Coronary heart disease (CHD), also called coronary artery disease (CAD), ischaemic heart disease, atherosclerotic heart disease, is the end result of the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium (the muscle of the heart) with oxygen and nutrients. While the symptoms and signs of coronary heart disease are noted in the advanced state of disease, most individuals with coronary heart disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a "sudden" heart attack, finally arise. After decades of progression, some of these atheromatous plaques may rupture and (along with the activation of the blood clotting system) start limiting blood flow to the heart muscle. The disease is the most common cause of sudden death^[1], and is also the most common reason for death of men and women over 20 years of age.^{[citation needed]} According to present trends in the United States, half of healthy 40-year-old males will develop CHD in the future, and one in three healthy 40-year-old women.^[2] According to the Guinness Book of Records, Northern Ireland is the country with the most occurrences of CHD. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Ischaemic (or ischemic) heart disease is a disease characterized by reduced blood supply to the heart. ... Atherosclerosis is a disease affecting arterial blood vessels. ... Heart disease is an umbrella term for a number of different diseases which affect the heart and as of 2007 it is the leading cause of death in the United States,[1] and England and Wales. ... In pathology, an atheroma (plural: atheromata) is an accumulation and swelling (-oma) in artery walls that is made up of cells, or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. ... The coronary circulation consists of the blood vessels that supply blood to and from the heart muscle itself. ... Myocardium is the muscular tissue of the heart. ... The heart and lungs, from an older edition of Grays Anatomy. ... Heart attack redirects here. ... In pathology, an atheroma (plural: atheromata) is an accumulation and swelling (-oma) in artery walls that is made up of cells, or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. ... A thrombus is the final product of blood coagulation, through the aggregation of platelets and the activation of the humoral coagulation system. ... Blood flow is the flow of blood in the cardiovascular system. ... Cardiac muscle is a type of involuntary striated muscle found within the heart. ... A cardiac arrest, also known as cardiorespiratory arrest, cardiopulmonary arrest or circulatory arrest, is the abrupt cessation of normal circulation of the blood due to failure of the heart to contract effectively during systole. ... Suresh Joachim, minutes away from breaking the ironing world record at 55 hours and 5 minutes, at Shoppers World, Brampton. ... Northern Ireland (Irish: , Ulster Scots: Norlin Airlann) is a constituent country of the United Kingdom lying in the northeast of the island of Ireland, covering 5,459 square miles (14,139 km², about a sixth of the islands total area). ...

Overview

Atherosclerotic heart disease can be thought of as a wide spectrum of disease of the heart. At one end of the spectrum is the asymptomatic individual with atheromatous streaks within the walls of the coronary arteries (the arteries of the heart). These streaks represent the early stage of atherosclerotic heart disease and do not obstruct the flow of blood. A coronary angiogram performed during this stage of disease may not show any evidence of coronary artery disease, because the lumen of the coronary artery has not decreased in calibre. In most modern usages of the word spectrum, there is a unifying theme of between extremes at either end. ... In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ... Angiography or arteriography is a medical imaging technique in which an X-ray picture is taken to visualize the inner opening of blood filled structures, including arteries, veins and the heart chambers. ...

Over a period of many years, these streaks increase in thickness. While the atheromatous plaques initially expand into the walls of the arteries, eventually they will expand into the lumen of the vessel, affecting the flow of blood through the arteries. While it was originally believed that the growth of atheromatous plaques was a slow, gradual process, recent evidence suggests that the gradual buildup may be complemented by small plaque ruptures which cause the sudden increase in the plaque burden due to accumulation of thrombus material.

Intravascular ultrasound image of a coronary artery (left), with color coding on the right, delineating the lumen (yellow), external elastic membrane (blue) and the atherosclerotic plaque burden (green). As the plaque burden increases, the lumen size will decrease.

