Coronary Heart Disease: Causes, Impact, and Management Strategies

This report provides a comprehensive overview of Coronary Heart Disease (CHD), also known as Coronary Artery Disease. It begins by defining CHD and highlighting its prevalence as a leading cause of death in the United States. The report explores the causes of CHD, including the role of plaque buildup in coronary arteries, and discusses the impact of the disease, such as chest pains, heart attacks, and heart failure. It delves into the economic implications of CHD, including direct and indirect costs, and identifies various risk factors like diabetes, physical inactivity, overweight/obesity, smoking, and high blood pressure. The report also presents mortality rates and prevalence statistics. Finally, it offers recommendations for effective CHD management, emphasizing aggressive risk factor management, lifestyle modifications, and monitoring of blood pressure and sugar levels. The report underscores the importance of early diagnosis and proactive strategies in mitigating the impact of this widespread health issue.

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CORONARY HEART DISEASE MANAGEMENT
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Coronary Heart disease an overview.
Coronary heart disease can also be referred to as Coronary artery disease. In the past few years, it
has hit the headlines as being the leading cause of death of male and female individuals in the
United States. Coronary arteries are essential for the supply of blood rich in oxygen to the
muscles of the heart. For several years quite a substantial amount of research has been conducted
in regards to the causes and the prevention of coronary heart disease. Due to this development
researchers have come up with new findings in relation to this condition. For quite a substantial
number of years, the causes and contributors of coronary heart disease have been known to be
saturated fat and cholesterol. However, this has changed with the studies that have been
conducted recently. The limit of limiting the intake of saturated fatty acids and replacing them
with polyunsaturated fatty acids has been termed to be unwise. The significance of a diet has
been overrated taking into consideration an individual's genetic makeup. However, it may or may
not be a consideration factor. Substantive exercising also plays a great role in the prevention of
coronary heart disease. Taking into consideration aspect of human development, individuals
have a lot to learn concerning the human body and its interactions with diet, the environment,
and genetic makeup.
This study brings into perspective various key issues relating to Coronary heart disease. The key
issues can be highlighted at a glance at what coronary heart disease is, the impact of coronary
heart disease, and the various factors that act as catalysts to coronary heart disease.
Coronary Heart Disease Defined
As stated earlier, coronary heart disease has led to the death of many individuals in the United
States regardless of gender. The National Heart, Lung, and Blood Institute in the paper titled
‘AT-A-GLANCE: Coronary Heart Disease' brings into perspective a detailed explanation of
what the condition is all about. It manifests when plaque develops in the coronary arteries
(National Heart, Lung, and Blood Institute, 2009, p. 1). The arteries are essential for supplying
hear muscles with oxygen-rich blood. The composition of plaque includes calcium, cholesterol,
fat and other components of blood. With time these substances harden and clog the arteries and
hence the flow of blood to the heart is hindered and often limited (Lemos, & Omland, 2017, p.
25). Eventually, these areas burst hence causing the formation of clots on its surface. Taking into
consideration the clot size, the arteries can be blocked eventually, and a very small percentage of

CORONARY HEART DISEASE MANAGEMENT. 3
oxygen-rich blood can reach the heart muscles (National Heart, Lung, and Blood Institute, 2009,
p. 2). As a result of individual experiences massive chest pains which can also be referred to as
angina. Individuals suffering from coronary heart diseases often do not display any symptom.
However, individuals suffering from this condition often suffer from massive chest pains, heart
attack, cardiac arrhythmias, and heart failure (Hawaii State Department of Health, 2012, p. 1).
The causes of massive chest pains and heart attack are often the same that is clogged arteries
which reduce the flow of blood to heart muscles.
Overtime muscles of the heart weaken as a result of coronary heart disease. The weakening
reduces the heart's capabilities to pump sufficient blood through an individual's body (National
Heart, Lung, and Blood Institute, 2009, p. 1). This condition is often referred to as heart failure
or arrhythmias.
Information regarding family history and medical history is essential during the analysis of the
condition (Hawaii State Department of Health, 2012, p. 1). Doctors take into consideration the
results of various tests that are meant to evaluate the condition of an individual. These tests
include the exercise stress tests which are meant to evaluate the condition of one's heart during
and after exercises, cardiac catheterization which is geared towards the detection of the flow of
blood in the arteries, echocardiogram which employs the use of sound wave mechanism to
evaluate the heart functions (Mukhtar, 2012, p. 5), and the electrocardiogram which is essential
in measuring the electrical activity of the heart.
The Impact of Coronary Heart Disease
This condition has resulted in the death of many individuals in the United States. The Hawaii
state department in the article titled ‘Heart Disease and Stroke Prevention Program 2012
Coronary Heart Disease Fact Sheet' brings into perspective the impact of Coronary Heart disease.
It brings into perspective that an average of about one in every six deaths experienced in the
United States. About 785, 000 Americans depict a new instance of coronary infections while
470,000 individuals experience recurring coronary infections. The occurrence of this condition is
higher in men compared to women (ScholarlyEditions, 2012). The risk of developing this
condition stands at a rate of 49% after an average age of about 40 years for men, and that of
women stands at an average rate of about 32% (Hawaii State Department of Health, 2012, p. 2).

