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Pyridium (Phenazopyridine)

When doctors assess the causes of coronary disease, of which there are at least six main ones, they talk about ‘risk factors’. Possessing one or more of these risk factors will increase your chances of developing coronary disease and carefully evaluating these risk factors can help doctors predict who in the general population will be most at risk of having a heart attack.
It is said that coronary disease is the product of the lifestyle we lead in the Western world. Countries such as Japan, Czechoslovakia and Israel have a relatively low death rate from coronary disease but New Zealand, the USA, England and Wales have a much higher rate, and Finland and Scotland have very high rates, occupying first and fourth positions respectively in this league table of deaths. The way of life of a peasant in one of the poorer parts of the world is obviously very different from that of a city dweller in England or the USA. Food is less available and expensive food such as red meat is a rare delicacy. Hard physical exercise is a part of life in poor communities and stress in the form that we experience is unusual. Cigarette smoking used to be much commoner among more affluent people but the level of consumption, even in underdeveloped countries, is increasing all the time.
Family history
Coronary disease tends to run in families. If one member of your family has had a heart attack particularly if it occurred in his/her younger years, then the other members seem to be at risk. The main risk comes from a first degree relative – that is, one of your parents or a brother or sister. If a number of these first degree relatives have suffered a heart attack, then your risk is increased accordingly.
High blood pressure
When we are active, excited, or under stress, our blood pressure will go up automatically to supply extra blood and oxygen to the muscles and organs. High blood pressure, or hypertension, however, is a sustained high level of pressure even during rest. This is a major risk factor for heart disease and strokes. It is a very common disease in developed countries and affects about 20 per cent of the adult population in Britain today. High pressure in the artery walls puts a strain on the delicate lining, increasing the risk of some weaknesses occurring and accelerating the atheroma or silting-up process. Hypertension can affect any part of the body, but more usually it affects the brain in the form of a stroke, or the heart in the form of hypertensive heart disease. Being male, middle-aged or older, having a family history of hypertension, living a sedentary life and being under stress are the biggest factors in the risk of developing hypertension in the first instance, but once the disease has developed it can cause other complications such as heart disease.
High cholesterol
The level of fats or lipids in the blood is one of the most important risk factors in heart disease and the higher the levels the greater the risk. There are two main types of fats, cholesterol and triglycerides, both of which are made by the liver and are essential for life. One type of cholesterol, HDL cholesterol (HDL stands for High Density Lipoprotein), may be protective but LDL cholesterol (Low Density Lipoprotein) may increase the risk of thrombosis. These fats are transported around the body via the bloodstream to be used in maintaining the body. Taking a cholesterol-rich diet from which these fats can be absorbed and/or making too much of the wrong sort can cause the excessive fats to deposit themselves along the artery walls. This is especially dangerous in the small coronary arteries which can become blocked very easily. A high level of triglyceride is less common but can occur in people who are overweight, people with diabetes and people who take excessive sugar and alcohol. I laving high blood lipids (fats) puts someone at risk of developing coronary disease as well as multiplying the importance of other risk factors they might have.
The direct effects of smoking on heart disease are undeniable. Smoking is probably the single most important risk factor in heart disease because unlike cholesterol or blood pressure it is not necessary for maintaining life, and stopping smoking can produce a dramatic decrease in the risk of developing heart disease. Smoking also contributes to the risk of a heart attack occurring earlier in life, and increases one’s chances of not surviving a heart attack.
Cigar and pipe-smokers have a reduced risk of developing heart disease, but their risk is still well above that of someone who doesn’t smoke at all.
Smoking affects the heart by the action of nicotine and carbon monoxide. Nicotine stimulates adrenalin, the stress hormone, which suddenly increases the heart rate and blood pressure. The stress response is discussed more fully in Chapter 6. Carbon monoxide interferes with the ability of the blood to carry oxygen to the heart. The lasting effect of smoking is a combination of the effects of nicotine and carbon monoxide which stimulates the fatty deposit production, causes the blood to become sticky and therefore promotes the production and formation of a blood clot or coronary thrombosis.
Lack of exercise
Over the last 30 or 40 years our working and home life has changed dramatically. People now do less physically demanding work, homes have many labour-saving devices such as automatic washing machines and vacuum cleaners, and the majority of people own a car. As a result of all this, unless we seek exercise for exercise’s sake, many weeks can go by without us experiencing significant physical exertion. There is now a great deal of evidence from well-conducted research studies to show that those people who do less physically are more at risk of developing heart disease than those who exercise regularly. In fact, those who exercise regularly have a lower death rate from all causes than their sedentary contemporaries.
Regular aerobic exercise, that is the sort that trains your heart and lungs, for a minimum of 20 minutes per session, three to four times a week, is all that is required to lower the risk of developing heart disease. This is discussed more fully in Chapter 8.
There are many benefits from exercise. It can help to lower the blood pressure, help to control weight and it has the effect of calming and building confidence.
People who have diabetes are more likely to develop heart disease than people who don’t have diabetes. This book will not cover the reasons why, but will concentrate more on those risk factors that you can do something about.

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