Ischemic Heart Disease: The most notorious killer we forgot about

by Stacyann Gomez MD, MPH

Ischemia is defined as inadequate blood supply to an area of the body to blockage of the blood vessels supplying that area.

Ischemic means that an organ (e.g., the heart) is not getting enough blood and oxygen. Ischemic heart disease is also called coronary heart disease. In this condition, there is narrowing of heart (coronary) arteries that supply blood to the heart muscle. The narrowing is usually caused by a buildup of plaque, (a waxy, fatty-based substance) called atherosclerosis but can also be caused by a blood clot or by constriction of the blood vessel.

When the blood flow to the heart muscle is completely blocked, the heart muscle cells die. This is called a heart attack or myocardial infarction (MI). Most people with early coronary heart disease (less than 50% narrowing) do not experience symptoms.

However, as atherosclerosis progresses, symptoms may occur. Examples of common symptoms are a decrease in exercise tolerance, chest pain, shortness of breath, and palpitations. These are most likely to occur during exercise or emotional stress when the demand for the oxygen carried by the blood increases.

Why is this relevant to you?

The world’s biggest killer is ischemic heart disease. It is responsible for approximately 16% of the world’s total deaths.

What causes this disease?

Risk factors for coronary artery disease (CAD) are mostly related to lifestyle factors such as sedentary lifestyle, smoking, obesity, unbalanced diet high in fatty foods can lead to the development of heart disease. Other factors that increase a person’s risk of developing heart disease include, but are not limited to, uncontrolled high blood pressure, uncontrolled diabetes, and high cholesterol levels.

In 2012 a cardiovascular risk study in Grenada found the prevalence of CAD risk factors to be as follows: overweight and obesity 57.7% of the population; physical inactivity 23.4%; diabetes 13.3%; hypertension 29.7%; hypercholesterolemia 8.6%, and smoking 7%. Grenadians were found to have a higher risk of developing CAD when compared to Americans in a similar category (Bansilal et al., 2012).

Generally, the risk of developing CAD increases with age. For men, age greater than 45 years greater than 55 years in women is associated with increased risk. Another risk factor is a positive family history of early heart disease. For example, heart disease in the father or a brother diagnosed before age 55 years and in the mother or a sister diagnosed before age 65 years. Other genetic factors like certain ethnicities can also increase risk. Individuals of African descent and Asian descent are more likely to develop coronary heart disease than people of European descent.

We must fight the good fight!

The American College of Cardiology and the American Heart Association published joint guidelines on the primary prevention of cardiovascular disease. Recommendations include:

• Exercise at least an accumulated 150 minutes per week at moderate intensity or 75 minutes per week at vigorous intensity
• Achievement of appropriate weight loss when necessary
• Adequate glycemic control in diabetics
• Maintaining a tailored nutrition plan aimed at providing a heart-healthy dietary pattern, is recommended for all
• Tobacco users are advised to quit. This should be maximised by combining behavioral interventions with pharmacotherapy

We cannot change our genetics, but we can modify our lifestyle to significantly lower the chance of suffering from ischemic heart disease. Visit your primary care physician for screening and advice regarding cardiovascular disease.

Support systems are important in the fight against heart disease. Many people struggle to make the necessary changes on their own. There many groups and websites that exist to provide the necessary support and information regarding this. Your doctor and dietician may have more information regarding groups and support programmes suited to your individual need in your area.

Dr Stacyann Gomez is a medical professional. She recently completed her Master of Public Health in Preventative Medicine. She is an alumnus of St George’s University where she completed both her medical degree and master’s degree.

References

• Bansilal, S., Vedanthan, R., Woodward, M., Iyengar, R., Hunn, M., Lewis, M., Francis, L., Charney, A., Graves, C., Farkouh, M. E., & Fuster, V. (2012, July 1). Global heart. Global Heart. https://doi.org/10.1016/j.gheart.2012.06.002.
• Boudi, B. F. (2021, April 03). Risk factors for coronary artery disease: Practice essentials, risk factor biomarkers, conventional risk factors. Retrieved April 12, 2021, from https://emedicine.medscape.com/article/164163-overview#a10
• Institute of Medicine (US) Committee on Social Security Cardiovascular Disability Criteria. (2010, July). Cardiovascular Disability: Updating the Social Security Listings. Retrieved April 12, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK209964/
• World Health Organisation. (2020, December 9). The top 10 causes of death. Retrieved April 12, 2021, from https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

NOW Grenada is not responsible for the opinions, statements or media content presented by contributors. In case of abuse, click here to report.