Coronary
Heart Disease
(CHD)
Definition
Risk Factors
Diet
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Coronary heart disease is the leading cause of
death in the United States.
DEFINITION
Coronary heart disease (CHD) and its related
conditions are the most common cause of death
in the United States. Over 925,000 Americans
died of cardiovascular disease in 1995, account-
ing for 42% of all deaths (1). There are over
1.5 million heart attacks in the United States
each year with one-third of these patients dying
before they reach the hospital. The cost of lives
lost is high and so is the financial burden. Over
$100 billion is spent in the United States annual-
ly on cardiovascular related conditions.
The build-up of plaque, known as atherosclero-
sis, within the heart's arteries is responsible for
the morbidity and mortality related to this condi-
tion. This plaque, made up of a lipid-rich core
and covered with a fibrous cap, can obstruct the
heart arteries leading to heart-related chest
pain, also known as angina, shortness of breath,
or fatigue. The symptoms can vary widely
between individuals, especially women (2).
Rupture of this plaque may form a blood clot
which can obstruct the artery leading to death of
the heart muscle supplied by that artery. This
condition is known as a myocardial infarction
(MI) or more commonly, a heart attack.
RISK FACTORS
There are several risk fac-
tors for the formation of ath-
erosclerosis. Those which
are not modifiable, include
age, gender, race, and a
family history of premature
CHD (3,4). The incidence
of CHD increases with age
and men typically present
with symptoms of CHD on
average 10 years earlier
than women. This "protec-
tive effect" in women is felt
to be secondary to the hor-
monal state of women dur-
ing menses, however this
advantage gradually fades
in menopause leading to a
similar incidence of CHD in
the elderly. CHD rates are
30 to 70 per