Reducing Coronary Heart Disease Risk

What is coronary heart disease?
Coronary heart disease (CHD) is sometimes called coronary artery disease. A coronary artery is a blood vessel that carries blood to your heart muscle. Your arteries are like narrow tubes. A fatty substance called plaque can build up in your arteries, blocking or slowing the flow of blood and oxygen through them. This can happen in any artery, but when it happens in the coronary arteries, your heart muscle doesn't get the blood and oxygen it needs to work properly. Coronary heart disease can lead to serious health problems, including angina (pain or pressure in the chest) and heart attack.

What causes CHD?
Both men and women can get CHD. It can be hereditary (run in your family). It might also develop as you get older and plaque builds up in your arteries over the years. You may get CHD if you are overweight or if you have high blood pressure or diabetes. High cholesterol may also lead to CHD (see below). CHD can stem from making unhealthy choices such as smoking, eating a high-fat diet and not exercising enough.

What is cholesterol?
Cholesterol is a waxy substance that your body makes and uses to protect nerves, make cell tissues and produce hormones. It's also present in meat and dairy foods you eat. There are several types of cholesterol, including low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL cholesterol is called "bad" cholesterol because it can build up on the inside of your arteries, causing them to become narrow from plaque. HDL is called "good" cholesterol because it protects your arteries from plaque buildup.
Many foods, even if they don't contain cholesterol, contain fats that can lower or raise LDL or HDL cholesterol. Talk to your family doctor about how your diet can affect your cholesterol levels.

What can I do to lower my risk of CHD?
1. Don't smoke. Nicotine raises your blood pressure because it causes your body to release adrenaline, which makes your blood vessels constrict and your heart beat faster. If you smoke, ask your family doctor to help you make a plan to quit. After 2 or 3 years of not smoking, your risk of CHD will be as low as the risk of a person who never smoked.
2. Control your blood pressure. If you have high blood pressure, your family doctor can suggest ways to lower it. If you're taking medicine for high blood pressure, be sure to take it just the way your family doctor tells you to.
3. Exercise. Regular exercise can make your heart stronger and reduce your risk of heart disease. Exercise can also help if you have high blood pressure. Before you start, talk to your family doctor about the right kind of exercise for you. Try to exercise at least 4 to 6 times a week for at least 30 minutes each time.
4. Ask your family doctor about taking a low dose of aspirin each day. Aspirin helps prevent CHD, but taking it also has some risks.
5. Ask your family doctor about taking vitamin supplements. Some studies have shown that vitamin E may lower a person's risk of having a heart attack. Other vitamins may also help protect against CHD.
6. Eat a healthy diet. Add foods to your diet that are low in cholesterol and saturated fats, because your body turns saturated fats into cholesterol.

What if changing these things doesn't help?
Your body will need time to respond to the changes you've made. Your family doctor will watch your progress. If your cholesterol level hasn't improved after 6 months to 1 year, your family doctor may prescribe medicine to lower your cholesterol. However, you will still need to keep up the healthy lifestyle changes you've started to help the medicine work.
[AAFP]