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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