Introduction

One of the major causes of morbidity and mortality globally in spite of expensive medicines and upcoming interventions for surgeries is coronary artery disease (CAD). The root cause of the problem is failed to be understood at times, resulting in the development of coronary artery disease (CAD). Risk factors or causes could be unhealthy eating habits or improper diet schedule, no proper work-out or exercise, increased sedentary lifestyle, obesity, metabolic syndrome, cigarette smoking, excess alcohol intake, depression, stress and anger, increased levels of cholesterol or blood pressure, Constant evidence from the studies have depicted that the above-mentioned causes or factors affect approximately 80% of the population. Lifestyle changes have been considered to be the most important to improve the quality of life and reduce the risk of heart diseases.

What is Coronary Artery Disease?

CAD is considered to be one of the major factors of death among men and women. It is considered to be a type of heart disease that is very common. A lot of things can be done to treat it, even though it is one of the major causes of death in the US.

The problem arises when a waxy product named plaque is built in the arteries i.e. the coronary arteries that provide blood to the muscles of the heart. For the blood to be clogged it takes several years but it can gradually result in a heart attack or heart failure.

CAD results in the symptoms such as breathless, fatigue or tired mainly during exercises. The major symptom for CAD is a pain in the chest or angina. There could also be uncomfortable feelings in the arms, jaws, shoulders or back. It may result in tightness, too much pressure, squeezing, heaviness, burning sensations, aches or pain, numbness or feeling of fullness.

Lifestyle changes

Avoid Tobacco

It causes harm or injury to the lungs, heart and blood vessels. The heart and brain work appropriately in the presence of oxygen which might be affected if that place is taken up by the substances in the tobacco. The usage of tobacco increases the risk of heart attacks and stroke. Passive inhalers are also at higher risk of harming themselves like active inhalers.

Avoid Smoking

Giving up smoking, will help you decrease the risk of coronary heart disease (CHD). It has been seen that you are up to four times at an increased chance of giving up on smoking if use a support group with the medicines to stop smoking, such as patches or gums.

Physical Inactivity

An increase in the sedentary life-style and not being too active or fit causes the risk for CAD and other heart-related conditions to arise. By increasing your exercise or work-out it helps:

  • Maintain a healthy body weight, and helps in proper burning of the sugar and fats.
  • Blood Pressure/ Hypertension is also maintained.
  • It maintains the quantity of oxygen in the blood.
  • It helps decrease stress and tension.
  • Muscles of the heart and bones are strengthened by exercise or work-out.
  • It helps in toning the muscles and increases the circulation of blood.

If one is being active, it helps relieve any other medical conditions or diseases such as cancer, etc. If a person is active, they feel good and satisfied. They tend to get proper quality sleep, better energy, self-confidence, and concentration.

Physical Activity also helps increase the functioning of endothelium, increases the vasodilation, and function of vasomotor in the blood vessels. Exercise also helps lose weight, controls blood sugars, and maintains blood pressure, maintains blood cholesterol levels and decreases insulin resistance. Sedentary Lifestyle is linked with an increase in heart diseases.

Exercises that are included should be a moderate exercise for 30-45 minutes on most of the days. If vigorous activity is done, it is associated with more benefits. Include exercises that involve large muscle groups. Including Aerobic activities such as walking, running, brisk walking, swimming and more. If concentrating on walking, then use a pedometer to achieve at-least 10,000 step goal.

Unhealthy Eating Habits

Consuming food with excess calories, fat, sugar, salt and not excess consumption of fruits and vegetables. Weight will be put on, even if you eat too much and do not burn out calories. Over-weight or obesity can result in other medical conditions such as diabetes, blood pressure, and high fat i.e. lipids or cholesterol. All these medical conditions or problems increase the risk of heart conditions and illness. If overweight or obese individuals have higher fat deposition around the waist or abdominal area it results in the risk of heart diseases.

Consuming heart-friendly foods such as fruits, vegetables, whole grains and pulses, fish, nuts, low-fat milk, and milk products. Avoiding fried foods, processed foods, red meat, sweets, and full-fat dairy products. Limiting the intake of sugar and sugar-based beverages as they do not provide any nutritional value, except calories and carbohydrates.

Saturated Fats have shown to increase the levels of LDL Cholesterol. PUFA (Polyunsaturated Fatty Acids) and MUFA (Monounsaturated Fatty Acids) when used instead of Saturated Fatty Acids, tend to lower the total cholesterol, LDL Cholesterol, and Triglycerides. Trans-fatty acids are present in both animal and plant sources and made from partial hydrogenation of saturated fatty acids. An increase in the intake of trans-fats results in higher LDL Cholesterol and decreases the HDL levels. There is a positive link between trans-fats and coronary heart disease.

If the consumption of fat i.e.< 1/3rd of the total calories increases the consumption of saturated fats, and results in an excess gain in weight and calories. If consumption of fat is the only 1/5th of the total calories, it causes an insufficient intake of Vitamin E and Essential Fatty Acids (EFA) and brings adverse/critical differences in HDL Cholesterol and Triglycerides. According to the present recommendations diet that contributes to 30% of calories from fat i.e. via diet, < 10% from Saturated Fatty Acids, approximately 10% from PUFA and approximately 15% from MUFA. There was a study done which was a systemic review including 27 studies. According to the studies, it has shown that decreased intake of total fat or saturated fat or cholesterol via diet and shifting from saturated to unsaturated fats like PUFA and MUFA reduces the risk of cardiovascular diseases/heart diseases by 16% and Cardiovascular mortality/death by 9%. No changes were seen in overall death or mortality.

