The Psychological and Social Impact of Coronary Heart Disease - Essay Example

Coronary Heart Disease Name Course Tutor Date Coronary Heart Disease Coronary heart disease is a form of disease that occurs when the heart vessels become narrow or get constricted and hence hindering the normal low of blood. Recent sources show that coronary heart disease is now becoming one of the leading causes of deaths in both developing countries as well as developed countries. Coronary heart disease is classified as a lifestyle disease according to world health organization. It is caused by unhealthy lifestyles such as low physical activity, high intake of refined foods, excessive drinking of alcohol and poor dietary habits. However, research has shown that some coronary conditions are inherited. Poor physical activity for example makes the body to store the extra calories in adipose tissues and other body organs, which include the heart. This would eventually make the heart vessels constricted and hence reducing the normal rate of blood flow (Serruys, Morice, Kappetei &Colombo, 2009). When the flow rate of the blood is reduced, the heart has to try to complement this by increasing its beating rate. This would result n chest pain and conditions such as angina. Poor dietary practices also may results in coronary heart conditions. High intake of saturated fatty acids and refined foods has been linked to coronary heart disease. Actually, morbidity and mortality rate of coronary heart disease is going up at a high rate. This has raised a lot of concern both at all levels right from individual level to international level. In fact, coronary heart disease constitutes the ten global diseases. Due to this, there is need for public sensitization on coronary heart disease. This work is therefore dedicated in providing some insights about coronary heart disease in a relatively understandable and simple language whereby anybody can read and understand it(Serruys, Morice , Kappetei &Colombo,2009).. As mentioned earlier this condition is caused by those factors that directly or indirectly promote the deposition of fats along the vessels carrying blood away from the heart, the arteries. Low-density lipoproteins have been shown to exercabate the condition. Studies have shown that these forms of proteins carry a lot of cholesterol as compared to the proteins. High-density lipoproteins on the other hand have a relatively higher percentage of proteins as compared to the lipids. High intake of refined foods would result in conversion of the excess carbohydrates into lipids. These lipids are normally transported by the lipoproteins. Low-density lipoprotein will pick these lipids from the liver and carry t to other organs, which include the heart. Lipids are groups of compounds that can get oxidized easily. Some studies have shown that while the lipids are circulating in the body and specifically in the heart, some of them would undergo oxidation. (Serruys et al 2009). This would eventually results in the formation f streaks n the vessel of the heart. When streak is formed on the vessel, connective tissues would start developing in an attempt of repairing the damaged section. This would result in an offshoot or a small fingerlike projection from the heart vessel. This offshoot would form a conducive site where lipid oxidation and deposition can take place. After some series of development, the streak would turn to plaque. Plaque is a rigid, large and wide projection on the heart vessel that results from lipid deposition as well as development of connective tissues. Therefore, the immediate causes of coronary diseases constitute those things that either increases the serum levels of lipids such as triglycerides and cholesterols. These include the intake of saturated fats, animal fats refined foods such as sifted maize and cholesterol rich foods such as eggs and fatty meat. Low physical activity would also contribute to accumulation of fats in the body and hence promoting the development of coronary heart diseases. Hereditary factors are also other common causes of this disease. It has been shown that certain groups of individuals have a certain compound in their system called leptin that is responsible for regulating appetite. When the level of this compound is low in the system of an individual, such person is likely to consume a lot of food without feeling any satisfaction (Serruys, Morice, Kappetei &Colombo, 2009). Conversely, for those individuals whose leptin levels are high, their appetite would be regulated. Leptin is thought to be located on the gastrointestinal tract and when the stomach is full, this chemical sends a message to the hypothalamus and the feedback message is send back to the gastrointestinal tact notifying it that the body is satisfied. Therefore depending on the leptin levels some people are bound to eat too much and hence predisposing themselves to coronary heart diseases. Some of the common risk factors of coronary heart diseases include overweight and obesity, age, diabetes, smoking, alcohol consumption and stress. Research has demonstrated the relationship between obesity and coronary heart diseases. Obesity is a condition that results when the body weight of an individual exceeds the ideal body weight of such individual. Obesity occurs when there is high deposition and low breakdown of fats. These fats is likely to get deposited both on the subcutaneous tissues as well as other body organs which include the heart(Serruys, Morice , Kappetei &Colombo,2009).. Although the specific site of fat deposition in the heart is unclear, it is believed that at least a small percentage would be deposited along the blood vessels. However, there is no clear evidence to show this. This is because the role of fats in the heart is to provide a cushion to the heart. Some 5theories implies that obese people requires a lot of oxygen in their systems. Therefore, the heart would be forced to beat too faster and the friction generated may damage the hear vessel hence creating a site where deposition can take place and eventually leading to the development of the plague. Smoking on the other hand is believed to promote the intake of oxidizing agents. Studies have shown that smoke is made up of approximately 1000 chemicals and most of these chemicals are oxidizing agents. When an individual smokes a cigarette, these oxidizing agents would get into the blood and are likely to initiate the oxidation of lipids. Since most lipids are carried from the liver through the heart to the peripheral tissues, the