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Does Lifestyle Affect the Development of Coronary Heart Disease?

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Does Lifestyle Affect the Development of Coronary Heart Disease?

Coronary Heart Disease (CHD) otherwise known as Ischemic and Atherosclerotic Heart Disease is the result of a variety of factors such as the build up of fatty materials, calcium, and athermanous plaque within the walls of the arteries that acts as the supply for the myocardium of blood.

The arteries supplying the heart are divided into three different parts, the 'inner layer' which is elastic and made up of Squamous Epithelium cells. Also, a 'middle layer' made up of connective tissue and smooth muscle, and an 'outer layer' made of connective tissues. In CHD, the endothelium layer becomes damaged, constituted by a variety of lifestyle and genetic deficiencies, and results in a build up of cholesterol in the middle layer of connective and muscle tissue. As a result, these cells become known as 'foam' cells that swell within the cholesterol - thus narrowing the lumen. This is known as an 'arthroma' or 'atherosclerosis' of the lumen, where lipoproteins from the blood have accumulated to form a mass of fat swollen cells in the endothelium. 'If coronary artery becomes blocked, the cardiac muscle that it supplies will become short of essential nutrients and contract irregularly '. This arthroma pushes the endothelium lumen, and becomes known as a 'plaque' which can seriously narrow the lumen. A plaque is basically an area of muscle cells and fibers, where the narrowing of the lumen results in the reduction of blood to the myocardium, and can induce strains of angina - a form of ischemia. If large areas of the heart are ischemic, then this causes the irregularity of systole and diastole of the heart. This, therefore constituting a reduction of oxygen to the myocardium can induce far more dire consequences upon the heart, where in critical scenarios a myocardial infarction or sudden cardiac arrest could ultimately follow. If plaques are overly large, it is possible for part of the plaque to break off, causing a clot within the artery. This 'embolus' could restrict blood flow to the heart, and could also be the ultimately fatal cause of sudden cardiac arrest or myocardial infarction. 'Coronary heart disease (CHD) is a preventable disease that kills more than 110,000 people in England every year'

There are a variety of factors affecting the development of CHD, the perhaps most apparent of these being environmental factors and self inflicted lifestyle factors. For example, tobacco smoking is a huge contributor to the development of CHD, where smokers are more than twice as likely to have a heart attack than non-smokers . The development of CHD is four times as likely for a person than smokes, than a person who does not. Carbon Monoxide and nicotine are probably the most important substances in tobacco smoke which affect the heart . Nicotine acts as a stimulant - a vasoconstrictor, which raises heart rate and thus the blood pressure due to the narrowing of arteries. This contributes to the development of CHD. Research into nicotine also shows that it can contribute to the development of thrombosis, raising the risks of myocardial infarctions. Carbon Monoxide inhaled from the tobacco smoke can reduce the ability for red blood cells to carry oxygen pigments, as it latches onto the hemoglobin pigment of red blood cells which enables the transport of oxygen, and therefore deems it inoperable. Cholesterol - another major contributor to the development of CHD is further induced by tobacco smoking as it is known to increase blood cholesterol levels. Smoking is also the cause of many other cardiovascular diseases, and the best lifestyle option to prevent these is to avoid smoking tobacco.

Cholesterol is another major contributor to CHD, the higher the blood cholesterol level - the higher level of risk. Cholesterol is a soft, waxy substance when soaked in alcohol and is transported in the blood as a soluble lipoprotein. These lipoproteins are divided into two separate areas consisting of beneficial and less beneficial categories. Low density lipoproteins (LDL's) are high in cholesterol and therefore contribute to the development of atheromas and are considered less beneficial. High density lipoproteins (HDL's) are low in cholesterol and are not thought to contribute to the development of atheromas, and instead counteract the effects that LDL's ultimately produce; therefore making them less dangerous to health. It is cholesterol that congregates beneath the ruptured endothelium layer of the artery and turns the cells into a mass of 'foam cells', and so the consumption LDL's ought to be kept to a minimum by eating a healthy diet, although some levels of cholesterol for cell development.

Another major contributor to the development of CHD is blood pressure, where high blood pressure increases the heart's workload. As mentioned before, this can be influened by tobacco smoke, where nicotine acts a vasoconstrictor narrowing the arteries and raising the blood pressure. However, high blood pressure can cause a variety of disorders, ranging from anuerisms to the damage of the endothelium layer - thus conributing to CHD. High systolic pressure is most significant in this regard. 'Many factors lead to hypertention, these include stress, obesity, ecessive consumption of alcohol, a high intake of sodium and smoking tobacco' . It is normal to have a short term raised high blood pressure, or during vigerous exercise in order to compensate the muscles for their



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