Active ImageWhen atherosclerosis occurs in the arteries that supply blood to the heart muscle itself (the coronary arteries), the result is often coronary heart disease.
Like other organs, the heart muscle needs an adequate supply of blood. If that supply is partially blocked by arterial plaque, the heart muscle does not get enough oxygen, and chest pain (called angina pectoris) can occur.
In this case, open but narrowed arteries may not be able to deliver the additional oxygen that the heart muscle requires at times of emotional excitement or physical exertion.
Climbing stairs, for example, can trigger an angina attack; the pain is no different than that produced by any other muscle when it is taxed beyond its capacity.
The heart can compensate for atherosclerosis to a de¬gree by rerouting blood from other coronary vessels, but if atherosclerosis continues unchecked even this will not keep the heart healthy.
When a coronary artery becomes blocked, usually when a clot forms at a plaque deposit, the tissues downstream from the obstruction die, and this is called a myocardial infarction, or a heart attack.
About one-third of all people who suffer a heart attack die suddenly because the heart simply stops beating with any regularity. In many instances, prompt medical treatment can restore the heart’s rhythm, enough to keep the heart attack victim alive.
Other people have a nonfatal heart attack in which the heart is damaged but does not stop beating. Within the first few hours after the heart attack, the affected part of the heart dies, and the body begins replacing the dead muscle with connective tissue. Other parts of the heart, if their blood supply is not restricted, eventually grow larger to compensate for the missing muscle.
Approximately 6.7 million people in the United States have coronary heart disease, and in 1987 over 500,000 people died from a heart attack, making it the leading cause of death.
In addition, another 725,000 people suffered a heart attack and survived. Men are more likely than women to develop coronary heart disease and suffer a fatal heart attack at a younger age, but the risk rises rapidly for women after meno¬pause.
Women get coronary heart disease about 10 years later than men, but, overall, as many women as men die from coro¬nary heart disease in the United States. The risk of death from heart disease is greater for white men than for black men, but higher for black women than for white women.
The situation is improving, however, and the number of deaths has dropped from its high in 1967. This is true among all U.S. population groups.
At least part of the re-duced death toll from heart disease—some health experts estimate as much as 30 percent—can be tied to better eating habits among the U.S. public.
The death rate from heart disease has also dropped, thanks in part to improved medical treatment and because fewer people are smoking cigarettes.