Year: 2012
Type: article
Abstract: Coronary heart disease (CHD) is a major cause ofmortality and morbidity around the world. It isincreasing in the developing world and in countriesbelonging to the former Soviet Union. It is estimatedthat worldwide deaths from CHD will increase 100%in men and 80% in women from 1990 to 2020.The concept of prevention has been around for a longtime. Medical writings of as early as 2500 BC refer tothe practice of prevention.Homogentisic acid co enzyme -A reductaseinhibitors called statins have undergone manyrandomized primary prevention trialsWOSCOP,AFCAPS/TexCAPS39, 4S showing reduction incholesterol and some increase in HDL level in theblood15-17.Sedentary life style is associated with increased riskof coronary heart disease 26. A 45 minutes brisk walkon most days of week appears to give enough benefitfor coronary risk27-28.In conclusion there are three broad key groups ofpatients who require intensive primary prevention forCHD. The first group includes patients of 10 yearCHD risk > 20% on Framingham scoring table(Table 1). The second group is of diabetic patients.The metabolic and lipid abnormalities in diabetics,place them at high risk of CHD. These two groupsare considered to be CHD risk equivalents. That is,their 10 year risk is similar to 10 year risk of anindividual with CHD. A third group of patientsknown as of metabolic syndrome,(table-3) is also atmarkedly high risk of CHD and requires intensiveprimary prevention. The measures to bring down 10year risk of CHD in these three groups include lifestyle modifications and drugs. The life stylemodification include an array of steps to target diet,weight, smoking, physical activity, lipids and BP.These life style changes are to be employed prior toor along with drug therapy to achieve optimal goal ofprimary prevention.
Source: Pakistan Heart Journal
Authors: M. Rashid Chaudhry, Fahd A. Chaudhry
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W1900905193