Comprehensive Report: Coronary Heart Disease Management Analysis

This report provides a comprehensive overview of coronary heart disease (CHD), its impact, and various management strategies. It highlights the significance of understanding CHD, its effects on individuals, and the factors contributing to its development. The report emphasizes the importance of considering family and medical history in diagnosing CHD and discusses various diagnostic tests, including exercise stress tests, cardiac catheterization, echocardiograms, and electrocardiograms. It also addresses the economic impact of CHD, noting the substantial direct and indirect costs associated with the disease. Furthermore, the report identifies key risk factors for CHD, such as diabetes, physical inactivity, overweight and obesity, and emphasizes the importance of lifestyle modifications and quality measures in managing the condition. The analysis includes data on the prevalence of risk factors in the United States and Hawaii, underscoring the need for effective management strategies and patient education to reduce the risk of developing CHD.

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 very 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.
The use of Angiotensin-converting enzyme inhibitor therapy is highly recommended. It is
applicable to a section of patients aged 18 years and above who have been diagnosed of the
condition and have diabetes at the same time or have a condition with a current or prior left
ventricular ejection fraction.
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.
Background
Coronary heart disease can also be referred to as Coronary artery disease. In the past few years, it has been a leading cause of death of men and women 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.
Relevant Key Messages
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 Coronary artery disease is. 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. Depending on the size of the clot, the arteries can be blocked eventually and a very small percentage of 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 diagnosis of coronary heart disease (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
Coronary heart disease 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 out of every six deaths that
occur in the United States. About 785, 000 Americans experience 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 Mortality Rates per 100,000, Hawaii 1999-2009
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. Some factors such as 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 condition in which 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 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 very essential to each and every individual. When an individual does not engage in a 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
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 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 an increased risk 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 individual ranging between the ages of 25 years to 44 years. 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 ranging from 25 to 34 years of age.
High Blood Pressure.
Blood pressure can be defined as the force applied by blood as it is pushing against arterial walls. High blood pressure levels can cause arterial wall hardening which eventually results in 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 (Gotto Jr, 2012, p. 10).
Prevalence of adults to risk factors in the United States and Hawaii
Source: Hawaii Behavioral Risk Factor Surveillance System, U.S Behavioral Risk Factor Surveillance System, 2009/2010
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 fully identify the
cause of the condition. 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 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
Student Name and ID
Year 1999 2000 2001 2002 2
0
0
3
2004 2005 200
6
2007 2
0
0
8
2009
Death
Rate
125 110 100 112 1
0
0
98 80 90 75 7
9
75
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 practicing a lifestyle at the
high end of this range experiences 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
activity to which no additional health
benefits accrue.
Percentage as per risk factor
HBP HBC Di
ab
ete
s
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

References
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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
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Kelley, D., 2014. Heart Disease: Causes, Prevention, and Current Research. JCCC Honors Journal, Volume 5(Issue 2 Spring 2014), pp. 1-15.
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