Effect of Lifestyle Changes on Coronary Heart Disease | JAMA | JAMA Network
Prospective cohort studies showed a strong, graded relationship between cigarette smoking and coronary heart disease. A moderate alcohol intake of 1 or 2. Relationships between the development of biological risk factors for coronary heart disease and lifestyle parameters during adolescence: The Northern Ireland . The main contributions are linked to coronary heart disease (and The initial hypothesis was linked to the relationship of saturated fatty acids.
Outlook Following a healthy lifestyle can help you and your children prevent or control many CHD risk factors. Because many lifestyle habits begin during childhood, parents and families should encourage their children to make heart healthy choices.
For example, you and your children can lower your risk of CHD if you maintain a healthy weight, follow a healthy diet, do physical activity regularly, and don't smoke. If you already have CHD, lifestyle changes can help you control your risk factors.
This may prevent CHD from worsening. Even if you're in your seventies or eighties, a healthy lifestyle can lower your risk of dying from CHD. If lifestyle changes aren't enough, your doctor may recommend other treatments to help control your risk factors. Your doctor can help you find out whether you have CHD risk factors. He or she also can help you create a plan for lowering your risk of CHD, heart attack, and other heart problems.
If you have children, talk with their doctors about their heart health and whether they have CHD risk factors. If they do, ask your doctor to help create a treatment plan to reduce or control these risk factors.
Coronary Heart Disease Risk Factors High Blood Cholesterol and Triglyceride Levels Cholesterol High blood cholesterol is a condition in which your blood has too much cholesterol—a waxy, fat-like substance. The higher your blood cholesterol level, the greater your risk of coronary heart disease CHD and heart attack. Cholesterol travels through the bloodstream in small packages called lipoproteins. Two major kinds of lipoproteins carry cholesterol throughout your body: LDL cholesterol sometimes is called "bad" cholesterol.
This is because it carries cholesterol to tissues, including your heart arteries. HDL cholesterol sometimes is called "good" cholesterol.
The impact of basic lifestyle behaviour on health: how to lower the risk of coro
This is because it helps remove cholesterol from your arteries. Many factors affect your cholesterol levels. For example, after menopause, women's LDL cholesterol levels tend to rise, and their HDL cholesterol levels tend to fall. Other factors—such as age, gender, diet, and physical activity—also affect your cholesterol levels. Routine blood tests can show whether your blood cholesterol levels are healthy.
Talk with your doctor about having your cholesterol tested and what the results mean. Children also can have unhealthy cholesterol levels, especially if they're overweight or their parents have high blood cholesterol. Talk with your child's doctor about testing your child' cholesterol levels. To learn more about high blood cholesterol and how to manage the condition, go to the Health Topics High Blood Cholesterol article.
Triglycerides Triglycerides are a type of fat found in the blood. Some studies suggest that a high level of triglycerides in the blood may raise the risk of CHD, especially in women. High Blood Pressure "Blood pressure" is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.
This risk grows as blood pressure levels rise. Only one of the two blood pressure numbers has to be above normal to put you at greater risk of CHD and heart attack.
Most adults should have their blood pressure checked at least once a year. If you have high blood pressure, you'll likely need to be checked more often.
Talk with your doctor about how often you should have your blood pressure checked.Heart Disease Prevention: The Impact of Diet and Exercise on Heart Health; By David Maron, MD
Children also can develop high blood pressure, especially if they're overweight. Your child's doctor should check your child's blood pressure at each routine checkup. Both children and adults are more likely to develop high blood pressure if they're overweight or have diabetes. For more information about high blood pressure and how to manage the condition, go to the Health Topics High Blood Pressure article. Diabetes and Prediabetes Diabetes is a disease in which the body's blood sugar level is too high.
The two types of diabetes are type 1 and type 2. In type 1 diabetes, the body's blood sugar level is high because the body doesn't make enough insulin. Insulin is a hormone that helps move blood sugar into cells, where it's used for energy. In type 2 diabetes, the body's blood sugar level is high mainly because the body doesn't use its insulin properly.
Over time, a high blood sugar level can lead to increased plaque buildup in your arteries. Having diabetes doubles your risk of CHD. Prediabetes is a condition in which your blood sugar level is higher than normal, but not as high as it is in diabetes. If you have prediabetes and don't take steps to manage it, you'll likely develop type 2 diabetes within 10 years.
You're also at higher risk of CHD. Being overweight or obese raises your risk of type 2 diabetes. With modest weight loss and moderate physical activity, people who have prediabetes may be able to delay or prevent type 2 diabetes. They also may be able to lower their risk of CHD and heart attack.