Atheromatous plaques that cause obstruction of less than 70 percent of the diameter of the vessel rarely cause symptoms of obstructive coronary artery disease. As the plaques grow in thickness and obstruct more than 70 percent of the diameter of the vessel, the individual develops symptoms of obstructive coronary artery disease. At this stage of the disease process, the patient can be said to have ischemic heart disease. The symptoms of ischemic heart disease are often first noted during times of increased workload of the heart. For instance, the first symptoms include exertional angina or decreased exercise tolerance. Image File history File links Download high-resolution version (1218x598, 501 KB) Intravascular ultrasound image of a coronary artery (left), with color coding on the right, delineating the lumen (yellow), external elastic membrane (blue) and the atherosclerotic plaque burden (green). ... Image File history File links Download high-resolution version (1218x598, 501 KB) Intravascular ultrasound image of a coronary artery (left), with color coding on the right, delineating the lumen (yellow), external elastic membrane (blue) and the atherosclerotic plaque burden (green). ... Intravascular ultrasound (IVUS) is an medical imaging methodology using (a) specially designed long thin complex manufactured catheters attached to (b) computerized ultrasound equipment. ... Ischaemic heart disease is a disease characterized by reduced blood supply to the heart. ... angina tonsillaris see tonsillitis. ...

As the degree of coronary artery disease progresses, there may be near-complete obstruction of the lumen of the coronary artery, severely restricting the flow of oxygen-carrying blood to the myocardium. Individuals with this degree of coronary heart disease typically have suffered from one or more myocardial infarctions (heart attacks), and may have signs and symptoms of chronic coronary ischemia, including symptoms of angina at rest and flash pulmonary edema. Lumen can mean: Lumen (unit), the SI unit of luminous flux Lumen (anatomy), the cavity or channel within a tubular structure Thylakoid lumen, the inner membrane space of the chloroplast 141 Lumen, an asteroid discovered by the French astronomer Paul Henry in 1875 Lumen (band), an American post-rock band... Heart attack redirects here. ... angina tonsillaris see tonsillitis. ... Pulmonary edema is swelling and/or fluid accumulation in the lungs. ...

A distinction should be made between myocardial ischemia and myocardial infarction. Ischemia means that the amount of oxygen supplied to the tissue is inadequate to supply the needs of the tissue. When the myocardium becomes ischemic, it does not function optimally. When large areas of the myocardium becomes ischemic, there can be impairment in the relaxation and contraction of the myocardium. If the blood flow to the tissue is improved, myocardial ischemia can be reversed. Infarction means that the tissue has undergone irreversible death due to lack of sufficient oxygen-rich blood.

An individual may develop a rupture of an atheromatous plaque at any stage of the spectrum of coronary heart disease. The acute rupture of a plaque may lead to an acute myocardial infarction (heart attack). Heart attack redirects here. ...

Pathophysiology

Limitation of blood flow to the heart causes ischemia (cell starvation secondary to a lack of oxygen) of the myocardial cells. When myocardial cells die from lack of oxygen, this is called a myocardial infarction (commonly called a heart attack). It leads to heart muscle damage, heart muscle death and later scarring without heart muscle regrowth. In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. ... General Name, symbol, number oxygen, O, 8 Chemical series nonmetals, chalcogens Group, period, block 16, 2, p Appearance colorless (gas) pale blue (liquid) Standard atomic weight 15. ... Heart attack redirects here. ... Cardiac muscle is a type of involuntary striated muscle found within the heart. ... Cardiac muscle is a type of involuntary striated muscle found within the heart. ... Cardiac muscle is a type of involuntary striated muscle found within the heart. ...

Myocardial infarction usually results from the sudden occlusion of a coronary artery when a plaque ruptures, activating the clotting system and atheroma-clot interaction fills the lumen of the artery to the point of sudden closure. The typical narrowing of the lumen of the heart artery before sudden closure is typically 20%, according to clinical research completed in the late 1990s and using IVUS examinations within 6 months prior to a heart attack. High grade stenoses as such exceeding 75% blockage, such as detected by stress testing, were found to be responsible for only 14% of acute heart attacks the rest being due to plaque rupture/ spasm. The events leading up to plaque rupture are only partially understood. Myocardial infarction is also caused, far less commonly, by spasm of the artery wall occluding the lumen, a condition also associated with atheromatous plaque and CHD. In pathology, an atheroma (plural: atheromata) is an accumulation and swelling (-oma) in artery walls that is made up of cells, or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. ... A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure. ... The coronary circulation consists of the blood vessels that supply blood to, and remove blood from, the heart. ... Intravascular ultrasound (IVUS) is an medical imaging methodology using (a) specially designed long thin complex manufactured catheters attached to (b) computerized ultrasound equipment. ... Heart attack redirects here. ... A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure. ... A cardiac stress test is a medical test performed to evaluate relative arterial blood flow increases to the left ventricular heart muscle during exercise, as compared to resting blood flow rates (i. ... Heart attack redirects here. ... Heart attack redirects here. ... In pathology, an atheroma (plural: atheromata) is an accumulation and swelling (-oma) in artery walls that is made up of cells, or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. ...

