Coronary Heart Disease (CHD) is caused by atherosclerosis , which is the gradual buildup of plaque on the inside of the arteries. Plaque is made up of cholesterol, fat, and other substances that narrow the arteries and reduce the amount of blood that can flow to your heart and other organs. The real danger occurs when the plaque completely blocks an artery or a chunk of it breaks off and causes a clot that stops blood flow. If this happens near the heart, a heart attack occurs. If it happens near the brain, a stroke occurs.
WHAT IS CHOLESTEROL?
No one seems to have anything nice to say about cholesterol, but the fact is that you literally couldn’t live without it. Cholesterol helps build the walls of every cell in your body. It helps you digest your food, and is even involved in keeping your reproductive system in working order. But it’s possible to get too much of a good thing. Your body naturally produces some cholesterol and absorbs more from the foods you eat. Cholesterol is found only in animal-based products such as meat, chicken, fish, eggs, milk, and cheese. In addition, your body converts some plant based foods into cholesterol during digestion. If you end up with more cholesterol than you need, the excess goes into your bloodstream, where it begins to clog your blood vessels. That, as we mentioned, increases your risk of heart disease and stroke.
Understanding Your Cholesterol Levels
To measure your cholesterol levels, you’ll need a blood test. When you look at the results, you’ll see that there are actually two different kinds of cholesterol:
- LDL (low-density lipoprotein). Often called the “bad” cholesterol, because it clogs the blood vessels. An LDL score of 100 or less is great, while a score of 130 or more means you’re at risk of developing heart disease.
- HDL (high-density lipoprotein). Called the “good” cholesterol, because it actually removes the LDL. A score of 60 or more generally means your risk of heart disease is low, while a score of 40 or less may mean your risk is high. Ideally, you want your total cholesterol—the LDL number plus the HDL number plus other lipid components —to be less than 200. 200 to 239 is considered moderately high; 240 and above is high. If your healthcare provider tells you that your cholesterol is too high, you have several options:
- Make lifestyle changes. This means eating less saturated fat and high cholesterol foods (meat, eggs, and dairy products), and eating more foods that contain monounsaturated and polyunsaturated fats (nuts, olive oil, and avocados), which help decrease LDL cholesterol. It also means getting more exercise.
- Take medication. Your healthcare provider can prescribe one of several drugs that have been proven to lower cholesterol.
RISK FACTORS FOR CORONARY HEART DISEASE (CHD)
The risk factors for CHD are essentially the same as for high blood pressure, and include:
- Age (As you grow older, your risk increases.)
- Gender (Men have a greater risk earlier in life than women.)
- Genetics (You have a higher risk of developing heart disease if your parents or other close relatives have had it.)
- Ethnicity (African Americans, Hispanics, American Indians, Hawaiians, and some Asian Americans also have a higher risk for heart problems.)
- Being overweight or obese
- Lack of physical activity
- Excessive alcohol or caffeine use
- Recreational drugs, such as cocaine
- High blood pressure
- High cholesterol levels (LDL too high, HDL too low)
Heart Disease Facts in Men
- Heart disease is the leading cause of death for men in the United States, averaging 1 in every 4 male deaths.
- Heart disease is the leading cause of death for men of most racial/ethnic groups in the United States, including African Americans, American Indians or Alaska Natives, Hispanics and Caucasians. For Asian American or Pacific Islander men, heart disease is second only to cancer.
- About 8.5% of all Caucasian men, 7.9% of African American men, and 6.3% of Mexican American men have coronary heart disease.
- Half of the men who die suddenly of coronary heart disease have no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease.
- Between 70-89% of sudden cardiac events occur in men.
Atherosclerosis affects different people in different places, but it often affects the penis first. The most common sexual problem in men is erectile dysfunction (ED). ED affects up to 30 million men in the United States. Surprisingly, ED might be a sign of heart problems and that a heart attack or a stroke may follow, often in the next 3 to 5 years. It is important to discuss sexual health with your doctor. Not only can your doctor prescribe medications to improve sexual function, but together you may be able to prevent a major heart problem like a heart attack.
The most common symptom of CHD is chest pain or discomfort (called angina). If you have angina, you may feel heaviness, as if someone is stepping on your heart. You’ll feel it under your breastbone or in your neck, arms, stomach, or upper back.
Other symptoms include:
- Tightness, squeezing, crushing, burning, choking, or aching
- Shortness of breath, restlessness, rapid heartbeat, dizziness, nausea, and fatigue
- Erectile dysfunction may indicate heart problems. The arteries in the penis are smaller than the rest of the body so can show blood flow issues sooner than anywhere else in the body.
Angina pain usually happens with physical activity (such as running up stairs or even having sex), strong emotions—especially anger, rapid changes in the weather, and overeating. In most cases, angina pain lasts only a few minutes and either goes away on its own with rest or after taking a medicine called nitroglycerin. If you feel any of the above symptoms, contact your healthcare provider immediately. Do not ignore them. The fact that you experienced any symptoms of angina at all increases your risk of having a heart attack.
If you don’t already have CHD, following a healthy lifestyle can reduce your risk by as much as 80%. This means
- Quitting smoking
- Eating a healthier diet and watching your weight
- Managing chronic conditions (such as high blood pressure, diabetes, and high cholesterol)
- Getting more exercise daily
- Limiting your alcohol and caffeine intake
- Reducing the stress in your life
- In addition, be sure to brush your teeth twice a day and see your dentist regularly. Sounds odd, but some interesting research suggests that there may be a connection between gum disease and an increased risk for heart disease and stroke. If you do have CHD, there is, unfortunately, no way to cure it completely.
However, the symptoms and causes can be managed by following the steps outlined above.
Questions to Ask Your Health Care Provider
It’s important that you become a proactive partner in your healthcare in order for you to get the best treatment. Here are some questions you can ask your healthcare provider about coronary heart disease.
- What degree or percent of the arteries are blocked?
- What type of treatment options do you recommend and why?
- What are the side effects and benefits of the available treatment options?
- Will I need to have surgery? If so, how long does it take to recovery from surgery?
- How will my daily life be affected? Can I still work, play sports, have sex, and do household chores?
- What are the most important things I can do to manage this condition?
- What types of foods should I eat and what should I avoid?
Your healthcare provider may suggest one or more of the following medical approaches to treat your condition:
Medication. Your healthcare provider may prescribe beta-blockers or calcium channel blockers to lower blood pressure and/or nitroglycerine to treat angina. Because these medications can cause serious side effects, take only the ones your healthcare provider prescribes—never take anything given to you by a friend or relative.
Surgery. Options include stents or angioplasty to open fully or partially blocked blood vessels, and coronary bypass surgery, where the surgeon is able to restore normal blood flow to the arteries by bypassing the blockage.