CHD case study

Global prevalence and distribution

• leading cause of death worldwide, 7.5 million deaths annually

• Rates vary considerably among populations - varying levels of risk factors among individuals

Links to physical environment

Air quality

• industrialisation has brought a number of negative effects and increased exposure to airborne pollutants from industry and transport systems increase risk. Rural environments would indicate a lower risk

Climate

• extremes of cold or heat can put additional strain on the cardiovascular system

Links to socio-economic environment

Socio-economic factors and lifestyle choices are more likely to be important determinants of CHD prevelance

Social deprivation

• London - people in tower hamlets have 3x increased risk of dying prematurely of CHD than those living in Kensington and Chelsea

Tobacco use

• mortality from CHD is 60% higher in smokers

Alcohol use

• 2% of CHD in men in developed countries is due to excessive alcohol consumption

High blood pressure and cholesterol

• 22% of heart attacks in Western Europe are due to hypertension, which doubles the risk of heart attacks

• 45% of heart attacks in Western Europe are due to abnormal blood lipids

Poor nutrition

• diets high in saturated fat, sodium and sugar increase CHD risk

Obesity

• also associated with high blood pressure/cholesterol and diabetes

Urbanisation and cardiovascular diseases

• According to world heart federation, one major factor increasing the risk of CHD in developing countries and societies is the rapid rate or urbanisation.

• Higher levels of particulate matter air pollution

• Urban environments discourage physical excercise and promote sedentary lifestyles

• Individuals turning to heavily processed convenience foods

• Urban residents more likely to smoke

• Children in cities more susceptible to second hand smoke

Impact on health and wellbeing

• heart attacks can cause permanent damage to heart muscle and may become fatal

• Rehabilitation programmes for those recovering rom a heart attack mainly focus on excercise, lifestyle choices, and relaxation

• CHD sufferers are required to age continued medication for the rest of their lives

Prevention of CHD

• governments can protect heath of citizens by educating the public, making treatments available and affordable, and advising patients on healthy living practices

  • In the UK, dieticians promote the benefits for heart health

Health education

• the WHO has initiated a number of activities to assist schools around the word, including:

  • Medical activities such as blood pressure testing

  • Activities to negate the public in physical activities

  • Scientific conferences

Policies and legislation

• advertising bans on smoking

• Smoke-free areas

• Health warnings on tobacco product packaging

• Taxation on tobacco products

• Bans in public places on smoking

Role of international agencies

WHO - primary role of directing and coordinating international health

• advertise on prevention of CHD and treatment strategies

• Set up schemes to educate people

NGOs - non-profit organisations that operate independently of government, primarily funded by public donations

• promote social welfare activities

• Encourage education of CHD

• Reach areas severely affected at relatively low costs