Weight loss and physical activity also can help control diabetes. Even children can develop type 2 diabetes.
Most children who have type 2 diabetes are overweight. Type 2 diabetes develops over time and sometimes has no symptoms. Go to your doctor or local clinic to have your blood sugar levels tested regularly to check for diabetes and prediabetes. For more information about diabetes and heart disease, go to the Health Topics Diabetic Heart Disease article. Overweight and Obesity The terms "overweight" and "obesity" refer to body weight that's greater than what is considered healthy for a certain height.
There has been much discussion in order to identify the minimum levels of activity that are useful for protection and are also safe. The present orientation is that moderate daily physical activity such as walking or biking min a day has the same protective effects as performing more intense sports activities two or three times a week .
It is not completely clear whether physical activity is beneficial for diseases other than cardiovascular ones, but at least for diabetes it seems so. Benefits have also been documented from the psychological point of view. Physical activity produces its beneficial effects through mechanisms that involve the physiology of the cardiocirculatory system and glucose and lipid metabolism in general, and the coagulation process.
Effect of Lifestyle Changes on Coronary Heart Disease
The initial hypothesis was linked to the relationship of saturated fatty acids on serum cholesterol and of serum cholesterol on the occurrence of coronary events.
Initial findings based on ecological analyses showed the strong relationship of saturated fat intake with coronary heart disease incidence and mortality across different populations of different cultures . Later, the approach turned to the dietary pattern analysis of food groups , that prompted the identification of the so-called Mediterranean Diet, roughly characterized by a predominance of plant versus animal food intake. Such a diet seems beneficial against several morbid conditions, including coronary heart disease, cancer and others.
Certainly, many mechanisms intervene in the process, linked at least to the influence on lipid metabolism, the coagulation process and the antioxidant properties of the Mediterranean Diet. Subsequently, many other studies, carried out in Mediterranean and non-Mediterranean countries, confirmed that within any population it is possible to identify subgroups of people who follow dietary habits similar to those described as the Mediterranean Diet, and are protected against major morbid conditions and all-cause mortality.
One of the early studies of this type was carried out in Greece . Presently, many other studies tend to refine these concepts and to find a better definition of the ideal diet for health purposes. An additional important point, that is not always focused on the description of the Mediterranean Diet, is the need to reduce the daily consumption of salt .
Presently, in most populations, its use exceeds by two times the physiological needs, favouring the elevation of blood pressure and perhaps the evolution of atherosclerosis.
There is indeed increasing evidence for additional blood pressure-independent pathways linking excess salt intake to the process of atherosclerosis, and some meta-analyses of randomized controlled trials have shown that a moderate reduction of salt intake is associated with a reduction of blood pressure and, consequently, with a reduction of cardiovascular and cerebrovascular events in hypertensive individuals .
However, the response of patients to these recommendations is heterogeneous, mainly due to variable compliance with the doctor's prescription, and, to a lesser extent, to different individual BP salt sensitivity . There is accordingly, plenty of room to intervene favourably with a potentially high impact for prevention. Another important point, frequently ignored, is the adverse effect of trans fatty acids that are artificially produced and introduced in prepared foods, although this is a declining trend, at least in some countries .
Labels of food composition must be the guidance for avoiding its use. The three basic behavioural risk factors, i. Some investigations also included alcohol consumption independently from diet and some indices of obesity, such as body mass index and waist circumference or even other behaviours. The duration of follow-up was variable but usually covered 10 years and up to 24 years, except one study that reported follow-up data of 50 years. All-cause mortality was the endpoint analysed most, but some contributions also considered cardiovascular diseases, coronary heart disease and cancer mortality, while only one presented data on the incidence of major coronary heart disease CHD events.
The reported relative risk of people with healthy behaviours versus those with unhealthy behaviours provided a wide range, from 0. However, this depended upon the number of combined behaviours up to sixthe kind of endpoint, age range, gender, and duration of follow-up.
The conclusion from the above reports is that, despite differences in risk factor measurement techniques, age range, gender, geographical and cultural settings, duration of follow-up and endpoint definition, the outcome seems relatively homogeneous across the various experiences.
A recent meta-analysis confirms and reinforces this impression . Therefore, attention should be paid, if needed, to control these risk factors by the use of drug intervention, which becomes an integral part of preventive action.
Detailed indications and guidelines are available from expert committees of various scientific organizations: