CAD or coronary artery disease is the leading cause of sudden death in developed countries.  With changing life styles its prevalence is increasing in the developing nations also.

CAD is the result of accumulation of plaques within the coronary arteries (those supplying blood to the heart).

These plaques are fat deposits formed on the inner layer of coronary arteries. They may be single or multiple. The coronary vessels or their branches may be involved at one or multiple sites.

Clinical manifestations depend on site/sites affected in the vessels. For example total blockade of a major artery may damage larger portion of the heart leading to a major heart attack. Block in smaller arteries, causes mild symptoms. Angina is the manifestation of partial blocking of coronary arteries.

How are  these fat deposits  formed? The hypothesis postulated is that since infancy because of turbulence caused by blood flow small damage occurs in inner lining of blood vessels.

Body’s defense mechanisms try to cover the injury thus forming the plaque or atheroma. Later on atherogenic substances (substances or factors aggravating the process) go on adding to that deposit. More the number of such factors, greater and faster is the deposit accumulated.

Therefore it is necessary to know the risk factors which are involved in accelerating and augmenting this process of fat deposition or atherosclerosis leading to CAD. Some   factors are not in hands of human beings. Genetics is one of them.

Somebody inheriting the genes of CAD at birth is more prone then others to develop CAD. Age is another such factor. It is said that men after age 40 and women above 50 years of age are susceptible to develop CAD.

Up to menopause women are protected by feminine sex hormone estrogen from CAD. Well stopping advancing age is certainly not within human capability. But every adult can make conscious efforts to overcome the other risk factors and thus avoid CAD.

Obesity particularly abdominal obesity is one such risk factor. It comes about due to intake of high fat intake and lack of exercise. Both these factors  can be remedied very well.

Physical exercise is mandatory for the body and should be done at for 30 minutes at least 3 times a week and ideally daily. Food should contain more of vegetables, fresh fruits, whole grains, fish and skimmed milk. Saturated fats like butter, chocolates,  margarine, cheese, meat, e.t.c. should be avoided .

If one cannot resist them sufficient physical exercise should be done daily,  so as to burn the extra calories.
High cholesterol levels in the body   add on to the risk of developing CAD directly and also indirectly by augmenting obesity.

Taking the correct diet and good physical exercise can help control this factor very well.

Alcohol tends to increase the blood glucose and lipid levels both being risk factors for CAD. It also contributes to obesity by providing, "empty calories”, to the body, i.e. body receives only calories but no other nutrition. One can easily give up alcohol provided there is determination to do so.

Cigarettes contain nicotine which augments atherosclerosis and also causes narrowing of lumen of all vessels including the coronaries. It is said to be more harmful than alcohol for overall health of the body and is also a high risk factor for CAD. Giving up smoking is known to reduce the incidence of CAD.

Even in people who have suffered from it are known to improve much after quitting smoking. 

Hypertension and diabetes mellitus are yet another known factors putting one more at risk for developing CAD. They are easily controlled. Only thing needed is to follow the diet as advised and take regular medicines prescribed by the doctor.

Last but most important thing needed is to avoid stress both physical and mental stress. Stress leads to release of adrenaline and cortisol in the body , which in turn increases blood pressure and tends to provoke cardiac problems.

To avoid physical stress, it does not mean that one takes to bed. Suggestion is only to do physical activity according to one’s capability. Activities like lifting or pushing heavy weights are harmful and should be avoided, particularly in people having hypertension.

Any exercise when  commenced  should be done for  short time  initially and then increased slowly in frequency and time.

One should try to keep the mind relaxed all the time. Because mental stress leads to not only  CAD  but many other diseases.

CAD is a totally preventable problem. If one is vigilant enough and avoids the risk factors,  there is no reason why he should suffer from it.

E-mail:  rachna212002@yahoo.co.uk