Coronary Heart Disease (CHD) is also known as ischemic heart disease. It is a disease resulting from the impairment to the supply of oxygenated blood to our heart tissue. It is one of the leading causes of death in New Zealand. Sixteen New Zealanders die each day, or one person every 90 minutes, as a result of CHD. [1]
Signs and Symptoms
Depending on the severity of the CHD, it may lead to any one of the following conditions:
- Angina , probably the first and the most common complaint of CHD.
- Myocardial Infarction (Heart Attack)
- Cardiac Arrhythmias (Irregular Heart Beat)
- Heart Failure
- Stroke or Sudden Death due to any of the above
Causes
In the majority of people, CHD is caused by the narrowing and hardening of the coronary arteries serving the heart due to fatty build up commonly associated with high blood cholesterol.
Risk Factors
The risk factors for CHD identified by the New Zealand Heart Foundation include:
- age - 85% of all coronary heart disease deaths are in people aged 65 and older. [2]
- gender - more men die of CHD than women. [2]
- ethnicity - in New Zealand, Maori and Pacific islanders are at great risk than the rest of the population. 1 Ethnic Indians are also at high risk.
- genetics - a family history of CHD or genetic predisposition to high blood cholesterol level.
Whilst the above risk factors can not be changed, there majority of risk factors CAN be changed. They include:
- Diet - probably the most important avoidable risk factor. A common cause of high blood cholesterol level in New Zealand is a high saturated fat diet. By following a nutritious diet, we can minimise the risk of developing CHD.
The New Zealand Heart Foundation Nine Steps to eating for a healthy heart
- Exercise - Regular physical exercise helps to improve the blood cholesterol level. The New Zealand Heart Foundation recommends 30 minutes or more of exercise on more than 5 days a week.
- Obesity - An obese person is three times more likely to have a heart attack or stroke.
- Smoking - The risk of CHD is two to three time higher in smokers, than non-smokers. [3]
- Cholesterol - The New Zealand Heart Foundation recommend the following cholesterol levels for CHD prevention:
| Total cholesterol |
< 4mmol/L* |
| LDL cholesterol |
< 2.5mmol/L* |
| HDL cholesterol |
=> 1 mmol/L |
| TC/HDL ratio |
<4.5 |
| Triglycerides |
<1.7mmol/L |
*Lower lipid targets are appropriate for people after coronary artery bypass surgery (TC<3.5mmol/L or LDL-C <2.0 mmol/L).
The higher the blood cholesterol level, the greater the CHD risk. A 1mmol/L reduction in LDL cholesterol leads to a 30 to 50% reduction in coronary heart disease and stroke. [2]
- Blood Pressure - The World Health Organisation (WHO) defines high blood pressure as when repeated measurement shows the top number (systolic pressure) greater than 140mmHg or the bottom number (diastolic pressure) to be greater than 90mmHg. A 10mmHg drop in the top number (systolic pressure) is associated with a 30% reduction in risk of death from CHD. [2]
- Diabetes - CHD is a major complication of diabetes.
Heart disease is preventable and manageable. Apart from the above mentioned modifiable factor, people might also find the following helpful:
Useful Links
New Zealand Heart Foundation
Stroke Foundation of New Zealand
[1] Hay DR, Cardiovascular Disease in New Zealand 2004. Heart Foundation NZ Technical Report No.82, April 2004
[2] New Zealand Guidelines Group, The Assessment and Management of Cardiovascular Risk. Evidence-based Best Practice Guideline, December 2003.
[3] The New Zealand Heart Foundation
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