oxidizing agents from the cigarette are likely to cause oxidation of the lipids along the vessels and the process of plaque formation would have started. The vulnerable groups of coronary heart diseases are majorly the elderly. However, the current trend shows that even the adolescents and the mid-life individuals are also among the risk group. This is mainly due to adoption of western life whereby life is characterized by low physical activity and other lifestyle behaviors that tend to promote the accumulation and deposition of lipids in the body(Serruys, Morice , Kappetei &Colombo,2009).. Other risk group includes those people with metabolic problems such as individuals with excessive fat tissue in and around the abdomen, those with atherogenic dyslipidemia whereby their blood are high in triglycerides, low HDL cholesterol and high LDL cholesterol these forms of lipids fosters plaque buildups in artery walls. Those whose blood pressure is elevated and those with insulin resistance or glucose intolerance whereby the body cannot properly use insulin or blood sugar. Diagnosis of coronary heart disease must be followed by adequate management practices. Although it is better to control than to cure, this work would base its discussion on the management section of coronary heart disease. To start with, I will venture on the emotional aspect of management. Individual’s emotion constitute the way someone reacts to situations. These reactions are accompanied by bodily reactions such as increase in the heartbeat and breathings. It is therefore very important for the nurse to counsel and advice the patient about his or her emotions. Stroke, a cardiovascular condition that occurs when the vessels supplying blood to the brain is blocked, mainly occurs due to emotional factors(Serruys, Morice , Kappetei &Colombo,2009).. To fully manage the emotional factors of a patient, constant counseling of the patient is required. The patient should also have enough moral and social support from his or her fancily members. Additionally the nurse must understand other socioeconomic factors of the patient as well as his or her responsibilities in the family to enable him to come up with proper advice for the patient, caregiver and even the religious leader. In other words, the emotions of the patient can be managed well if the patient’s responsibilities are within his or her control and also if he or she knows that the family members as well as the society knows and cares about his or her conditions. Physical perspectives of the management involve the physical exercise. The level of physical activity has an impact on the progression or initiation of the coronary heart disease. However since I am discussing on the management section of the coronary heart disease, I would focus on the relationship between physical activity and the progression of the coronary heart disease. Enough physical exercise would ensure that any extra calories are burnt down to release energy to be used by the muscles. This would therefore ensure that fewer lipids are circulated in the body and hence help in reducing the build up of the plaque (Serruys, Morice , Kappetei &Colombo,2009).. Moreovere4xercise help in reduction of stress levels and since stress is a risk factor of coronary heart disease, then exercise is very important method of managing the coronary heart disease. Exercise also assist in promoting the normal blood flow in the body. There are many kinds of exercise a patient can indulge in. However, the patient should not just be advised to get up each morning and run or to start visiting a nearby gym. Good physical exercise is only achieved through commitment and self-discipline. Therefore, the nurse should adequately counsel the patient on the importance of the physical exercise. A nurse should also give him a diary where the patient can records his or her daily exercise. The kind of the exercise should be feasible to the patient. The importance of exercise in reduction of other conditions apart from the coronary heart disease must be mentioned to the patient, as this would encourage the patient to really involve himself in exercise program. Psychological perspectives also constitute an important aspect of the management of coronary heart disease. The relevance of patient’s psychology in management of coronary here disease can be viewed from two perspectives. Psychology can as an impact in determining the progression of any disease. Stress for example makes the immune system of an individual weak hence predisposing individual to illnesses. Studies have shown that most men get common cold during stressful conditions. Therefore the patient suffering from coronary heat disease must get adequate counseling on how to manage his or her stress levels(Serruys, Morice , Kappetei &Colombo,2009).. Other studies have shown that stress promotes the oxidation of the fatty cells in the body. As earlier mentioned, oxidation of the lipids especially along the coronary vessels encourages the development of streaks which after undergoing some series of development become plaques. In order to adequately advice the patient on stress, he or she must first understand it from the general definition whereby stress is biologically defined as accumulation of unused energy in the body. Normally, when a person is expecting to achieve a certain goal, a certain proportion of energy is set aside by the body for such particular goal. However, if the person would not do or achieve the goal he or she had set, then the energy, which had been set aside by the body, will remain in the body. If this energy were not used up, it would result in stress. Therefore, a sure way of getting rid of stress is doing physical exercise. Therefore, the patient must be advised on the importance of physical exercise(Serruys, Morice , Kappetei &Colombo,2009).. Additionally, as was defining stress, I mentioned an issue of goal. Some people set goals, which are too high. In the long run, they are bound to fail in meeting these goals and these results in stress. The nurse must advice the patient on goal setting. This would help in minimizing stress. Age is another important factor that must be discussed. Traditionally, coronary heart disease was believed to be a disease of the elderly. However, the recent data shows that coronary heart disease also affects the adolescents, midlife as well as the elderly. The reason for this can be traced to the current lifestyles (United States, 1999). In the past, most of the means of transport were not there. People used