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Demographic influence on ischemic heart diseases (IHD) (Dissertation Review Sample)


the paper requires the writer to start with general review about ischemic heart diseases then aging ,gender,race,ethnicity,diabetes


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Literature Review
General View of Ischemic Heart Disease
Secondary prevention for ischemic heart disease is hardly the main focus for epidemiology research and clinical practice. The risk factors that influence IHD have become more involved in practice as practitioners take responsibility for preventing occlusion or angioplastry during operation. Preventive cardiology appears to favor one segement of the population more than others. The landmark heart study conducted by Framingham that was done in 1948 transformed the beliefs of the time about heart disease. It set the pace for a paradigm shift in approaches to cardiovascular diseases. The popular belief during the time of the study was that aging was the primary cause of coronary diseases. The study however brought out the concept of risk factors with the suggestion that coronary diseases can be prevented by a change in lifestyles.[Alka Kanaaya, Deborah Grady, Elizabeth Barrett. Explaining the sex difference in coronary heart diseasesmortality among patients with type 2 diabetes: a metaanalysis, Arch Intern Med. 2002, 162:1737-1745]
Ischemic heart disease (IHD) is a leading cause of mortality and morbidity across the globe. Despite the existence of effective methods for reducing risks, methods of predicting Ischemic heart disease are limited. Equally, methods of classifying individuals according to their demographics is affected by wrong misclassification.[Radek, Bukowski, Davis, Karen, and Wilson, Peter. "Delivery of a Small for Gestational Age Infant and Greater Maternal Risk of Ischemic Heart Disease." Plos ONE 7, no. 3 (March 2012): 1-7.]
The Ischemic Heart Disease (IHD) also known as the Coronary Heart Disease (CHD) is an illness depicted by lowered blood supply to the heart. The word Ischaemia implies reduced blood supply to the heart. The disease is the leading cause of death in various western nations. Coronary arteries are the principle blood suppliers to the heart as there are no other alternative blood supply. Any blockage on the coronary arteries will have an impact of lowering the heart blood supply. A great percentage of Ischemic heart disease is as a result of atherosclerosis. In most occasions, atherosclerosis may exist even in situations where the artery lumen seems to normal through angiography. Among the various IHD risk factors include smoking and tobacco use, high blood cholesterol, physical inactivity, diabetes mellitus, and obesity and overweight. Though the disease may not be curable, it can be managed through ensuring excellent and appropriate nutrition, appropriate exercise and practice, and good medication.[Patel, V. Ethnic differences in myocardial infarction in patients with hypertension. Q J Med 2008; 101:231–236.]
Aging is the major risk factor for development of ischemic heart disease. Men have a higher risk of developing the condition at old age compared to women. They can begin developing the condition as early as 50 years while women begin ten years later than men. The world health organization has also reported that the major cause of death for people over the age of 65 is cardiovascular diseases. The increase in the number of old people in developed countries has made cardiovascular diseases to be a total burden.
The prevalence of the IHD increases with age. Therefore, aging is one of the risk factors in the IHD development with men clinically depicting this disease between 50 and 65 years of age. Females on the other hand manifest the condition approximately 10 years later after menopause. The WHO findings indicate that IHD is the main cause of death for individuals aging above 65 years old. Accordingly, at above 60 years of age, a significant percentage of deaths consist of females. Male and females continue to have the same chance of developing the fatal disease at 60 years and above. In various developed nations, the number and percentage of aging people is rising, which explains the continued decline in mortality and fertility. The increase in aging population in various nations has increased the contribution of IHD to total disease challenge. It is expected with the increasing aging population around the world that the IHD will be maintained as the main cause of death. In countries that have recorded high but declining IHD mortality, it is argued that this development is as a result of changing trends with regard to younger age.[American Heart Association. Heart Disease and Stroke Statistics—2010 Update. American Heart Association, Inc., 2010.] [Beltrame John, Dreyer Rachel, and Rosanna Tavella. Epidemiology of Coronary Artery Disease. Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital, Australia, 2009.]
