In coronary artery disease, the coronary arteries (which supply blood to the heart muscle) have become so furred up with fatty material that the blood supply to the heart muscle is compromised, leading to heart damage. Disorders of the heart, mainly myocardial infarction (heart attack) and angina pectoris (chest pains from heart disease) that are due to blockages in the coronary arteries of the heart. Also called coronary artery disease.
Heart disease is the number one killer of old individuals, and according to the American heart association (aha), 84.5 percent of patients who die from coronary heart disease are age 65 and older. The AHA also says that of about 2.3 million Americans discharged from hospitals in 1999 with a first Diagnosis of coronary heart disease, 57.6 percent were age 65 or older. Certainly coronary heart disease is a high risk medical issue for elderly people. An estimated 12.4 million individuals in the United States have coronary heart disease according to the American Heart Association. About 6.3 million individuals suffer from angina pectoris, including about 4 million girls and 2.3 million guys, and the risk for heart disease increases with aging. For instance, in America, the rate of hospitalization as a result of heart failure is 13.2 per 1,000 individuals for adults aged 65-74 years.
That speed more than doubles to 26.7 per 1,000 for individuals ages 75-84. It almost doubles yet again to 52.7 per 1,000 for adults age 85 and older. The speed is higher for many African Americans than for whites.
Risk Factors for Coronary Heart Disease
There are several important risk factors for heart disease.
- High cholesterol amounts of low density lipids (LDL or “bad” cholesterol)
- Race (African Americans are at greater risk than Caucasians.)
- Sex (Men have a higher risk of developing heart disease, but girls have a greater risk of death.)
Causes of Coronary Artery Disease
Coronary artery disease is usually due to atherosclerosis, in which fatty deposits accumulate on the inside of the artery walls. These deposits narrow the arteries and restrict the blood flow.
If a blood clot forms or lodges in the narrowed area of an artery, it can become completely blocked. CAD caused by atherosclerosis is more likely if your blood cholesterol is high and you eat a diet high in animal fat. CAD is also linked to smoking, obesity, and lack of exercise, diabetes mellitus and high blood pressure. In women, the hormone oestrogen reduces the risk of developing CAD.
Cholesterol Levels and Their Impact on The Heart
There are two main kinds of cholesterol levels, including “bad” cholesterol levels, which are low density lipids (LDL), and “good” cholesterol, a phrase that refers to high-density lipids (HDL). The poor cholesterol chokes up the arteries. Conversely, the good cholesterol clears them up. Consequently, elderly people (and most other adults) need to have low amounts of LDL and high levels of HDL. Generally, this means reaching an LDL of less than 130 and an HDL of more than 40.
High Blood Pressure and Heart Disease
Individuals with hypertension have a greater risk of coronary heart disease than non-hypertensive people. Because the risk for hypertension increases with age, elderly folks should have their blood pressure checked at each visit to a doctor. If their blood pressure levels are high, patients may must take drugs to lower their blood pressure, that’ll also in turn work to lower the risk for coronary heart disease.
Because African Americans as a racial group experience a higher rate of hypertension than Caucasians (40 percent of blacks older than age 20 are hypertensive, versus 27 percent for whites older than age 20), their risk for developing heart disease is, in addition, significantly raised.
Smoking and The Heart Tobacco
Use increases the risk of developing heart disease and of death. Individuals who don’t die of cancer from smoking may instead have problems with congestive heart failure, while individuals who quit smoking reduce their death risk. For instance, people who quit smoking before the age of 50 cut their risk of expiring in the next 15 years by 50 percent. But even individuals older than age 65 who smoke can obtain advantage by stopping their tobacco addiction.
Obesity and Coronary Disease
Excessive weight is another risk factor for developing coronary heart disease, and elderly folks in addition to individuals of all ages in America have a significant issue with obesity. Elderly folks in other states also have an obesity issue. In several cases, the issue isn’t only overeating and high bad cholesterol levels but also a difficulty with a serious lack of physical exercise. Even easy exercises for example walking many times weekly can help reduce excessive weight and enhance overall well-being.
Many individuals erroneously believe they must lose substantial amounts of weight to reap the benefits of weight loss; yet, studies have shown that if a man who weighs 50 pounds more than the standard loses even 10 pounds, her or his risk for heart attack, stroke, and other disorders is substantially decreased.
Although girls have an overall lower rate of coronary heart disease, they have a greater risk of death when they do suffer from myocardial infarction (heart attack). Almost half (44 percent) of the girls in America who have a heart attack die within a year, versus 27 percent of men who expire within a year of a heart attack. This is especially difficult for elderly girls, who have double the risk of dying within weeks of a heart attack than faced by guys.
Symptoms of Coronary Heart Disease
The most common symptom of cardiac disorder is chest pain. Although all chest pain isn’t necessarily diagnosed as heart disease, this medical issue should be assessed, and heart disorders should be ruled out first before other potential medical issues are investigated.
- Chest pain (angina).
- Palpitations (awareness of the heartbeat).
- Light-headedness or loss of consciousness.
- Irregular heartbeats in some people. These
are a result of an abnormality of the heart rhythm (arrhythmia). Some severe arrhythmias can cause the heart to stop pumping completely – cardiac arrest – which accounts for most of the sudden deaths from CAD.
- In elderly people, CAD may lead to chronic heart failure, a condition in which the heart gradually becomes too weak to pump an adequate circulation of blood around the body. Chronic heart failure may then lead to the accumulation of excess fluid in the lungs and tissues, causing additional symptoms such as shortness of breath and swollen ankles.
Some people have pain in one or both arms or in their belly, back, neck, or jaw. Another common symptom is persistent shortness of breath. A sudden pallor from the standard skin tones may be another symptom of heart disease.
Diagnosis of Coronary Heart Disease
Doctors who imagine heart disease will normally order an electrocardiogram and many different lab evaluations. They may also order a treadmill test to ascertain the stamina of the person and the stress that exercise puts on the heart (if the treadmill test is deemed safe enough for the patient to perform).
Treatment of Heart Disease
Treatment for CAD falls into three categories: lifestyle changes, drug treatments and surgical procedures. A variety of different drugs may be purchased by the doctor if heart disease is diagnosed. Many physicians also advocate using daily aspirin to fight heart disease in patients that have been diagnosed with heart disease or who are at high risk. Aspirin treatment has been found to be quite successful in averting both heart attack and stroke for many individuals.
Doctors also often recommend lifestyle changes, like easy exercises, fat loss, and dietary changes to improve cholesterol levels and to fight issues with obesity.
If tests show that you have a high blood cholesterol level, you will be treated with lipid-lowering drugs to slow the progression of CAD and, as a consequence, reduce the risk of a heart attack.
Angina may be treated with drugs, such as nitrate drugs and beta-blocker drugs that improve the blood flow through the arteries and help the heart pump effectively. An abnormal heart rhythm is often treated using anti-arrhythmic drugs. Surgical treatment includes angioplasty and coronary bypass surgery.
Exercise testing is usually done when coronary artery disease is suspected. It is used to assess heart function when the heart is put under stress. The test involves raising your heart rate by exercising, generally using a treadmill with an adjustable slope or an exercise bicycle, and monitoring the heart’s’ function.
The exercise is tailored to ensure your heart is tested adequately without putting you at risk. Various methods of monitoring may be used, including radionuclide (thallium) scanning, which can image the heart’s function, and electrocardiography (ECG), which monitors the heart’s electrical activity.