Research Paper on Coronary Artery Disease

Introduction and Relevance to Public Health

Coronary artery disease is one of the common heart diseases characterized by impairment of the blood flow system through the coronary arteries. According to the Center for Disease Control and Prevention report, coronary artery disease is ranked among the top causes of death especially in developed countries United States of America accounting for more than one third of all deaths in both sexes (Hajar, 2020). As the report suggests, at the ages of 25 to 34, the coronary artery disease has a mortality rate of about 1 / 1000 among the white men and about 1/ 100 as for those aged between 55 and 64 (Fioranelli et al., 2018). Scientists have indicated that although there are unknown reasons, the sex difference is less marked in patients suffering diabetes mellitus and in non-whites. Based on epidemiological evidence, coronary artery disease mortality rate is highly triggered by common traits such as low level of physical activity, hypertension, heavy smoking, overweight, and high total cholesterol (Harrington, 2020). The disease cause the patient’s heart muscles to lack enough supply of both oxygen and blood which further lead to fatal health complications such as heart attack and chest pain as known as angina.

Over time, the heart is forced to work extra harder and this can cause heart failure or make the heart beat too quickly or irregularly. However, research shows coronary artery disease develops over years slowly, thus, there is a huge space of opportunity to implement effective prevention measures through healthy and lifestyle habits (Malakar et al., 2019). This research paper will review and evaluate the current and past scholarly data on the coronary artery disease as one of the great public health concern by analysing the epidemiology, causes and risk factors, and prevention of the disease.

Epidemiology of Coronary Artery Disease

Every year, cardiovascular diseases kill more than twenty million people across the world representing one third of all deaths reported. Most of these deaths are recorded for the middle aged adults. According to scientists, the first and second major cause of death among adults are heart disease and cerebrium especially in the developed countries (Peyser, 2017). However, the cardiovascular disease burden has grown considerably in developing countries over the past decades. In these developing countries, twice as many coronary artery disease deaths are reported as in developed countries (Fioranelli et al., 2018). In general, coronary artery disease is ranked third in disease burden in developing countries. As at 2020, coronary artery disease has grown to be one of the most important causes of death in developing countries.

The major cause of coronary artery disease is atherosclerosis that reduces blood fluid to the coronary arteries, which is caused by the accumulation of the fatty material and plaque. The reduced or interrupted blood and oxygen flow result to can circumstances such as angina, failure, arrhythmia, and heart attack. According to the Centers for Disease Control and Prevention report, the top leading cause of death in the world today is coronary artery disease and kills approximately 4.1 million men and 3.5 million women every year (Hajar, 2020). As one of the major cardiovascular diseases, coronary artery disease is considered as the major cause of mortality in men and women in developed countries. The estimated annual deaths in developed nations such as Europe are estimated at about 200 million (Rudisch & Nemeroff, 2020). At the same time, the disease is also the primary and leading cause of death in the United Kingdom. In United Kingdom, approximately one in five men and two in eight women die every year due to coronary artery disease (Malakar et al., 2019). As at 2020, the disease had killed more than killed two hundred thousand people in the United Kingdom. As statistics indicate, for every year, England faces more than 150, 000 deaths due to coronary artery disease.

In the United Kingdom and United States of America, since the late 1970s, death rates from coronary artery diseases have fallen. In the last ten to fifteen years, the figures for people aged above sixty five were down by about forty percent. In a recent study, approximately forty percent of the decrease in coronary artery disease in the 1990s was primarily as a result of heavy smoking. The remaining decrease in mortality was as a result of individual treatments, such as secondary prevention. However, developed nations such as United Kingdom has a relatively high death rate from coronary artery disease, despite recent declines. Only states such as Finland and Ireland have a higher rate among more developed countries than the United Kingdom.

In nations such as India, the epidemiological transition of coronary artery disease has been dramatic for the past two decades. For a very short period of time, the primary epidemiological features have been changed from malnourishment diseases, maternal and infantile diseases, and contagious diseases to non-communicable diseases such as cardiovascular disease (Hata & Kiyohara, 2018). In many developing nations, the burden of diseases caused by massacres, maternal disorders, and malnutrition of protein energy has further decreased by approximately 40 percent over the past two decades (Harrington, 2020). At the same time, the life span increased at birth from 59 to 65 which led to age in the same time period (Fioranelli et al., 2018). As a result, in developing nations, the burden of non-communicable diseases has increased rapidly further pushing the burden of coronary artery disease.

According to the World Health Organization 2020 report, cardiovascular disease related conditions have widely contributed to more than two-thirds of the burden of mortality in developing nations (Sarnak et al., 2020). In most remote and developing nations, especially the poorer states and rural areas, coronary artery disease is considered as the leading cause of death despite the widespread heterogeneity of risks across different regions. The transition to disease in these nations over the last two decades is similar to the accelerated epidemiological transition pattern with a rapid shift to chronically delayed age.

