By Dr Chi-Woon Kong, MD

Coronary heart diseases generally refer to deposition of cholesterol within the coronary vessel wall and leading to narrowing of the vessel lumen and even blockage of the coronary artery. This phenomenon may affect heart muscle perfusion and cause dysfunction of the heart, which leads to a high death rate. Once a person develops coronary heart disease, it jeopardizes not only the persons wellbeing, but also creates problems to his/her family, his/her business and society.

According to the data provided by the World Health Organization and World Heart Federation, out of every hundred deaths, 26 died from cardiovascular disease in 1990; but this increased to 30 cases in 1999. It is estimated that by 2020, the number will reach as high as 36. In other words, the number of deaths from cardiovascular diseases will be one third of the total death population. What is more concerning is that this phenomenon is much more prevalent in the economy-transforming and developing countries. In recent years, our country has undergone rapid economic transitioning and development, and the peoples lifestyles and eating habits have changed as a result. We can no longer overlook the issue with cardiovascular diseases.

The Interior Script of the ancient Chinese Yellow Emperor said that an outstanding doctor will treat diseases before they develop. This is equivalent to what we say today that prevention is better than treatment. Therefore, we should understand the risk factors of coronary heart disease in order to effectively control its outbreak. It is also emphasized in many epidemiological investigations and guidelines that life-style modification plays a major role in management of this problem. However, some risk factors cannot be changed, for example, age. As age increases, incidence of coronary heart disease becomes higher. Another example is sex. After the age of 40, the number of male patients increases, whilst there are more female patients after the age of 50 when their periods cease; but there is not much difference when both sexes reach 70. In addition, family history, that is, the effect of genetics cannot be changed either. Some patients even say that it is because they are unlucky that they inherited bad genes from the family. Nevertheless, we ought to recognize that many risk factors are closely related to our daily living and we can modify our lifestyles. The three most serious risk factors of coronary diseases are smoking, high blood cholesterol and blood pressure. All of these are controllable. The effect of smoking can last as long as five years after quitting. Therefore, we must avoid smoking or quit altogether so we will not harm others and ourselves. Some reports even disclosed that passive smokers may bear higher risks. Problems with cholesterol and hypertension can be improved by controlling intakes of oily foods, salt and sodium. Moreover, regular exercises can decrease blood pressure, reduce body weight and bad LDL-cholesterol, and increase good HDL-cholesterol, all of which are beneficial to our body. A busy and anxious pace also increases the incidence of cardiovascular diseases. So it is important to effectively reduce work pressures and maintain a regular lifestyle. This includes maintaining regular hours of sleep. Not burning the midnight oil is beneficial for the health of the heart.

Even when you have done all that you can to reduce the risk factors, with the increase in age, as mentioned earlier, it is still possible to develop atherosclerosis. Its main symptom is angina pectoris. Typical angina pectoris has chest oppression, or the feeling of being squeezed in the chest and breathing problems. It usually occurs during an exercise, for example, when going uphill, climbing the stairs or lifting heavy goods. Or it may happen in winter when one is exposed to sudden cold air when going outdoors. Typical angina will be over soon once patients take some rest. However, when the above symptoms take place, cardiology physicians should be consulted so that an accurate diagnosis can be obtained through a treadmill exercise test and cardiac catheterizatio