Case Study – A Different Look at Coronary Heart Disease Risk Factors and Nutrition

The leading cause of both death and disability in the United States is coronary heart disease, accounting for about 40% of all deaths. A million new cases of coronary heart disease are diagnosed every year as well. There are many forms of coronary heart disease, including myocardial infarction and angina pectoris, both caused most typically by veins and arteries that are blocked off and narrowed by deposits called plaque. Known medically as atherosclerosis, this blockage prevents oxygen-rich blood from making it to the heart or can block off blood flow to other areas of the body, including the brain. This reduced flow of blood to the brain can result in a cerebral vascular accident, commonly referred to as a stroke.

There are four major types of risk factors for coronary heart disease, some that can be changed and some that can not. These four types include bodily characteristics, health habits, community, lifestyle and cultural factors and personality. Each of these four categories includes several sub-headings that should be considered individually to assess the real risk of coronary heart disease.

Bodily Characteristics

These include age, hypertension (high blood pressure), cholesterol, obesity and heredity. Of these, hypertension, cholesterol and obesity are changeable, while age and heredity are obviously not something that can be changed by anyone. Obesity may be the most important factor to change because it can influence the others positively. For instance, even a small reduction in weight can lower the cholesterol level as well as the blood pressure.

Gender is an important consideration as well. Coronary heart disease is a major killer of men starting at age 39, and for women the increased risk begins at 66. Women will often have chest pain for a very long time before they suffer an actual heart attack, but theirs will more likely be fatal . (For women, the rule is typically one and done, while the opposite is true for men). It is generally accepted that if a man is having any chest pains, he is already actively having a heart attack. It is also important to note that some of the accepted tests for heart disease may miss clues in women because of differences in the way that their arteries and veins are made.

Stress and Personal Life Styles

Although coronary heart disease is still the leading cause of death in the United States, the rate of death has decreased roughly 35% in the last forty years and is progressively decreasing. There are several factors that influence this progress, including better education about general good health. There are several studies that have been done in regard to personality types as well – identifying the Type A personality (high stress, hurried, competitive and hostile) which is at a high rate for heart attack and the Type B personality, which is more relaxed and less at risk.

Although most people assume that it is the stress that is the impetus for heart disease, it is not the case. Hostility is a bigger factor for determining the risk factors for coronary heart disease, with the more hostile people at higher risk for having a fatal heart episode.

Can Loneliness Cause Heart Disease?

Having a support system and social network can help to alleviate some of the stress that is felt through life, whether or not it is a typical stressor or something more serious. Support that is given by a woman has been shown by studies to have more impact on good health than that of a man, regardless of who is getting the support. Another study showed that pet owners had lower rates of coronary heart disease as well as lower blood pressure than non-pet owners.


The number of adults who are considered to have pre-hypertension is 20% of the population in the United States. Hypertension (high blood pressure) is a major factor for coronary heart disease and is considered by most to be one of the most common and leading causes to consider. Chronic anger and stress can raise hypertension in many people, especially for those who are more susceptible to it. (Type A personalities, for example).

Finding ways to reduce stress and to accept the stress that can not be changed is important not only to physical health but to mental health as well. However, one of the most common sources of stress seems to be the workplace.

Reducing Risks of Coronary Heart Disease: A Case Study

Beth is 68, and her son, Bret, is 38. Both have been diagnosed with heart disease and both have been directed by their doctors to make changes in their lifestyle and to reduce their risk factors as much as possible. Beth is twenty pounds over her optimal weight, while her son is fifty pounds over his own. Neither of them is very active any more, although they both enjoyed golf, bowling and tennis in the past. Neither of them is a smoker, which is a plus; however, both of them have major stress in their lives. Beth just retired from a job that she enjoyed and she finds herself lonely most of the day, unable to figure out what to do with her newfound time. Bret, on the other hand, has been very busy, trying to find a new job because he loathes the man that he works with, he loathes his office and he loathes his job in general.

The first step for mother and son is finding a new dietary plan and returning to exercise. Tennis is not on the horizon quite yet, however, but golf and bowling might be enough for right now. They are both going to reduce the amount of red meat that they eat and eliminate all simple carbohydrates from their diet. They are also going to swap out their fat sources for healthier fats, including Omega-3 fatty acids.

Bret is not as dedicated as his mother and she is soon well on the way to her goals. Her weight is down by fifteen pounds, and her blood pressure and cholesterol levels are within normal limits. She has moved beyond the weekly golf games and bowling with her son and added daily walks; one day a week she adds a jog for the last part of her walk, adding a little more distance every day as she gets stronger and stronger. Beth's last five pounds are no longer a problem, as they are now healthy, lean muscle mass instead of flab.

Both Bret and Beth have added a liquid protein supplement to their daily diet as well, with Bret using his as a between-meal snack and Beth using hers as a meal replacement. (She is smaller and does not need to eat as much as her son.) The liquid protein shot gives them both 25 grams of protein per serving, 100 calories and the whole day's worth of vitamin C. They each have their favorite flavor and have their rituals to consume them. Bret always has his on the way back to the office after lunch, while Beth has hers in the park after her walk / jog on sunny days.