According to the Philippine Statistics Authority, coronary artery disease (also known as ischemic heart disease and coronary heart disease) remains the leading cause of death in the Philippines in 2021 despite (and possibly due to the impact of) the COVID-19 pandemic. Incidentally, coronary artery disease was also the number one cause of death in the country in 2019 and 2020.

Coronary artery disease (CAD) is the most common type of heart disease. It is characterized by the build-up of cholesterol-rich plaque in the coronary arteries—the blood vessels that supply oxygen-rich blood to the heart. The process of plaque formation that predisposes an individual to CAD is known as atherosclerosis and is commonly seen in people who have high cholesterol levels, diabetes, hypertension, and those who smoke and have a family history of heart disease.

How serious is coronary artery disease?

Most people with early onset of coronary artery disease (with less than 50 % of narrowing of artery) do not experience symptoms at all and may go unnoticed for years. However, as the plaque continues to collect in the artery, it can cause the inside of the arteries to narrow, causing reduction of blood flow to the heart. When this happens, angina (tightness, squeezing, pressure, or pain in the chest) may occur, especially during physical or emotional stress when the demand for the oxygen carried by the blood increases.

In some cases, the plaque surface may also rupture and form a blood clot, causing total blockage of the artery. The lack of blood flow due to the blockage can trigger a heart attack or an acute myocardial infarction (AMI). This can happen instantly with or without warning signs or symptom.

Over time, coronary artery disease can also weaken the heart muscle because of the reduced blood flow, possibly causing heart failure (when the heart cannot pump efficiently) or arrhythmia (when the heart beats irregularly or too quickly).

Coronary artery disease often develops gradually, so you might not notice a problem until you experience the complications mentioned above. Because of this, it is better to take preventive measures before anything more serious happens later.

How to prevent coronary artery disease?

There are many factors that may increase your risk for coronary artery disease. Some are uncontrollable such as age and family history, but there are also others that can be controlled. This heart month, learn how to prevent coronary artery disease by taking steps to change the risk factors that you can control.

1. Keep your blood pressure at a healthy range. High blood pressure is one of the major risk factors for heart disease. It usually has no symptoms, so it is important to get your blood pressure checked regularly - at least once every 2 years if you have never had high blood pressure or other risk factors for heart disease. This is important so that you can do necessary actions before your blood pressure could silently damage your blood vessels. If you have been diagnosed with high blood pressure, also called hypertension, make sure to talk with your doctor to have your condition under control. You will be advised to follow lifestyle changes, such as lowering the sodium in your diet and/or prescribing medicine to help lower your blood pressure.

2. Keep your cholesterol levels in check. High levels of cholesterol can clog your arteries and increase your risk of coronary artery disease and heart attack. Keep your blood cholesterol at healthy levels by having it checked at least once every 4-6 years. If you have already been diagnosed with high cholesterol or have a family history of hypercholesterolemia, however, make sure to talk with your doctor more often to keep your cholesterol levels at safe levels through medications and necessary lifestyle changes.

3. Manage your diabetes if you have it. Having diabetes doubles your risk for heart disease. That is because over time, high blood sugar from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. So, if you have diabetes, monitor your blood sugar level carefully. Talk to your doctor about treatment options. Your doctor may recommend certain lifestyle changes to help keep your blood sugar under control. These actions will help reduce your risk for heart disease.

4. Maintain a healthy weight. Being overweight or having obesity can increase your risk for heart disease. This is mostly because they are linked to other heart disease risk factors, including high blood cholesterol and triglyceride levels, high blood pressure, and diabetes. To achieve a healthy weight, control your calorie intake by eating more whole foods and less processed ones. Eating in moderation and increasing physical activity are also important factors to manage your weight.

5. Follow a heart-healthy diet. Try to limit intake of foods high in saturated fats, sodium, and added sugars which are commonly found in processed food items. Eat plenty of fresh fruit, vegetables, and whole grains instead. Following these nutritional strategies can help you reduce or even eliminate some risk factors such as reducing total and LDL-cholesterol; lowering blood pressure, blood sugars and triglycerides; and reducing body weight.

6. Get regular exercise. Exercise has many benefits, including strengthening your heart and improving your circulation. It can also help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can lower your risk of heart disease. Aerobic activities that use large muscle groups have the greatest benefits; such activities include brisk walking, running, swimming, cycling, dancing, and stair-stepping. Alternatives for busy people include heavy house cleaning, lawn mowing, raking leaves, and walking to and from work. Regardless of the exercise regimen you choose, check with your physician before starting one.

7. Limit alcohol intake. Too much alcohol can elevate your blood pressure. It also adds calories which may result to weight gain and raise your risk of heart disease. Men should have at most two alcoholic drinks per day while women should have at most one. One “drink” is equivalent to 12 ounces of beer, 5 ounces of wine, 10 ounces of wine cooler, or 1 1/2 ounces of 80 proof distilled spirits such as gin, rum, vodka, and whiskey.

8. Don't smoke. Cigarette smoking can damage the heart and blood vessels, which increases your risk for heart disease. The nicotine in cigarette also raises your blood pressure which, as mentioned, is one of the major risk factors for heart disease. If you smoke, quitting will lower your risk for heart disease. Consult your health care provider for help in finding the best way to quit. If you do not smoke, do not start. You must also avoid exposure to secondhand smoke as it can an also increase the risk for heart disease.

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