CORONARY HEART DISEASE MANAGEMENT. 4
Coronary Heart disease Mortality Rates per 100,000, Hawaii 1999-2009
Year 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Death
Rate
125 110 100 112 100 98 80 90 75 79 75
Source: Hawaii State Department of Health
The Economic Impact of Coronary Heart Disease
The economic implication of coronary heart disease is not to be ignored. The disease brings
about numerous direct and indirect costs. In the year 2007 $ 177.5 billion represented a
proportion of money consumed by coronary heart disease. Coronary heart disease is ranked
among the highest conditions that result in disabilities among American individuals. The
disabilities, in turn, contribute to the loss in productivity in the states (World Health
Organization, 2009, p. 12). Taking into consideration Hawaii, coronary heart disease consumed
$240 million which was a representation of direct costs and $620 million which is a
representation of indirect impact costs. With the prevalence of this condition being on the rise,
the figures are bound to follow an upward trend.
Coronary Heart Disease Risk Factors
In the paper titled ‘Heart Disease: Causes, Prevention, and Current Research' Deeanna Kelley
bring into perspective various issues that increase the chance of one suffering from the coronary
heart disease condition. Other factors including age and the history of the genetic makeup of a
family are beyond the control of an individual but increase the chances of one developing this
condition (Kelley, 2014, p. 5).
Diabetes
Diabetes is a term that is used to refer to a medical condition where the body is unable to
produce enough insulin or no insulin at all (Rieske, 2011, p. 116). This results in an aberrant
metabolism of carbohydrates and an increased level of blood sugar in body fluids especially
blood and urine (ScholarlyEditions, 2012, p. 231). A high level of blood sugars in an individual's
system may result in blood vessel hardening and also may result in an increase in the blood
pressure rate. Diabetes is a condition that its prevalence increases with age and hence it is quite

CORONARY HEART DISEASE MANAGEMENT. 5
clear that many adult experience this condition as compared to children. The prevalence
difference between genders is yet to be determined.
Physical Inactivity
Physical activity is essential to each and every individual. When an individual does not engage in
physical activity, he or she risks experiencing issues related to high blood pressure, high levels of
cholesterol, and diabetes (Kokkinos, 2010, p. 230). All the condition stated above are high-risk
factors of coronary heart disease. Therefore, when an individual avoids engaging in physical
activity, he or she risks increasing his or her chances of developing the coronary heart disease.
Groups of individuals that tend to participate in few or no physical activity include the aging,
females, and those that are retired or have an inability to work.
Weekly amounts of physical activity classification
Physical Activity
Levels
Intensity Minutes
Range Per Week
Overall Health
Benefits Summary
Comments
Inactivity Totally no activity
beyond the normal
None This practice is very
unhealthy
Low activity The activity here is
beyond normal but
does not exceed 150
minutes in a week
Some benefits accrue It is better to have
low levels of activity
than no activity at all.
Medium Ranges between 150
minutes to 300
minutes in a week
substantial An individual
practising a lifestyle
at the high end of this
range experience
more benefits than
one at the 150
minutes range.
High Activity ranging to
more than 300
minutes a week
Additional benefits
accrue
Current levels of
science do not allow
individuals to identify
upper limits of

CORONARY HEART DISEASE MANAGEMENT. 6
activity to which no
additional health
benefits accrue.
Source: Retrieved from http: //www.health.gov/paguidelines/pdf/paguide.pdf
Overweight and Obesity
The BMI index is often used as a body fact indicator. It is often used to measure the extent of
weight and obesity. These conditions result from the consumption of more calories than is
required. This results in the straining of the cardiovascular system (Watson & Zibadi, 2018, p.
25) and as a result increasing the chances of developing high blood pressure, Diabetes, and high
blood cholesterol levels. Some researchers bring into perspective an aspect which suggests that
other aspects such as the circumference of the waist and the ratio of the waist to the hip can be
associated with the upward trend of poor health issues (Iacobellis, 2009, p. 2). The prevalence of
weight condition is more common in men as compared to women. The condition is also widely
spread in an individual between the 25 to 44 years age bracket. Unemployed people also tend to
suffer from this condition.
Smoking
Smoking escalates the process of atherosclerosis by increasing the chances of occurrence of
blood clots (Diana, 2013, p. 89). This is effected by causing the clumping together of platelets.
Smoking is very common in young adults aging 25 to 34 years.
High Blood Pressure.
Blood pressure is the force that is applied by blood as it is pushing against arterial walls. High
blood pressure levels can cause arterial wall hardening which eventually results in a lower rate of
blood flow. It usually kills silently and hence the term the silent killer. Individuals with low
levels of education usually suffer from this condition. It is more dominant in individuals who are
over the age of 55 years than those below that age bracket (Gotto Jr, 2012, p. 10).
Prevalence of adults to risk factors in the United States and Hawaii