IHD is a disease that affects both the adult females and males across the world. However, several studies and reports have indicated that male white people have a greater prevalence than other. Arguably, the first manifestation of IHD in females is delayed for approximately ten years when comparison is made to males. There is no sudden rise in IHD death rates for women after menopause, however there is a gradual increase in deaths as females get older. Post-menopause females above 65 years of age succumb to IHD more than males. Nonetheless, IHD does not affect the elderly men and women only, but there are cases of young and middle age people with the disease. The main increases in the development of the heart disease starts at the age of 35 for males. IHD mortality rates are high in black people as compared to white people until at an advanced age where the rates are similar. Accordingly, the white males have a higher death rates at an advanced age as compared to other males. There is an indication that as socioeconomic status goes down, the IHD incidence and death rates goes up. Consequently, there have been greatest reductions in IHD mortality rates for individuals earning highest income and with good education. IHD can develop as a result of genes inherited. This is especially where there has been a history of the heart disease in the family. Evidence have indicated that family history has the possibility of predisposing an individual to premature IHD through genetics and risk factors combination.[Chilton, Robert. Pathophysiology of Coronary Heart Disease: A Brief Review. Journal of the Royal Society of Medicine Cardiovascular Disease, 2010.] [Goyal A, and Yusuf S. The burden of cardiovascular disease in the Indian subcontinent. Indian J Med Res 2006;124:235–44]
The IHD is common in almost all the nations across the world and is prevalent more in white males and aging people. In the beginning of IHD, there occurs severe closure or narrowing of the end branches of the coronary arteries or the large coronary arteries by debris, which showers downstream in the blood flow. The blockage or closure of the arteries is mainly as a result of atheromatous plaques covering in the artery walls, which causes a heart attack. A heart attack damages the heart muscle through the sudden cut off of the blood supply. IHD is a fatal disease and is the main killer in most nations around the world. In the United Kingdom, the leading killer is the IHD with approximately 82,000 deaths per year. Studies have indicated that male white persons are at more risk of suffering from IHD. In the UK, approximately one out of five males and one out of eight females die from the heart disease. Evidently, the disease generally increase with aging, and affect more male white persons than women. However, studies indicate that there are similar chances of developing the heart diseases for men and women above 60 years. Studies indicate that there are approximately 2.7 million individuals suffering from the heart disease and approximately 2 million other affected by angina, IHD main symptom.[Dwivedi S, and Jhamb R. Cutaneous markers of coronary artery disease. World J Cardiol 2010; 2: 262.] [American Heart Association. Heart Disease and Stroke Statistics—2010 Update. American Heart Association, Inc., 2010.]
Gender is another critical demographic that influences Ischemic heart diseases (IHD). IHD among other cardiovascular condition is a leading cause of mortality among both males and females. The rate of mortality for women is progressive over subsequent years after reaching menopause. More women succumb to death after reaching menopause as compared to men. Alarming research studies have found out that decrease in mortality rate is seen in men more than in women. Even younger women who develop ischemic heart diseases at an early age have high mortality rate compared to men within the same age bracket. It is even further alarming for women following myocardial infarctions because the rate of mortality among them is found to be very high. It is not that mortality rates are higher in female compared to men, however, the men have shown high decline in mortality over a period of four decades compared to women.[Ueshima, H. Sekikawa, a et al. (2008). Cardiovascular disease and risk factors in Asia: aSelected review. Circulation 118(25): 2702-2709.]
Kanaya et al brings a different perspective into the issue. The article explains the gender differences in mortality cases due to ischemic heart diseases (IHD) in patients with type 2 diabetes. According to most research studies, diabetes is a strong risk factor for the development of heart diseases in women as compared to men. However, majority of these studies identified by Kanaya have not updated their findings to include other risk factors such as smoking, cholesterol levels, hypertension, and age. The study found out that there is a reduced relative risk for developing cardiovascular diseases in b...
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