to walk long distances when going to school, market as well as when visiting friends. During the process, all the bad cholesterols as well as other lipids were oxidized to release energy. Moreover, traditional people used to eat a lot of indigenous vegetables as well as fruits. These kinds of vegetables and fruits contain photochemical which have the antioxidant properties. These antioxidants are responsible in counteracting the effects of free radicals generated by the oxidation of the double bonds of the lipids. However, the current generation have adopted another lifestyle which characterized by low physical activity, intake of processed foods and drug and substance abuse. These features are therefore responsible for the current outlook of the coronary heart disease (United States, 1999). Young children must therefore be sensitized about the coronary heart diseases. This can be done by incorporating this fatal condition in the curriculum of both the primary and secondary education. Physical exercise should also be made compulsory in primary, secondary as well as tertiary levels. In tertiary levels, physical activity can be reinforced through motivations. Coronary heart disease currently affects the elderly as well as the midlife and adolescent, the elderly represent the largest percentage of the cases. This is due to the fact that the coronary heart disease develops slowly. At adolescent stage for example, a small streak may occur. Then depending on the prevailing factors, the streak would progress at a given rate towards formation of plaque (United States 1999).. If the conditions are more conducive for the development of streak, then the effect of the coronary heart disease may start as early as the midlife stage. Therefore, people at all stages of their life must get inform of coronary heart disease. As mentioned earlier, as the person grows older, the development of plaque and thus coronary heart disease increases. This section of this work is going to expound on the mechanism behind this. Studies have shown that free radicals constitute one of the factors of aging. Millions of chemical reaction takes place in the cells of the human being at any given time. These reactions generate free radicals. Free radicals are chemicals whose some of its atoms have been deprived of their electrons. These free radicals are therefore very reactive and if their effects are not quenched, they are likely to result in an endless chain of reaction on the cells. However, human bodies are made up of specific enzymes that have the antioxidant properties. As person ages, the integrity of such enzymes reduces and hence their antioxidant properties are significantly reduced. This would therefore encourage the development of the plaque (United States, 1999). Another aspect of age that plays part in the development of plaques is the metabolic factors. The metabolic rates of the old people are very low. Due to this, the blood flow rate through the circulatory system is very low. This encourages the development of the plaque along the blood vessels and hence coronary heart diseases In conclusion, the public must be sensitized on the facts about the coronary heart disease and various way of preventing it. As earlier stated, coronary head disease is mainly caused by modifiable factors, then with proper sensitization of the public, this disease can be easily prevented through easier means. However, the general and universal aspects of management of coronary heart diseases include the following. The patient should decrease the intake of saturated fats, as this has been associated with the plaque development and thus coronary heart disease. An individual must also increased the intake of vegetables and fruits as this are important sources of phytochemicals of which some have the antioxidant properties. Individual must also increase the intake of whole grains as this would help in weight reduction (United States, 1999). Drug and substance abuse especially smoking should be stopped. People are also advised to have at least annual heart checkup so that earlier measures and strategies can be adopted. High intake of vitamins such as folate is also recommended. This is due to the fact that the level of homocysteine in the blood has been linked to the coronary heart disease. Therefore since folate reduces the homocysteine levels in the blood, then high intake of folate is likely to reduce the incidences of coronary heart diseases. Folate is obtained from green leafy vegetables. If an individual cannot access the vegetables then supplementation can be done. Other vitamins that are also very important in reduction of the incidence of coronary heart diseases include vitamin A, C and E. additionally, the intake of micronutrients such as zinc selenium should be increases. Moderate amounts of alcohol (one glass a day for women, two for men) may reduce your risk of cardiovascular problems. However, drinking larger amounts does more harm than good. For the case of someone with one or more risk factors for coronary heart disease, he should talk to his doctor about possibly taking an aspirin a day to help prevent a heart attack or stroke. He may be prescribed low-dose aspirin therapy if the benefit is likely to outweigh the risk of gastrointestinal side effects (Highlander &Shaw, 2010). Treatment with appropriate medicine should also constitute the management plan for example Beta-blockers may be administered to lower heart rate, blood pressure, and oxygen use by the heart (Highlander &Shaw, 2010). These reduce the risk of arrhythmias and improve survival after a heart attack or with heart failure. Alternatively, calcium channel blockers may be administered to relax arteries, lower blood pressure, and reduce strain on the heart. This is recommended for patients whose blood pressure is high. For individuals whose cholesterol levels are high, Statins should be administered. Nitrates (such as nitroglycerin) can be used to stop chest pain and improve blood supply to the heart (Highlander &Shaw, 2010) References Serruys, P., Morice M, Kappetein A., Colombo, A,. (2009) Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease pp 961-972. United States (1999). "Chronic Disease Overview". United States Government. Andraws R, Berger J, Brown D ( 2005). "Effects of antibiotic therapy on outcomes of patients with coronary artery disease: a meta-analysis of randomized controlled trials Highlander P, Shaw G.(2010) Current pharmacotherapeutic concepts for the treatment of cardiovascular disease in diabetics. Read More