Author: Dr Ng Kiang Seng
Date: August 2011
Coronary heart disease is the most common form, in which the thickening or hardening of arteries (also known as atherosclerosis) damages the coronary arteries. These arteries feed blood to your heart muscle, and are essential for continuation of your heartbeat. Many scientists and clinicians see atherosclerosis as a preventable illness.
The key to lowering your risk of heart disease is to determine how much risk you have now – none, low, intermediate, high, or severe – before you develop symptoms.
Most people who develop heart disease have factors that predict they are likely to have a problem. Here are the basic risk factors:
Most important:
- Age
- Previous heart attack
- Diabetes
- Hypertension
- Smoking
Moderate risk factors include:
- Family history of early heart disease
- Abnormal cholesterol or triglyceride levels
- Obesity
- Atherosclerosis elsewhere in your body
- Lack of exercise
- Impaired glucose tolerance
The best quick estimate of the likelihood of a cardiac event (heart attack, sudden death, or chest pain) comes from the Framingham Heart Study. Using that information, one can determine one’s own Framingham Risk Score. The result is a percentage risk of having a cardiac event in the next ten years. Minimal risk is less than 10%; intermediate risk is 10 to 20%, and elevated risk is greater than 20%.
For people of at least intermediate risk (3 or more risk factors, or a Framingham Risk Score of 10% or more), it is important to get a more precise estimate of their likelihood of having coronary heart disease. Tests include calcium score, exercise treadmill and echocardiography. There are ono-invasive studies but coronary angiography to fate remains the definitive test.
