Cardiac Risk Factors - Term Paper Example

CARDIAC RISK FACTORS Introduction Coronary heart disease (CHD) is the leading single cause of death worldwide and hence can be rightly referred to as ‘the Global Epidemic’. As per WHO statistics, heart disease and stroke kill more than 17 million people a year, which is almost one-third of all deaths around the world. It has been predicted that by 2020, CHD will become the leading cause of both death and disability worldwide and the number of fatalities are expected to reach 24 million a year by 2030. (WHO News Release 2004) This essay discusses the risk factors of CHD, with a specific emphasis on self-controllable ones, such as, smoking, alcoholism and obesity. The discussion further evaluates interventions that may be used to reduce the risk of cardiac disease in smoking. Cardiac risk factors Cardiac risk factors are specific characteristics that predict individual’s chances of developing atherosclerosis or coronary heart disease. In the case of any individual, the risk of such a disease increases with increasing number and severity of these factors. Identification of risk factors applicable to a person is the first step towards helping him to improve his health condition. A health professional can help the patient lower the risks of developing a cardiovascular condition by taking active steps to reduce the number and frequency of such risk factors. The major risk factors identified by American Heart Association through extensive clinical and statistical studies include heredity, Gender, Age, Smoking, High Blood Cholesterol, high blood pressure, Obesity, Physical inactivity, stress and behavior. Of these, there are certain risk factors which can be modified, treated or controlled by the patient by changing his lifestyle or taking medication. Such factors include Smoking, Obesity and Alcoholism, among many others. Smoking Cigarette smoking is considered to be the major culprit for most of the sudden cardiac deaths. The risk of developing CHD is 2 to 4 times greater in case of a smoker compared to a non-smoker. Both active as well as passive smoking increases the risk of cardiac diseases. Cigarette smoking in combination with other risk factors is known to aggravate the chances of stroke. (Risk factors and Coronary Heart Disease) In the US, Cigarette smoking has been labeled as ‘enemy no.1’ on the list of things known to cause illness and hence decrease the life span of an individual. It has been reported that 20% deaths in the country are due to smoking. Smoking not only increases the risk of heart disease but also increases the risk of Lung cancer, Laryngeal cancer, esophageal cancer, ulcers and many other diseases. (Cardiac Risk Factors) The smoke released from tobacco has been shown to enhance development of atherosclerosis by damaging artery walls and creating cholesterol deposits. It also reduces the HDL (High Density Lipoprotein) cholesterol levels (“good” cholesterol) and causes formation of blood clots that can lead to stroke. Obesity Obesity is most likely to lead to heart disease and stroke even in such individuals who do not have any other risk factors.. Excess weight increases the load on the heart. It leads to high blood pressure, increases the blood cholesterol and triglyceride levels, and lowers HDL cholesterol levels. People who are obese are also prone to developing diabetes which further increases the risk of developing cardiovascular disease. Many factors govern the extent of risk due to obesity. Two such factors are sex and the fat accumulation in the abdominal region. Obesity increases the risk in men more than that in women. Individuals with increased fat accumulation in the abdominal region have high lipid profiles which can result in atherosclerosis thus exposing them to increased cardiovascular risk. Excess stored fat in the abdominal region and high triglyceride levels in cardiac tissues cause ventricular dysfunction and increase the risks of heart disease considerably. (Weight Loss Surgery and Major Cardiovascular Risk Factors) Alcoholism Drinking too much alcohol is known to cause increase in blood pressure and raise the triglyceride levels resulting in heart failure and leading to stroke. Women who generally drink one peg of alcohol and men who have around two of them per day have lower risks of heart disease as compared to those who do not consume any alcohol. One drink is defined as 1-1/2 fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.), 1 fl oz of 100-proof spirits, 4 fl oz of wine or 12 fl oz of beer. (Risk factors and Coronary Heart Disease) Excessive consumption of alcohol increases the calorie intake thus leading to obesity and a higher risk of developing diabetes. Besides these there are some other serious cardiac disorders one might encounter. These are cardiomyopathy, cardiac arrhythmia and sudden cardiac death. Health Promotion interventions People at high risk of coronary heart disease should be advised by the health professionals to make every attempt to reduce their risk factors. Interventions which may be used to help reduce the risks of heart diseases include health education, stress management, or both, sometimes combined with exercise training. Psychoeducational interventions have been proven to reduce risks such as high blood pressure, weight and smoking habits. These further reduce the cardiac deaths, angina and myocardial infarctions (Gerry Benson 2000). Psychoeducational programs can help Health professionals promote ‘Self-help’ through lifestyle changes. Of all the possible options available, Smoking cessation is probably the single most important risk factor modification for both primary and secondary prevention of cardiovascular disease. Interventions adopted to assist cessation of smoking have proved to be highly beneficial. The reduction in mortality and morbidity achieved through smoking cessation is so appreciable that one can ignore the other risk factors such as weight gain. Hence intervention procedures should be aimed at enabling smoking cessation (Non-pharmacological modification of cardiac risk factors 1998). Smoking Cessation Definitely, ‘Habits die hard’ and smoking is one habit which is highly addicting and extremely difficult to give up. But the point to be considered is that as immediate are the negative impacts of smoking, as rapid are the results of quitting. It has been reported that after a person quits smoking, the risk of heart disease decreases dramatically within two years. A counseling session with a smoker should explain to him the measurable changes in the body within hours of smoking the last cigarette, which consistently improves the health condition. Though it may not be possible to completely reverse the negative effects of smoking, yet considering the extent of positivism, it is worth a try (Smoking Cessation) Smoking Cessation improves the lipid profile, decreases thrombotic tendency, reduces vascular endothelial damage and improves insulin sensitivity. These factors have been proved to reduce the risk of developing coronary heart disease (Non-pharmacological modification of cardiac risk factors 1998) All these benefits of quitting smoking emphasize the need for the right interventions to promote this act. It has been reported that patients who had received psychoeducational program were 3 times more likely to quit smoking than those who had not. Many studies may have reported inconsistent results with smoking cessation. But such programs have at least positively resulted in increased desire to quit smoking. Participation by patients, nurses and other health professionals in cardiac rehabilitation programs using stress management, health education interventions, results in clinical benefits. Nurses can play a major role in planning, implementing and evaluating educational programs. For secondary prevention after a cardiac event, nurses can team up with their patients in choosing evidence based behavioral strategies (Robert Gluckman 2000) REFERENCES Cardiac risk factors, retrieved 13 December 2006, Gerry Benson, Psychoeducational programmes reduce long term mortality and recurrence of myocardial infarction in cardiac patients, Evidence Based Nursing, 2000;3;80, retrieved 13 December 2006, Non-pharmacological modification of cardiac risk factors: part 3. Smoking cessation and alcohol consumption, Journal of clinical pharmacy and therapeutics,1998, vol. 23, no1, pp. 1-9, retrieved 13 December 2006, Risk Factors and Coronary Heart Disease, retrieved 13 December 2006, Robert Gluckman, Multiple interventions modestly reduce cardiovascular risk factors in primary prevention, but effects on mortality are uncertain, Evidence Based Medicine, 2000;5;48, retrieved 13 December 2006, Smoking Cessation, retrieved 13 December 2006, Weight Loss Surgery and Major Cardiovascular Risk Factors, retrieved 13 December 2006, WHO News release, WHO publishes definitive atlas on global heart disease and stroke epidemic, 23 September 2004, retrieved 13 December 2006, Read More