Non-pharmacological modification of cardiac risk factors: part 1

Abstract

SUMMARYMany fadors influence whether a person will develop coronary heart disease. Genetic predisposition, gender and advanced age are recognized risk factors for the development of coronary heart disease over which we have little control. On the other hand, high serum cholesterol, cigarette smoking, high blood pressure, excessive body weight and long-term physical inactivity are key risk factors over which we have considerable control. In many cases cardiac risk factors can be modified without resorting to pharmacological intervention. Current evidence suggests that individuals who follow a diet which is low in saturated fats and cholesterol, lose weight, stop cigarette smoking and take regular aerobic exercise will significantly reduce their risk of developing coronary heart disease. In addition, patients who already have evidence of coronary heart disease may improve their symptoms and prognosis by similar life-style changes. In the first of two parts, we review the role of exercise in modifying cardiac risk factors. T H E ROLE OF EXERCISE TRAININGThere is evidence that vigorous activity at work or during leisure time requiring an energy expenditure of 7.5 kcals per min or greater than 65% maximal oxygen uptake (VO, max) and maintained for at least three periods of 20 min each week (I), reduces rates of cardiovascular disease (2, 3). The relationship between physical activity and coronary heart disease (CHD) has been reviewed, studies with good designs and methods demonstrating a significant inverse relation between physical activity and CHD (4, 5). Overall,

Evaluation of risk factors in acute myocardial infarction patients admitted to the coronary care unit, Tripoli Medical Centre, Libya

“…The risk factors associated with CHD are multifactorial and work synergistically. Genetic predisposition, sex (it is more common in males), family history of ischaemic heart disease (especially in a first-degree relative under 55 years), stroke, peripheral vascular disease and advanced age are recognized risk factors for the development of CHD over which there is little control [10,11].…”

Self-responsibility predicts the successful outcome of coronary artery bypass surgery

“…Research has suggested that aggressive risk factor modification can lower plasma lipid concentrations, reverse atherosclerosis and substantially diminish acute cardiac events in patients who already have the disease (DeBusk, 1996;Maines et al, 1997;Eagles and Gulati, 1996). Traditionally the role of the patient in the health care system has been characterised as essentially passive, demanding that patients place the responsibility for their health in the hands of health care professionals (Mahler and Kulik, 1990).…”

Lifestyle pattern change in males following percutaneous transluminal coronary angioplasty/intracoronary stenting

“…There are many factors that contribute to the development of CAD 3,5,12–15 . In order to retard the progression of this disease sustained lifestyle modifications are of paramount importance for the individuals concerned 4,9 .…”

“…Nonetheless, lifestyle pattern change for CAD sufferers remains essential if rehabilitation measures are to decrease the likelihood of a second potentially more severe MI following a PTCA/stent procedure 3,12 . Despite evidence regarding what lifestyle factors require change, a significant number of MI victims still do not make any lifestyle changes 3,5,12–15 . Currently, the literature describes numerous risk factors associated with CAD and the lifestyle behaviours required for a healthy heart.…”