Coronary Heart Disease is the most common cause of cardiovascular disability and fatalities in the world today, affecting males more than females with a ratio of 4 - 1.
Epidemiologic studies have identified a number of important risk factors contributing to coronary heart disease.
Positive Family History.
Blood Lipid Abnormalities.
Hypertension (High Blood Pressure).
Elevated Blood Homocysteine Levels.
Hypoestrogenemia in Females.
Overwhelming evidence indicates that abnormalities of lipid metabolism play a direct role in the pathophysiology of this condition. Risk increases progressively with higher blood pressure levels of LDL cholesterol and declines with higher blood levels of HDL cholesterol; therefore the ratio of LDL cholesterol to HDL cholesterol provides a composite marker of risk, with a ratio below 3 indicating a lower risk and a ratio above 5 indicating a higher risk.
This happens because abnormal lipid metabolism or excessive intake of cholesterol and saturated fats initiate the atherosclerotic process. The initial steps are the "Fatty Streaks" or the accumulation of lipids in the vessels.
LDL is the major Lipid that attacks the vessels while HDL, in contrast, is a protective Lipid and can assist to remove LDH from the vessels.
Another preventative measure is the use of Aspirin Prophylaxis, which makes the blood consistency more liquid and so reduces the incidence of Myocardial Infarction, having said this, Aspirin Prophylaxis should only be used under strict medical control in order to prevent the possible side effects and to evaluate the correct dosage.
The role of physical exercise still remains uncertain and a matter of controversy in the medical world, although it has been shown that individuals, who exercise for at least 30 minutes per week, are at the lower risk end. It is difficult to be certain whether this outcome relates directly to exercise or to a generally healthy lifestyle.
Another controversial matter is the effect of "Hormone Replacement Therapy" used in postmenopausal women. Although observation data suggest that estrogen replacement protects the development of coronary artery disease, prospective controlled trials have not yet confirmed a definite benefit.
Of course it is clear that interventions such as smoking cessation, treatment of dyslipdemia and lowering of blood pressure, all prevent heart disease and disorders, or at least they delay the progression and complications after the problem has already manifested itself.
In general, even if a patient does not present a high factor risk as mentioned above, a complete health check-up is a must after the age of 50 or so, complementing this with regular follow up check so as not to detect future possible risks and prevent cardiac Ischemical Injuries.