According to Health Canada, cardiovascular diseases are the leading cause of
death in this country. Several risk factors may lead to heart disease, including
sedentary living, smoking, obesity, stress, high blood cholesterol, high blood
pressure and diabetes. Cholesterol is a naturally occurring substance, which
is an important component of the cells in human beings and other animals. It
also forms the basis for many hormones, including sex hormones. Human beings
have two sources of cholesterol; the one produced naturally in the body and the
one found in food.
It has been clearly shown that having too
much cholesterol in the bloodstream can contribute to progressive narrowing of
the arteries supplying the heart and other parts of the body. However,
since cholesterol plays important biological roles, having enough of it is absolutely
essential for life.
One particularly dangerous form of lipoprotein that
carries cholesterol is called LDL, or low-density lipoprotein. LDL cholesterol,
also known as bad cholesterol, deposits extra cholesterol on the walls of blood
vessels, which can lead to heart disease and strokes.
On the other hand, a beneficial type of lipoprotein,
high-density lipoprotein, HDL, can actually help protect the heart from heart
disease. HDL cholesterol, also known as good cholesterol, takes cholesterol from
the blood vessels back to the liver, which leads to its removal from the
body.
The amount of LDL (bad) cholesterol in the blood is
controlled in two important places. First, in the liver, which produces
cholesterol and uses it to make digestive (or bile) acids. Cholesterol is
controlled in the digestive tract as well – which absorbs cholesterol both from
food and from bile made by the liver.
What
is angina? Angina (chest
pain or discomfort) is a symptom of heart disease. This disease is more serious
when someone has unstable angina, a type of angina that worsens over time
despite treatment. Unstable angina episodes may become more frequent, and occur
when a person is resting or not doing anything strenuous. Stable angina is a
less severe form of angina, which is usually triggered by exertion, stress, or
temperature changes. Unlike stable angina, unstable angina is not controlled
well or completely relieved with nitroglycerin.
What are the symptoms? In angina, the
discomfort may be felt as pressure, tightness or "fullness" in the chest. The
pain may also radiate to the neck, arms or shoulders. Any of those symptoms may
indicate unstable angina or a heart attack. Other symptoms may include one or
several of the following symptoms:
Perspiration;
Weakness;
Nausea (feeling like vomiting);
Shortness of breath;
Lightheadedness;
Fainting;
Extreme anxiety.
What are the treatments? Anti-anginal medications reduce
the heart’s demand for oxygen during exertion and/or increase the blood supply
to the heart. Nitrates (nitroglycerin), beta-blockers, and calcium channel
blockers are three types of medications used to treat angina. They may be used
alone or in combination.
Nitrates reduce the heart’s demand for blood, increase the supply of
oxygenated blood to the heart, and improve blood flow. Nitrates are available in
several forms:
Patches that are placed on the skin and deliver the
medication continuously;
Long-acting tablets taken orally; or
Short-acting nitroglycerin tablets taken under the
tongue or spray taken under or on the tongue.
Beta-blockers and some calcium channel blockers reduce
the heart’s workload, therefore reducing its need for oxygenated blood. They
also lower blood pressure, which helps the heart work better. In addition,
calcium channel blockers improve blood flow.
Reference: Affairs of the Heart, Answers about unstable
angina, Published by Kommunicom Publications, (1999)
What is hypercholesterolemia? Hypercholesterolemia, or
high blood cholesterol, is a leading risk factor of cardiovascular disease. Its
prevalence rises rapidly between the age of 18 and 44 in men, whereas it is more
gradual in women, up until the age of 44. However, the prevalence is higher in
women than in men after that age.
According to the Heart and Stroke Foundation, in Canada, 48% of
men and 43% of women have hypercholesterolemia, while 18% of Canadian men and 16% of
Canadian women have a "high-risk" cholesterol level.
What are the treatments? Many people use diet and exercise
to manage their cholesterol. Others take a cholesterol-lowering medicine and
combine it with dieting and exercising.
There are several types of cholesterol-lowering medications
available. Of these, the most commonly prescribed class of medicine is called
“statins”. Several other medications may also be used, such as fibrates, resins,
bile acid sequestrants or cholesterol absorption inhibitors (CAIs). Some combinations
of these medications are also possible.
CAIs decrease the amount of cholesterol absorbed from
food and from bile, meaning that less cholesterol is sent back to the
liver. Statins decrease the amount of cholesterol made by the liver. Because the
liver now stores smaller amounts of cholesterol, it tries to maintain a balance
by taking cholesterol from the blood. The amount of cholesterol in the blood is
decreased even more when CAIs are used with a statin.
The information provided herein is of a general nature and is in no way
intended to replace the knowledge, assistance or diagnosis of your
physician or healthcare provider. All decisions regarding your health are
your sole responsibility and that of your physician or healthcare
provider, as the case may be. For specific guidance regarding your
personal health, we strongly advise that you consult your physician or
healthcare provider. Schering-Plough Canada cannot be held responsible
for any interpretation or misinterpretation you may make of the
information provided herein.