In nations such as Northern England and Scotland, the death rates due to coronary artery disease are highest. The premature mortality rate is approximately 70 per cent higher for men living in Scotland and 80 per cent higher for women compared to the south-western part of England (Hajar, 2020). There are substantial socio-economic mortality differences for coronary artery disease. The premature coronary artery death rates at the end of the 1900s were about 60 percent higher for male manual laborers compared to male non-manual workers (Hata & Kiyohara, 2018). In addition, the coronary artery disease death rates were more than twice as high for female manual workers. South Asians have observed the highest death rates for coronary artery disease. From this statistics, it is evident that the rapid increase in coronary artery disease burdens is primarily due to the unstable and unreliable acquisitions of lifestyle socio-economic changes, and increases in life span in most low- and middle-income countries (Musunuru & Kathiresan, 2020). However, in the developing countries, the coronary artery disease death rate varies dramatically.

Causes and Risk Factors

Coronary artery disease occurs when the primary blood vessels that supply the heart are with blood and oxygen are damaged. Deposits of cholesterol in the coronary arteries and inflammation are usually responsible for coronary artery diseases (Musunuru & Kathiresan, 2020). The coronary arteries are very crucial as they provide the heart with blood, oxygen and nutrients. When the plaques be accumulate at the walls of the blood vessels, the blood flow to cardiac artery decrease. Eventually, a decreased flow of blood may cause chest pain, breathlessness, or signs and symptoms of coronary artery disease.

The risk factors of the disease are certain habits and conditions that increase the risk of an individual developing heart infection. These factors include smoking, unhealthy eating, smoking, family history, inadequate exercise, and age (Shao et al., 2020). Coronary artery disease has a genetic element, meaning that family history is one of the primary risk factors connected to the disease (Hajar, 2020). This generally applies if the first-grade relative cardiovascular disease of a person is relatively young. For example, a case where the disease was developed by a father or brother before he was fifty five years or her mother or sister before she was sixty five. A family history of high cholesterol, diabetes, and high-prescription blood pressure can also raise the probability of having the disease (Hata & Kiyohara, 2018). Having a family history of heart disease is not unavoidable but increases the likelihood of coronary artery disease. It is typically encouraged to lead a healthy lifestyle in order to lower the disease risk for people with a hereditary disorder.

Tobacco use also increases the likelihood of coronary artery disease. Smoking damages and reduces the arteries, increasing the chance of Angina pectoris and cardiac attack. Angina pectoris is a condition that causes pain in the center of the chest due to a lack of blood on the heart’s muscle (Harrington, 2020). Besides, nicotine also raises the blood pressure forcing the heart to work harder to pump blood around the body. Smoking affects both the arteries which supply your heart and other areas of the body with blood and causes cancer. This decreases the blood oxygen and damages the walls of artery. Smoking increases the risk of heart attack, vascular disease and stroke, which could lead to amputation of the gangrene and limbs. Smoking ‘sticks’ blood, clumping blood cells together. This slows the blood circulation and causes more common blockages. Heart attack and stroke may be caused by blockages. Smoking also sticks the walls of the artery so that the fatty material called the plaque or atheroma is obstructing them.

The risk of the heart disease as studies suggest is greater for elderly individuals. Though the aging process cannot be altered, it is recommended to conduct a usually healthy lifestyle to reduce the chance of heart and circulatory diseases.

Though long regarded as a male disease, the risk of women developing coronary artery disease of coronary artery disease and symptoms are unrecognized, thus complicating the treatment of the disease as far as women are concerned (Musunuru & Kathiresan, 2020). Although men and women share similar coronary artery disease risk factors, some can become more prevalent for one gender.

People with low socioeconomic status appear to be more likely to experience cardiovascular diseases (Thuijs et al., 2019). Although there are many reasons and their relationships are complex, diet is usually regarded as one of the biggest factors with higher socioeconomic backgrounds usually having better access to a more nutritive diet.

According to study, there is a greater risk of developing coronary artery disease in people of originating from Africa, South Asia, and or Caribbean descent (Hajar, 2020). As one of the risk factors of coronary artery disease, Type 2 diabetes is more prevalent among these groups. It is difficult to explain the reasons for this. However, it is commonly recommended that people of all backgrounds should lead a healthy lifestyle to help avoid the development of heart and circulatory diseases.

Having diabetes is a risk factor in the development of coronary artery disease bearing the characteristic that the condition causes high levels of glucose in the blood. High levels of glucose can damage the artery walls and increase the likelihood of fatty deposits (Thuijs et al., 2019). These fatty deposits can lead to possible coronary heart disease and heart attack if they occur in the coronary Arteries. Two types of diabetes exist, that is, Type 1 and Type 2 diabetes, where Type 1 occurs when the body system is not able to develop insulin and is primary found in infants and young adults (Rudisch & Nemeroff, 2020). Type 2 on the other side is highly connected to older people occur when the body does not produce enough insulin. Type 2 diabetes is closely linked to risk factors of the disease such as inadequate physical activity and overweight.

