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About CHD
Epidemiology
Coronary Heart Disease (CHD) and stroke (together known as cardiovascular disease) result from clogged arteries that supply the heart and the brain. CHD is the number one killer in the industrialized world, causing 50% of deaths in people over the age of 40.
The American Heart Association (AHA) estimates that approximately 19 million people in the United States have one or more forms of cardiovascular disease (CVD) or a known lipid disorder. Another 46 million are believed to be at substantial risk for a form of the disease.
For 200,000 people in the U.S. every year, the first symptom of CVD is sudden death. In 2003, approximately 1.4 million people died of heart disease.
Cost
In addition to being both widespread and deadly, the disease is also extremely costly. The AHA estimated that in 2002 the healthcare cost of CVD in the U.S. was $340 billion, including $140 billion in direct costs and $200 billion in indirect costs.
Risk factors
Major CVD risk factors include increased age (>45 in men, >55 in women), male gender, high blood pressure (systolic pressure >140 mm Hg), diabetes, smoking, elevated levels of low-density lipoprotein (LDL) cholesterol (>160 mg/dl), and decreased levels of high-density lipoprotein (HDL) cholesterol (<40 mg/dl in men and <50 mg/dl in women). Emerging CVD risk factors include elevated levels of triglycerides, C reactive protein (CRP), and lipoprotein(a) or Lp(a). Obesity increases the likelihood of high blood pressure, diabetes, elevated LDL cholesterol, and decreased HDL cholesterol. A sedentary lifestyle and diets rich in calories, saturated fat, cholesterol, trans fats, and sugars predispose a person to obesity and elevated triglyceride and LDL cholesterol levels.
Lipoproteins are the carriers of cholesterol in the bloodstream. Elevated low density lipoprotein (LDL) cholesterol (>160 mg/dl) and decreased high density lipoprotein (HDL) (<40 mg/dl for men and <50 mg/dl for women) have been defined as important independent risk factors for coronary heart disease (CHD), the leading cause of death and disability in the U.S. . Moreover, lowering LDL cholesterol to less than 100 mg/dl and raising HDL cholesterol to over 40 mg/dl and 50 mg/dl have been associated with decreased CHD risk in men and women, respectively. However, despite treatment with cholesterol lowering drugs, mainly statins, many CHD patients continue to have recurrent problems and have increased "residual risk."
This risk is related in part to the fact that patients with CHD often have elevated small size LDL > 35 mg/dl, remnant-lipoprotein cholesterol >10 mg/dl, Lp(a) cholesterol >10 mg/dl, and suboptimal HDL particle distribution. The patient might have increased bodily cholesterol production and/or increased cholesterol absorption as well. Moreover, CHD patients frequently have insulin resistance, with elevated levels of insulin and glycated albumin, as well as decreased levels of adiponectin.
How Boston Heart Lab can make a difference
To map the underlying mechanism for the patient's CHD risk, Boston Heart Lab offers:
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The most complete, individualized CHD-risk assessment to date, using state-of-the-art, proprietary testing developed by Boston Heart Lab for established and emerging risk factors. |
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The most complete, individualized insight into genetic and metabolic bases of cardiovascular health therapy options (lifestyle and/or pharmacological) to prevent or manage CHD based on the patient's individual profile. |
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