What causes coronary heart disease?

Coronary heart disease (CHD) is arguably the the UK's biggest killer. CHD develops when the blood supply to the muscles and tissues of the heart becomes obstructed by the build-up of fatty materials inside the walls of the coronary arteries.

What is coronary heart disease?

Your heart is a pump the size of a fist that sends oxygen-rich blood around your body. The blood travels to the organs of your body through blood vessels known as arteries, and returns to the heart through veins.

Your heart needs its own blood supply to keep working. Heart disease occurs when the arteries that carry this blood, known as coronary arteries, start to become blocked by a build-up of fatty deposits.

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How common is CHD?

• CHD causes round 74,000 deaths each year. That's an average of 200 people every day
• In the UK, there are an estimated 2.3 million people living with the condition
• About one in six men and one in nine women die from the disease
• Death rates are highest in Scotland and northern England
• In the past couple of decades, deaths from CHD have nearly halved due to better treatments

Source: British Heart Foundation

The inner lining of the coronary arteries gradually becomes furred with a thick, porridge-like sludge of substances, known as plaques, and formed from cholesterol. This clogging-up process is known as atherosclerosis.

The plaques narrow the arteries and reduce the space through which blood can flow. They can also block nutrients being delivered to the artery walls, which means the arteries lose their elasticity. In turn, this can lead to high blood pressure, which also increases the risk of heart disease. This same process goes on in the arteries throughout the body, and can lead to high blood pressure which puts further strain on the heart.

If your arteries are partially blocked you can experience angina - severe chest pains that can spread across your upper body - as your heart struggles to keep beating on a restricted supply of oxygen. You are also at greater risk of a heart attack.

Some people have a higher risk of developing atherosclerosis due to genetic factors - one clue to this is a family history of heart disease in middle-age. Lifestyle factors that increase the risk include an unhealthy diet, lack of exercise, diabetes, high blood pressure and, most importantly, smoking.

However, in the past couple of decades deaths from coronary heart disease have nearly halved, thanks to better treatments.

What happens during a heart attack?

A heart attack happens when one of the coronary arteries becomes completely blocked. This usually happens when a plaque, which is already narrowing an artery, cracks or splits open. This triggers the formation of a blood clot around the plaque, and it is this blood clot that then completely blocks the artery.

With their supply of oxygen completely blocked, the heart muscle and tissue supplied by that artery start to die. Emergency medical intervention is needed to unblock the artery and restore blood flow. This may consist of treatment with drugs to dissolve the clot or thrombus, or a small operation done through the skin and blood vessels to open up the blocked artery.

The outcome of a heart attack hinges on the amount of the muscle that dies before it is corrected. The smaller the area affected, the greater the chance of survival and recovery.

While a heart attack will always cause some permanent damage, some areas may be able to recover if they are not deprived of blood for too long. The sooner a heart attack is diagnosed and treated, the greater the chance of recovery.

Other heart diseases

Other diseases that commonly affect the heart include:

• Chronic heart failure - CHD is one of the main causes of heart failure. It affects around one million people in the UK, and many more have it but haven't been formally diagnosed. Here, the heart doesn't works effectively as a pump, and fluid gathers in the lower limbs and lungs. This causes a variety of symptoms and significantly reduces quality of life.
• Infection - bacterial infections such as endocarditis are much rarer these days thanks to antibiotics, but can damage the valves of the heart as well as other tissues. Viral infections can damage the heart muscle leading to heart failure, or cause abnormal heart rhythms.
• Congenital heart disease - a number of defects can develop in the heart as a baby grows in the womb. One example is a hole in the heart, also known as a septal defect. Congenital heart disease may cause abnormal blood flow and put excessive strain on the infant's heart after it has been born.
• Cardiomyopathy - a disease of the heart muscle that can occur for different reasons, including coronary heart disease, high blood pressure, viral infection, high alcohol intake and thyroid disease.
• READMORE:http://www.bbc.co.uk/science/0/21686950

Nutrition 'must be a global priority', say researchers

Malnutrition is responsible for 45% of the global deaths of children under the age of five, research published in the Lancet medical journal suggests.

Poor nutrition leads to the deaths of about 3.1 million under-fives annually, it says.

An international team reviewed different causes of malnutrition in pregnancy and childhood.

They say the first 1,000 days of life - from conception to two years - have lasting consequences for health.

Malnutrition - which includes being overweight or obese as well as under-nourished - also has an economic impact.

According to a recent United Nations report, malnutrition is estimated to cost the world $3.5tn (£2.3tn) - or $500 for every person - in healthcare and lost productivity.

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If maternal and child nutrition can be optimised, the benefits will accrue and extend over generations, which is why we must work together now to seize this opportunity.”

Dr Richard HortonThe Lancer

A team led by Prof Robert Black, of Johns Hopkins Bloomberg School of Public Health, Baltimore, US, reviewed evidence on maternal and child under-nutrition and obesity in low-income and middle-income countries since 2008.

The team also assessed national and international progress on nutrition programmes.

Prof Black and colleagues say while some progress has been made in recent years, they estimate that more than 165 million children were affected by stunting (low height for age) and 50 million by wasting (low weight for height) in 2011.

An estimated 900,000 lives could be saved in 34 countries if 10 proven nutritional interventions were scaled-up to 90% of the world, they say.

"The nutritional consequences of the months during pregnancy and the conditions during the first two years of life have very important consequences for mortality and for adult chronic disease," Prof Black told BBC News.

"The early nutritional deficit results in developmental consequences for the individual and that has implications for their ability to succeed in school and ultimately in society to have the most productive jobs."

The researchers warn that countries will not break out of poverty unless nutrition becomes a global priority.

Dr Richard Horton, editor-in-chief of the Lancet, said: "If maternal and child nutrition can be optimised, the benefits will accrue and extend over generations, which is why we must work together now to seize this opportunity."

Experts working in development are gathering in London this weekend for a summit on nutrition hosted by the UK and Brazilian governments.

This will be followed by the annual summit of leaders from the G8 countries.

The Enough Food for Everyone IF campaign is calling for $1bn per year in additional aid money to be spend on malnutrition by 2015.

Enough Food for Everyone IF spokesperson Anita Tiessen said:

"These new figures confirm our worst fears - that hundreds of thousands more children are dying from malnutrition than we previously thought.

"We have made incredible progress in tackling child deaths around the world, but malnutrition remains the Achilles' heel in our efforts to prevent millions of needless deaths each year. We must urgently prioritise tackling hunger if we are to continue the progress we have made."

READMORE:http://www.bbc.co.uk/news/health-22779656