Heart Diseases

Heart diseases (cardiovascular disease) is any abnormal organic condition of the heart or the heart and circulation. A number of conditions can lead to the development of heart disease, including angina, atherosclerosis, cardiac arrhythmia, cardiomyopathy, chronic venous insufficiency, diabetes, heart attack, high cholesterol, high homocysteine, high triglycerides, hypertension, insulin resistance syndrome, mitral valve prolapse, and stroke.

Coronary artery disease (CAD), which involves atherosclerosis (hardening of the arteries) that supply the heart with blood is the most common cause of heart attacks and is a leading killer in the United States. The primary risk factors for CAD are diabetes, male gender, family history of coronary disease at an early age, smoking, elevated blood pressure (hypertension), high LDL cholesterol, and low HDL cholesterol. The control of diabetes and blood pressure has resulted in a small benefit in preventing heart attacks. Proper ranges of cholesterol are effective in the prevention of heart attack or stroke. Total blood cholesterol above 200 mg/dl, LDL cholesterol above 130 mg/dl, HDL cholesterol below 35 mg/dl; and lipoprotein(a) level greater than 30 mg/dl are indicators of problematic cholesterol. Cholesterol is not actually a damage mechanism but is more an indicator of compromised liver function, and increased risk of heart attack. These factors mentioned above, however, do not fully account for all of the risks for heart disease since some patients without any of the above risk factors can develop heart attacks.

Throughout history, diseases of the heart have captured the concern and interest of investigators. Ancient Greek and Roman physicians observed the serious and often fatal consequences of heart disease. But effective treatment for heart disease was limited to rest and painkillers until the eighteenth-century discovery of the therapeutic properties of the foxglove plant, whose dried leaf is still used to make the medicine digitalis.

While the heart was once considered a part of the body that could never be improved surgically, the twentieth century has seen a revolution in surgical treatment for heart disease. Blocked coronary arteries can be bypassed using new tissue and failing hearts can be transplanted. Yet heart disease remains the primary cause of death in the United States. Preventive health measures, such as improved diet and regular exercise, have become fundamental tools in the battle against heart disease.