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Coronary heart disease can be defined as a condition that is characterized by the development of a plaque in the rumen of coronary arteries. The coronary arteries supply oxygen and other nutrients to the heart muscles which play the role of pumping blood throughout the body. This plaque consists of scar tissue, calcium, fatty material, and cholesterol. The plague narrows the arteries and as a result the does not receive enough blood.  When the problem of building up of a plague is not treated, the coronary heart disease can bring about angina. Angina is the chest pain that comes about when the heart muscles do not receive enough oxygen-rich blood.  The coronary heart disease can also result into development of blood clots, heart attacks, arrhythmias, and heart failure (Young, 2006).

For the past 80 years in the United States, the heart disease has been a major cause of death as well as disability. Treatment of the heart disease results into substantial health-care expenditures hence a burden to affected individuals. In America, coronary heart disease is the leading cause of death today. In the year 2006 the coronary heart disease caused 425,425 deaths in America. Over the last two decades, Americans have reduced the risk of dying from coronary heart disease by watching the amount of cholesterol in blood stream, ensuring normal blood pressure, and smoking less (AHA).

The American Heart Association has come up with strategies to identify the risk factors.  They have found that some of the factors can be controlled or treated, modified, and some can neither be controlled nor modified.  When an individual has more risk factors, he tends to have a greater chance of being attacked by coronary heart disease. And it has been seen that, when an individual has a high level of a particular risk, the risk tends to be greater. For instance, an individual with cholesterol amounting to 300 mg/dl will have a greater risk than another individual with cholesterol amounting to 245 mg/dl, even if every individual with cholesterol greater than 240 mg/dl is regarded being at high-risk. When the amount of cholesterol in the blood stream exceeds normal levels, it builds up in the lumen of arteries. With time, the buildup brings about hardening of the arteries such that they become narrow hence slowing down the blood flow to the heart and can even block altogether. The blood supplies the heart muscles with oxygen and nutrients such that if enough blood cannot reach the heart, one suffers chest pain. In the case when blood supply is blocked completely from reaching some portions of the heart, normally the result is heart attack (Young, 2006).

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Eating for Lower Cholesterol provides forefront information on cholesterol to enable individuals lower their cholesterol levels in blood stream therefore reducing their risk of developing heart disease. In America, doctors advise the great number of citizens with high cholesterol, on medications and alternatively to follow diets which are cholesterol-lowering. A leading nutritionist has designed a Stay Balanced Scale to enable individuals take charge of their diets free from feeling deprived (Marmot, 2010).

Heredity can also bring about the tendency of an individual being attacked by the heart disease. Sometimes the heart disease is inherited from parents, such that children of parents with heart disease have a greater chance of developing the disease themselves. Through research findings, it has been seen that African Americans have severe high blood pressure as compared to Caucasians and as a result are at an increased risk of heart disease. American Indians, some Asian Americans, Mexican Americans, and native Hawaiians have been found to be at more risk of developing coronary heart disease. It has been found out that most people having a family history of developing heart disease have other risk factors such that it is the risk factors that can be controlled or treated and not the family history that can be controlled (AHA).

Tobacco smoking also brings about increased risk of developing heart disease. Those individuals who smoke have a higher risk of developing coronary heart disease as compared to nonsmokers. By research findings it is clear that about 20% of deaths caused by heart disease in the United States are directly associated with cigarette smoking. This is due to the fact that smoking is the primary cause of coronary heart disease. The risk is brought about by nicotine which is present in smoke. The nicotine decreases the amount of oxygen that should be supplied to the heart, increases heartbeat rate which in turn increases blood pressure, increases blood clotting, and bring about damage to the cells that form the lining at the lumen of coronary arteries and other blood vessels (CDC).   

So that to combat the increased number of deaths due to smoking, the U.S. Food and Drug Administration have sanctioned five medications that can enable individuals to stop smoking and diminish the urge to smoke.  These include:  Bupropion SR which does not have nicotine and as well reduces the urge to smoke; nicotine supplements for instance gum, so that the addicted people cannot suffer from the declining levels of nicotine in blood; a nicotine nasal spray; a nicotine inhaler; and a nicotine patch (Marmot, 2010).

Inactivity is another major risk factor of coronary heart disease. In most cases the sedentary individuals develop obesity which is as a result of accumulation of fats in the body tissues including around the blood vessels. This narrows the blood vessels especially the coronary arteries hence reducing the amount of blood flow to the heart muscles. The heart muscles in turn receive less oxygen and nutrients resulting into heart attack or heart failure (CDC).           

It is advisable that physical activity should be done three to five times every week so that to diminish many of the risks. The physical activity reduces and individual's susceptibility to high blood pressure, high cholesterol, high levels of triglyceride, and diabetes. Exercise enables an individual to control or lose body fat and weight, and supports one's efforts to discontinue smoking. Since the heart is made up of muscles, it needs exercise to perform its roles as expected. Regular exercise enables the heart and cardiovascular system to work properly hence improving blood flow. By research findings, American Heart Association says that grouped studies indicate that regular physical activity and behavioral modifications after a heart attack ameliorate the rates of survival as well as quality of life (AHA).

According to Young (2006) some factors like increasing age are also associated with heart disease. The risk of heart disease increase as one grows older and older. In America it has been seen from the findings that more than 80% of people who die from heart disease are over 65 year of age. The heart's functions weaken as one grows older such that the muscles of the heart are less able to effectively pump the blood. The walls of coronary arteries may become thick, stiffen and become narrow. Other problems like hypertension can even make the condition worse. To control the problem with old people, it is advisable that their diet should not include a lot of fats and they should not be very inactive, at least they should do some walking.

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