CHD is associated with smoking, obesity, hypertension and a chronic sub-clinical lack of vitamin C. A family history of CHD is one of the strongest predictors of CHD. Screening for CHD includes evaluating homocysteine levels, high-density and low-density lipoprotein (cholesterol) levels and triglyceride levels. The cigarette is the most common method of smoking tobacco. ... For other forms of hypertension, see Hypertension (disambiguation). ... Homocysteine is a chemical compound with the formula HSCH2CH2CH(NH2)CO2H. It is a homologue of the naturally-occurring amino acid cysteine, differing in that its side-chain contains an additional methylene (-CH2-) group before the thiol (-SH) group. ... High-density lipoproteins (HDL) form a class of lipoproteins, varying somewhat in their size (8–11 nm in diameter), that carry cholesterol from the bodys tissues to the liver. ... Low-density lipoprotein (LDL) belongs to the lipoprotein particle family. ... Cholesterol is a sterol (a combination steroid and alcohol). ... Example of an unsaturated fat triglyceride. ...

Angina

Angina that occurs regularly with activity, upon awakening, or at other predictable times is termed stable angina and is associated with high grade narrowings of the heart arteries. The symptoms of angina are often treated with nitrate preparations such as nitroglycerin, which come in short-acting and long-acting forms, and may be administered transdermally, sublingually or orally. Many other more effective treatments, especially of the underlying atheromatous disease, have been developed. angina tonsillaris see tonsillitis. ... A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure. ... The heart and lungs, from an older edition of Grays Anatomy. ... Section of an artery For other uses, see Artery (disambiguation). ... Glyceryl trinitrate (GTN) has been used to treat angina and heart failure since at least 1880. ... In pathology, an atheroma (plural: atheromata) is an accumulation and swelling (-oma) in artery walls that is made up of cells, or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. ...

Angina that changes in intensity, character or frequency is termed unstable. Unstable angina may precede myocardial infarction, and requires urgent medical attention. It is treated with morphine, oxygen, intravenous nitroglycerin, and aspirin. Interventional procedures such as angioplasty may be done. This article does not cite any references or sources. ...

Risk factors

The following are confirmed independent risk factors for the development of CAD, in order of decreasing importance:

1. Hypercholesterolemia (specifically, serum LDL concentrations)
2. Smoking
3. Hypertension (high systolic pressure seems to be most significant in this regard)
4. Hyperglycemia (due to diabetes mellitus or otherwise)
5. Type A Behavioural Patterns, TABP. Added in 1981 as an independent risk factor after a majority of research into the field discovered that TABP's were twice as likely to cause CHD than any other personality type.
6. Hemostatic Factors [1]: High levels of fibrinogen and coagulation factor VII are associated with an increased risk of CAD. Factor VII levels are higher in individuals with a high intake of dietary fat.Decreased fibrinolytic activity has been reported in patients with coronary atherosclerosis.
7. Hereditary differences in such diverse aspects as lipoprotein structure and that of their associated receptors, homocysteine processing/metabolism, etc.

Significant, but indirect risk factors include: Hypercholesterolemia (literally: high blood cholesterol) is the presence of high levels of cholesterol in the blood [1]. It is not a disease but a metabolic derangement that can be secondary to many diseases and can contribute to many forms of disease, most notably cardiovascular disease. ... Low-density lipoprotein (LDL) refers to a class and range of lipoprotein particles, varying somewhat in their size and contents, which carry cholesterol in the blood and around the body, for use by various cells. ... The cigarette is the most common method of smoking tobacco. ... For other forms of hypertension, see Hypertension (disambiguation). ... Hyperglycemia or High Blood Sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. ... In some psychological theories, the Type A personality, also known as the Type A Behavior Pattern, is a set of characteristics that includes being impatient, excessively time-conscious, insecure about ones status, highly competitive, hostile and aggressive, and incapable of relaxation. ...

• Lack of exercise
• Stress
• Diet rich in saturated fats
• Diet low in antioxidants
• Obesity
• Men over 60; Women over 65 [2]

Risk factors can be classified as The term Exercise can refer to: Physical exercise such as running or strength training Exercise (options), the financial term for enacting and terminating a contract Category: ... Saturated fat is fat that consists of triglycerides containing only saturated fatty acids. ... Space-filling model of the antioxidant metabolite glutathione. ...

1. Fixed: age,male sex,family history
2. Modifiable: smoking, hypertension,diabetes mellitus,obesity and etc.

Prevention

Coronary heart disease is the most common form of heart disease in the Western world. Prevention centers on the modifiable risk factors, which include decreasing cholesterol levels, addressing obesity and hypertension, avoiding a sedentary lifestyle, making healthy dietary choices, and stopping smoking. There is some evidence that lowering uric acid and homocysteine levels may contribute. In diabetes mellitus, there is little evidence that blood sugar control actually improves cardiac risk. Some recommend a diet rich in omega-3 fatty acids and vitamin C. The World Health Organization (WHO) recommends "low to moderate alcohol intake" to reduce risk of coronary heart disease.^[3] Cholesterol is a sterol (a combination steroid and alcohol). ... For other forms of hypertension, see Hypertension (disambiguation). ... The term sedentary in biology and anthropology applies to organisms and species that are not migratory but rather remain at a single location (permanently fixed or otherwise). ... A No Smoking sign Smoking cessation (commonly known as quitting, or kicking the habit) is the effort to stop smoking tobacco products. ... Uric acid (or urate) is an organic compound of carbon, nitrogen, oxygen and hydrogen with the formula C5H4N4O3. ... Homocysteine is a chemical compound with the formula HSCH2CH2CH(NH2)CO2H. It is a homologue of the naturally-occurring amino acid cysteine, differing in that its side-chain contains an additional methylene (-CH2-) group before the thiol (-SH) group. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... In medicine, blood sugar is a term used to refer to levels of glucose in the blood. ... This article is about the nutrient. ...

An increasingly growing number of other physiological markers and homeostatic mechanisms are currently under scientific investigation. Among these markers are low density lipoprotein and asymmetric dimethylarginine. Patients with CHD and those trying to prevent CHD are advised to avoid fats that are readily oxidized (e.g., saturated fats and trans-fats), limit carbohydrates and processed sugars to reduce production of Low density lipoproteins while increasing High density lipoproteins, keeping blood pressure normal, exercise and stop smoking. These measures limit the progression of the disease. Recent studies have shown that dramatic reduction in LDL levels can cause mild regression of coronary heart disease. Physiology (in Greek physis = nature and logos = word) is the study of the mechanical, physical, and biochemical functions of living organisms. ... Homeostasis or homoeostasis is the property of an open system, especially living organisms, to regulate its internal environment so as to maintain a stable condition, by means of multiple dynamic equilibrium adjustments controlled by interrelated regulation mechanisms. ... Low-density lipoprotein (LDL) belongs to the lipoprotein particle family. ... Molecular structure of ADMA Asymmetric dimethylarginine (ADMA) is a naturally occurring chemical found in blood plasma. ... A trans fatty acid (commonly shortened to trans fat) is an unsaturated fatty acid molecule that contains a trans double bond between carbon atoms, which makes the molecule less kinked compared to cis fat. Research suggests a correlation between diets high in trans fats and diseases like atherosclerosis and coronary... Low-density lipoprotein (LDL) belongs to the lipoprotein particle family. ... High-density lipoproteins (HDL) form a class of lipoproteins, varying somewhat in their size (8–11 nm in diameter), that carry cholesterol from the bodys tissues to the liver. ... A sphygmomanometer, a device used for measuring arterial pressure. ...

Exercise

Separate to the question of the benefits of exercise; it is unclear whether doctors should spend time counseling patients to exercise. The U.S. Preventive Services Task Force (USPSTF), based on a systematic review of randomized controlled trials, found 'insufficient evidence' to recommend that doctors counsel patients on exercise, but "it did not review the evidence for the effectiveness of physical activity to reduce chronic disease, morbidity and mortality", it only examined the effectiveness of the counseling itself.^[4] However, the American Heart Association, based on a non-systematic review, recommends that doctors counsel patients on exercise ^[5] Systematic reviews are named as the highest level of medical evidence, by evidence based medicine professionals. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ... The American Heart Association (AHA) is a non-profit organization in the United States that fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke American Stroke Association Web site. ...

Preventive diets

Main article: Diet and Heart Disease

It has been suggested that coronary heart disease is partially reversible using an intense dietary regimen coupled with regular cardio exercise.^[6] Image File history File links Unbalanced_scales. ... Diet may play an important role in causing or preventing heart disease. ...

• Vegetarian diet: Vegetarians have been shown to have a 24% reduced risk of dying of heart disease.^[7]

• Cretan Mediterranean diet: The Seven Country Study found that Cretan men had exceptionally low death rates from heart disease, despite moderate to high intake of fat. The Cretan diet is similar to other traditional Mediterranean diets: consisting mostly of olive oil, bread, abundant fruit and vegetables, a moderate amount of wine and fat-rich animal products such as lamb, sausage and goat cheese.^[8][9][10] However, the Cretan diet consisted of less fish and wine consumption than some other Mediterranean-style diets, such as the diet in Corfu, another region of Greece, which had higher death rates.^{[citation needed]}

The consumption of trans fat (commonly found in hydrogenated products such as margarine) has been shown to cause the development of endothelial dysfunction, a precursor to atherosclerosis.^[11] A variety of vegetarian food ingredients Vegetarianism is the practice of a diet that excludes all animal flesh, including poultry, game, fish, shellfish or crustacea, and slaughter by-products. ... For cuisine, see Cuisine of the Mediterranean. ... Crete, sometimes spelled Krete (Greek Κρήτη / Kriti) is the largest of the Greek islands and the fifth largest in the Mediterranean Sea. ... For the Popeye character, see Olive Oyl. ... Cheese is a solid food made from the curdled milk of various animals—most commonly cows but sometimes goats, sheep, reindeer, and water buffalo. ... This article is about the Greek island Kerkyra known in English as Corfu or Corcyra. ... A trans fatty acid (commonly shortened to trans fat) is an unsaturated fatty acid molecule that contains a trans double bond between carbon atoms, which makes the molecule less kinked compared to cis fat. Research suggests a correlation between diets high in trans fats and diseases like atherosclerosis and coronary... Hydrogenation is a chemical reaction in which unsaturated bonds between carbon atoms are reduced by attachment of a hydrogen atom to each carbon. ... Margarine in a tub Margarine (pronunciation: ), as a generic term, can indicate any of a wide range of butter substitutes. ... Endothelial dysfunction is a physiological dysfunction of normal biochemical processes carried out by endothelial cell, the cells that line the inner surface of all blood vessels, arteries and veins. ...

Aspirin

Aspirin, in doses of less than 75 to 81 mg/d^[12], can reduce the incidence of cardiovascular events.^[13] The U.S. Preventive Services Task Force 'strongly recommends that clinicians discuss aspirin chemoprevention with adults who are at increased risk for coronary heart disease'.^[14] The Task Force defines increased risk as 'Men older than 40 years of age, postmenopausal women, and younger persons with risk factors for coronary heart disease (for example, hypertension, diabetes, or smoking) are at increased risk for heart disease and may wish to consider aspirin therapy'. More specifically, high-risk persons are 'those with a 5-year risk ≥ 3%'. A risk calculator is available.^[15]

Regarding healthy women, the more recent Women's Health Study randomized controlled trial found insignficant benefit from aspirin in the reduction of cardiac events; however there was a signficant reduction in stroke.^[16] Subgroup analysis showed that all benefit was confined to women over 65 years old.^[16] In spite of the insignficant benefit for women < 65 years old, recent practice guidelines by the American Heart Association recommend to 'consider' aspirin in 'healthy women' <65 years of age 'when benefit for ischemic stroke prevention is likely to outweigh adverse effects of therapy'.^[17] A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ... In statistics, a result is significant if it is unlikely to have occurred by chance, given that a presumed null hypothesis is true. ... In statistics, a result is significant if it is unlikely to have occurred by chance, given that a presumed null hypothesis is true. ... For other uses, see Stroke (disambiguation). ... Subgroup analysis, in the context of design and analysis of experiments, refers to looking for pattern in a subset of the subjects[1]. Post-hoc analysis ^ Lagakos SW (April 20 2006). ... In statistics, a result is significant if it is unlikely to have occurred by chance, given that a presumed null hypothesis is true. ... Clinical practice guidelines are collections of practical information for use by doctors and other medical professionals. ... The American Heart Association (AHA) is a non-profit organization in the United States that fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke American Stroke Association Web site. ...