The intake of omega -3 fatty acids i.e. fish and fish oils which have eicosapentaenoic acid and docosahexaenoic acid and nuts and seeds and plant oils that have alpha-linoleic acid. According to the epidemiologic studies and trials which are clinically based, stated that the risk of coronary heart disease is reduced by the intake of omega-3 fatty acids.

Increasing the consumption of fruits and vegetables and proper folic acid intake tends to decrease the harmful effect on heart disease. The benefit is due to its contribution via micronutrients, antioxidants, phytochemicals, flavonoids, fiber, and potassium. When nine of ten ecological studies were done for heart disease, out of three-two and out of sixteen-six studies showed a positive relationship between the intake of fruits and vegetables and heart diseases. There was a study was done, which depicted a relationship between whole grains and coronary heart disease i.e. intake of whole-grain cereals has shown an inverse relationship with overall death and coronary heart disease. There was also a cohort study done for Japanese men and women, who were studied for up to 18 years. In this period when they were asked to consume green and yellow vegetables and fruits daily, it resulted in decreased risk of stroke, intracerebral hemorrhage and cerebral infarctions death in both men and women. In another study, they showed that by consuming fiber through the cereals and fruits, it decreases the risk of coronary heart disease. The recommendation is to consume at least 5-6 servings of fruits and vegetables per day.

To maintain weight (Body Mass Index)

Obesity is a health condition that is seen in both developed and developing countries. There is a connection between weight and heart diseases. Obesity or Overweight is one of the major causes of heart diseases, type-2 diabetes, blood pressure, glucose intolerance, and dyslipidemia.

Alcohol

Individuals who drink less or medium amount results in fewer deaths as compared to those who individuals who drink more and in large quantities results in increased death rates. There is an increased mortality rate seen among those individuals who drink in excess. Consumption of alcohol is also associated with a wide range of issues and problems which are medical and social.

Psychosocial Factors

Some of the factors such as eagerness, depression, no proper social support, stress, no socializing, all as an independent cause affect coronary heart disease. In studies, it has also been seen that the risk increases by 2-3 fold and 3-5 fold, respectively in both men and women in those suffering from social separation and no proper support socially. It is also important for the doctors and physicians to check the patient overall i.e. in terms of initial detection, treatment, and referral of individuals suffering from problems such as emotional and behavioral to improve the quality of life and avoid any sort of heart issues or heart conditions.

Monitoring Blood Pressure

Important to regulate the blood pressure to avoid heart diseases or medical conditions. It has been analyzed that approximately 7 million premature deaths happen due to increased blood pressure. This is one of the main factors for several medical conditions such as coronary heart disease, cerebrovascular disease and heart, and kidney failure. If the blood pressure is treated it helps reduce the risk for 35-40% of chances of stroke and 16% chances of Myocardial Infarction. Also to control blood pressure by reducing the intake of sodium.

To Control Diabetes

If an individual is diabetic, it has a higher chance of developing coronary heart disease (CHD). It is important to be physically active and fit, maintain your weight and regulate blood pressure will help control sugar levels.

Combined Risk Factors

If an individual is suffering from more than one risk factor i.e. high blood pressure, high blood sugar, and high blood fat which increases the risk of heart diseases and illness.

Metabolic Syndrome

Individuals with central obesity (abdominal obesity) i.e. weight around the waist i.e. high blood sugars, high fat, high blood pressure at the same time are known as metabolic syndrome. Individuals with metabolic syndrome are at a high risk of medical conditions.

Medications

If a heart disease is not reversed with only life-style changes, the physicians might have to prescribe medicines to treat heart disease. Medicines used to prevent coronary artery disease (CAD) are to lower cholesterol, prevent the formation of blood clots and decrease the blood pressure.

FDA has accepted various medicines that help maintain cholesterol levels. The drugs which lower cholesterol help lower LDL Cholesterol (Bad Cholesterol) and an increase in HDL Cholesterol (Good Cholesterol).

The best-known medicine is Statins. Statins blocks a product that requires to prepare cholesterol in the body. The production of cholesterol is slowed down by the liver and increases the rate of removing the LDL Cholesterol from the bloodstream.

  • Another class of drug is Bile Acid Sequestrants, this throws out the cholesterol from the blood.
  • Fiber Acid Derivative (Fibrates) helps the HDL Cholesterol to increase and decreases the Triglyceride levels.
  • Niacin is a B-complex vitamin that helps increase the Good Cholesterol (HDL).
  • Clot-preventing drugs

These drugs cause it hard for the blood to clot. This clot needs to be avoided to be formed as it causes partial or complete blockage of the blood flow to your heart.

Blood Pressure Lowering Drugs

Your blood vessels are relaxed by Angiotensin-Converting Enzyme (ACE) inhibitors and Angiotensin II Receptor Blockers (ARB’s).

Also, Calcium Channel Blockers help avoid the movement of calcium inside the muscle cells in the heart and blood vessels.

Beta-blockers help to slow down the heart-beat in-order to reduce the force of blood movement through the arteries.

Conclusion

To conclude, it is important to prevent coronary heart disease (CAD) by bringing about lifestyle changes, improving diet and physical activity. Ask the doctor to help you quit smoking. There are various long-term benefits of a lifestyle change such as weight loss, leaner body, decrease in blood pressure, good mood, decrease the stress levels, strengthen the bones, decrease the risk of osteoporosis, increases the capacity of the lungs, increases overall strength, stamina, energy, and health.

References

  1. https://www.ncbi.nlm.nih.gov/books/NBK547760/
  2. https://journals.sagepub.com/doi/10.1177/2048004016687211
  3. https://www.termedia.pl/Practice-setting-and-secondary-prevention-of-coronary-artery-disease,19,29143,0,1.html
  4. https://www.dovepress.com/primary-prevention-of-coronary-heart-disease-integration-of-new-data-e-peer-reviewed-article-DDDT
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