological stress, and elevated homocysteine levels.
Studies continue to show that nutrition plays a key role in lipid management and reducing heart disease risk. In 1999 Circulation published follow-up findings on the original report of the “Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease,” –the so-called Lyon Diet Heart Study. This study showed a dramatic 70% reduction in all-cause mortality due to reduction in CHD mortality. The remarkable beneficial effects of the dietary program showed that dietary changes achieved a greater reduction in risk of coronary events than any of the cholesterol lowering studies to date. This reduction in risk of CHD was not associated with differences in total cholesterol. Thus emphasizing the powerful risk factors within the diet that are associated with increased risk for heart disease.
Tags: atherosclerotic, Atherosclerotic coronary, Atherosclerotic coronary heart disease, coronary, disease, heart, heart disease, NUTRITION AND CORONARY HEART DISEASE
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