ABSTRACT
Coronary heart disease (CHD) is the single largest killer of both men and women in the world. The World Health Organization estimates that more than 16 million adults per year die of cardiovascular disease. Furthermore, an estimated 32 million adults per year have a new or recurrent myocardial infarction. In the United States, the estimated direct and indirect costs associated with cardiovascular disease exceed $100 billion per year. Risk factors include the following:
O High blood pressure O High blood cholesterol O Smoking O Obesity O Physical inactivity O Diabetes O Gender O Heredity O Age O Stress
Like any muscle, the heart requires a constant supply of oxygen and nutrients that are carried to it by the blood in the coronary arteries. In CHD, plaques or fatty substances (e.g., cholesterol) build up inside the walls of the arteries for some reason(s), probably an injury of some sort. These plaques also attract blood components (e.g., platelets) that stick to the artery wall lining and are reparative, but obstructive in the process. Called atherosclerosis, the process develops gradually, over many years. It often begins early in life, even in childhood. The fatty accumulation can eventually break open and lead to the formation of a blood clot. If the blood clot is large enough it can occlude the vessel and critically reduce blood 7 ow.