Omega-3 fatty acids

The benefit of fish oil is controversial with conflicting conclusions reached by a negative meta-analysis^[18] of randomized controlled trials by the international Cochrane Collaboration and a partially positive systematic review^[19] by the Agency for Healthcare Research and Quality. Since these two reviews, a randomized controlled trial reported a reduction on coronary events in Japanese hypercholesterolemic patients.^[20] A meta-analysis is a statistical practice of combining the results of a number of studies. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ... The Cochrane Collaboration developed in response to Archie Cochranes call for systematic, up-to-date reviews (currently known as systematic reviews) of all relevant randomized clinical trials of health care. ... Systematic reviews are named as the highest level of medical evidence, by evidence based medicine professionals. ... The Agency for Healthcare Research and Quality (AHRQ), formerly known as the Agency for Health Care Policy and Research (AHCPR), supports research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective services. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ...

Omega-3 fatty acids are also found in some plant sources including flax seed oil, hemp seed oil, and walnuts. Plant sources may be safer as fish products have been shown to contain heavy metals and other fat soluble pollutants. Omega-3 fatty acids are polyunsaturated fatty acids found in certain fish tissues, and in vegetable sources such as flax seeds, walnuts, and canola oil. ... Flax seed oil, often used as a popular Nutritional Supplement is an oil extracted from the stems of the plant flax. ... Hemp oil is from the seed of the hemp plant that contains between 25-35% oil by weight, which is high in essential fatty acids. ... For other uses, see Walnut (disambiguation). ...

Secondary prevention

Secondary prevention is preventing further sequelae of already established disease. Regarding coronary heart disease, this can mean risk factor management that is carried out during cardiac rehabilitation, a 4-phase process beginning in hospital after MI, angioplasty or heart surgery and continuing for a minimum of three months. Exercise is a main component of cardiac rehabilitation along with diet, smoking cessation, and blood pressure and cholesterol management. Beta blockers may also be used for his purpose.^[21]

Anti-platelet therapy

A meta-analysis of randomized controlled trials by the international Cochrane Collaboration found "that the use of clopidogrel plus aspirin is associated with a reduction in the risk of cardiovascular events compared with aspirin alone in patients with acute non-ST coronary syndrome. In patients at high risk of cardiovascular disease but not presenting acutely, there is only weak evidence of benefit and hazards of treatment almost match any benefit obtained.".^[22] A meta-analysis is a statistical practice of combining the results of a number of studies. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ... The Cochrane Collaboration developed in response to Archie Cochranes call for systematic, up-to-date reviews (currently known as systematic reviews) of all relevant randomized clinical trials of health care. ...

Recent research

Further information: atheroma and atherosclerosis

A 2006 study by the Cleveland Clinic found a region on Chromosome 17 was confined to families with multiple cases of myocardial infarction.^[23] In pathology, an atheroma (plural: atheromata) is an accumulation and swelling (-oma) in artery walls that is made up of cells, or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. ... Cleveland Clinic is a multispecialty academic medical center located in Cleveland, Ohio. ...

A more controversial link is that between Chlamydophila pneumoniae infection and atherosclerosis.^[24] While this intracellular organism has been demonstrated in atherosclerotic plaques, evidence is inconclusive as to whether it can be considered a causative factor.^{[citation needed]} Treatment with antibiotics in patients with proven atherosclerosis has not demonstrated a decreased risk of heart attacks or other coronary vascular diseases.^[25] Chlamydophila pneumoniae (previously known as Chlamydia pneumoniae) is a species of chlamydiae bacteria which infects humans and is a major cause of pneumonia. ...

References

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 1996 (MCMXCVI) was a leap year starting on Monday (link will display full 1996 Gregorian calendar). ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

See also

• Diet and Heart Disease
• ApoA-1 Milano
• Endothelium-derived relaxing factor

Diet may play an important role in causing or preventing heart disease. ... There are very few or no other articles that link to this one. ... Endothelium-derived relaxing factor (EDRF) was the tentative name of what was later discovered to be nitric oxide (NO). ...

External links

• Sir Ben-dover Risk Assessment of having a heart attack or dying of coronary heart disease, from the American Heart Association.
• The InVision Guide to a Healthy Heart An interactive website on the development and function of the cardiovascular system and cardiovascular diseases and consequences. The website also features treatment options and preventative measures for maintaining a healthy heart.