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Percentage as per risk factor
HBP HBC Diabetes Smoking Physical
inactivity
Overweight Obesity Diet low
in fruit
and
veggies
Hawaii 30.2 38.9 8.3 14.5 19.2 34.1 23.1 76.5
United
States
28.7 37.5 8.7 17.3 0 36.2 27.5 76.6
Source: Hawaii Behavioral Risk Factor Surveillance System, U.S Behavioral Risk Factor
Surveillance System, 2009/2010
Recommendations
From the study, it is essential that various aspects have to be taken into serious consideration for
effective management of coronary heart condition. An aggressive risk factor management
strategy should be put in place for individuals exhibiting high chances of developing the
condition especially those with a family history of the same at an early age.
Patients suffering from the condition should be advised about how lifestyle affects their current
condition. They should be made to understand that lifestyle is the basis of reducing risk
associated with developing this condition. It should be brought into perspective that they are not
meant to consume particular foods, they have to increase the intake of particular foods, and they
have to increase their physical activity levels, and have to avoid tobacco-related products.
Individuals have to take into serious consideration the levels of their blood pressure and blood
sugar levels at all times. These conditions are high-risk factors for developing coronary heart
disease, and therefore an early diagnosis of the same ensures for a sound coronary heart disease
management strategy.
The use of quality measures is essential when dealing with and managing coronary heart disease.
This quality measure includes the use of Antiplatelet therapy the therapy applies to individuals
that are of 18 years and above of age with diagnosed coronary heart disease condition and with a
prescription entailing aspirin and clopidogrel.

CORONARY HEART DISEASE MANAGEMENT. 8
The use of Angiotensin-converting enzyme inhibitor therapy is highly recommended. It is
applicable to a section of patients aging 18 years old and above and have been diagnosed of the
condition and have diabetes at the same time or have a condition with issues with the left
ventricular ejection.
It is highly recommended to take into consideration the symptom management strategies. It is
applicable to a percentage of patients above 18 years of age and with a diagnosed coronary artery
condition of over 12 months. An evaluation should be made on the level of activity and
assessment made in regards to the chest pain symptoms that are depicted or not depicted and
with an appropriate chest pain symptom management strategy for a 12 months duration.
Education is a critical aspect in the management of coronary heart disease condition. Therefore
medical practitioners should take into consideration putting in place mechanisms for bringing
together individuals with this condition. Through this individuals are able to share experiences
and acquire additional information that is to be provided by the experts present.
Implementation.
Implementation of issues that came into perspective is essential. Medical practitioners in
diagnosing Coronary heart condition should explore all the possible risk factors in order to
identify the cause of the condition fully. Information given to the patient should be gauged to fit
the understanding levels of that particular patient. When giving a directive regarding the foods
not to be consumed, medical professionals should take the initiative and provide an alternative to
the don'ts.
Through the study, various researchers came into agreement on the risk factors that increase the
chances of one developing the coronary heart disease condition. However, these conditions were
orchestrated by other micro factors depending on the level of education of individuals, the age,
family history, and the lifestyle of a particular individual. Therefore, when determining the risk
factors that an individual is exposed to consideration should be given to these micro factors.
However, the risk factors are universally applicable.

CORONARY HEART DISEASE MANAGEMENT. 9
References
Diana, J., 2013. Tobacco Smoking and Atherosclerosis: Pathogenesis and Cellular Mechanisms.
s.l.:Springer Science & Business Media.
Gotto Jr, A., 2012. Multiple Risk Factors in Cardiovascular Disease: Strategies of Prevention of
Coronary Heart Disease, Cardiac Failure, and Stroke. s.l.:Springer Science & Business Media.
Hawaii State Department of Health, 2012. Heart Disease and Stroke Prevention Program 2012
Coronary Heart Disease Control Fact Sheet. Chronic Disease Management and Control Branch,
pp. 1-8.
Iacobellis, G., 2009. Introduction: Redefinition of the relationship between obesity and the
cardiovascular system. In: Obesity and Cardiovascular Disease. s.l.:OUP Oxford, pp. 1-8.
Kelley, D., 2014. Heart Disease: Causes, Prevention, and Current Research. JCCC Honors
Journal, Volume 5(Issue 2 Spring 2014), pp. 1-15.
Kokkinos, P., 2010. Cardiovascular Disease Epidemiology and Physical Activity. In: Physical
Activity and Cardiovascular Disease Prevention. s.l.:Jones & Bartlett Learning, pp. 181-374.
Lemos, J. d. & Omland, T., 2017. Chronic Coronary Artery Disease: A Companion to
Braunwald's Heart Disease E-Book. s.l.:Elsevier Health Sciences.
Mukhtar, A. T., 2012. Echocardiogram: Left Ventricle Chamber Detection Using Image
Processing. s.l.:UMP.
National Heart, Lung, and Blood Institute, 2009. AT - A - G L A N C E :Coronary Heart
Disease. Coronary Heart Disease Journal, p. 1.
Rieske, K., 2011. Reversing Heart Disease and Preventing Diabetes: Apply Science to Lower
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ScholarlyEditions, 2012. Coronary Heart Disease: New Insights for the Healthcare
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CORONARY HEART DISEASE MANAGEMENT. 10
Watson, R. R. & Zibadi, S., 2018. Lifestyle in Heart Health and Disease. s.l.:Elsevier Science.
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