Diabetes people are more vulnerable to heart attack, angina and stroke. The risk of heart attack and stroke is greater for people with both diseases than for those without them. The reported increase in diabetes in Australia is thought to be associated with more people being overweight and physically inactive (Sarnak et al., 2020). In general, men have a higher risk of having coronary artery disease in their middle ages than women. As they grow older, the risk increases. The risk of developing coronary artery disease is however important for women, in particular when they are older. It is not clear why women tend to be coronary artery disease later than men, although hormal changes in combination with changes in their risk factors are likely to play a role after menopause.

Additionally, there are other behaviours although not classifiable as traditional risk factors of the disease that may increase the risk of developing the disease. For example, frequent consumption of certain legal and illicit drugs can lead to hypertension and thus coronary artery disease (Harrington, 2020). Also, the substances such as cocaine and amphetamines are able to increase the risk for developing the complication. Heavy drinking also increases the risk of coronary artery disease. Individuals suffering from alcohol addiction are advised to consider talking to health expert or a mental health provider about treatment or detox programs to avoid developing coronary artery disease.

Prevention and Research

Stopping smoking or using smokeless tobacco is one of the best things an individual can do to prevent developing coronary artery disease. Even for those who do not smoking, one should avoid passive smoking. Tobacco chemicals can damage the blood vessels to increase the chances of suffering coronary artery disease (Thuijs et al., 2019). The smoke from cigarettes reduces blood oxygen and increases blood pressure and heart rate because as the heart has to work harder to provide the body and brain with enough oxygen (Franceschini, 2018). The best part is that, after an individual stops smoking, the risk of the disease begins to drop. The risk of coronary artery disease falls to about half a smoker after a year without cigarettes. Regardless of how long or how much one has smoked, once the person quits, they begin to reap rewards.

Some foods have the potential to protect heart as others trigger the formation of plaques that block arteries. Eating more foods for protection, such as fruits, vegetables, entire grains, lean protein, fish, olive oil and nuts can easily help an individual lower the risk of developing the disease (Mageed, 2018). Foods such as red and processed meats and full-fat dairy products on the other side promote the development of the disease and giving one the reason to avoid them.

According to study, the risk to coronary artery disease can be reduced by regular daily physical activity. Physical activities help the individual control and maintain the perfect body weight and reduce the chances of developing additional conditions, such as type 2 diabetes, high blood pressure, and high cholesterol that are key triggers of coronary artery disease (Franceschini, 2018). The heart muscle is strengthened by aerobic exercise. Fat is also reduced, blood pressure is reduced and protective levels of high density lipoprotein are increased. Loss of weight from exercise may also reduce low density cholesterol. Even shorter physical activities can bring heart benefits, so individuals are urged not to give up (Musunuru & Kathiresan, 2020). Individuals don’t have to exert hard to get any benefits, but one can see greater benefits by increasing the exercise intensity, duration and frequency.

The risk of developing the disease also increases when an individual is overweight, especially when the person is middle aged (Shu & Santulli, 2018). Excess weight increase the chances of developing conditions such as high cholesterol, including hypertension, and type 2 diabetes which are key triggers of coronary artery disease. One the simple methods one can employ to determine whether the weight is good is by calculating body mass index used for determining if the body fat is in a good or bad proportion. An overweight is an individual whose body mass index is above of 25 and they are usually associated with greater blood pressure and higher cholesterol thus increasing the chances of coronary artery disease.

Sleep deficiency is also another contributing factor to consider in fight against the disease. Individuals with insufficient sleep have an increased risk of obesity, hypertension, cardiac assault, diabetes, and depression which further promote the chances of developing the disease (Mageed, 2018). Individuals with sleep deficiency indicate symptoms such as loud snoring, stopping breathing while sleeping for short periods, and arousing air snoring. To avoid this, the individuals are advised to working on their weight if one has excess weight or use an airway pressure unit that keeps the airways open while sleeping.

According to the recent research, high levels of physical fitness are able to lower the risk of coronary artery disease. The practice has lowered the risk of coronary artery disease death by more than 75 percent (Franceschini, 2018). At the same time, research has found that the ancient methods for assessing low density level cholesterol primarily underestimate the risk.

Conclusion

Although coronary artery disease mortality rates have reduced over the last few decades in developing nations, the condition still remains as one of the public health concerns for more than one third of individuals aged above 35 years. According to the Heart Disease and Stroke Statistics 2020 report, approximately one half and one third middle aged men and women respectively in In United States of America will develop some symptoms of coronary artery disease (Shu & Santulli, 2020). The prevalence as the report suggest is more likely to increase with age for both genders. The mortality rate of coronary artery disease has for few years been declining in united states of America and other developed nations where the healthcare systems and socio economic status are primarily advanced, however, the absolute experience across the world is often quite different.

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