3.  Since 1990, more people around the world have died from CHD than from any other cause  Its disease burden is projected to rise from around 47 million DALYs globally in 1990 to 82 million DALYs in 2020.  Disability-adjusted life year

7.  CHD is decreasing in many more developed countries due to  improved prevention, diagnosis and treatment,  and in particular reduced cigarette smoking and lower than average levels of blood pressure and cholesterol.

8.  However, it is increasing in less developed countries, partly as a result of increasing longevity, urbanisation and lifestyle changes.  The World Health Organisation (WHO) states that more than 60% of the global burden pf CHD occurs in newly developing countries

9.  There are over 300 risk factors associated with CHD. Many of these are significant in all populations. In MEDCs, there are five major risk factors: · Tobacco use · Alcohol use · High blood pressure · High cholesterol · Obesity

11.  Before treatment the patient can experience shortness of breath and fatigue with only light exercise. · They can also experience swelling in their feet, ankles, legs and abdomen. · They may also experience pain in their chest, shoulders, arms or neck (angina). · The patient may develop a life threatening arrhythmia (irregular heartbeat that can mean the body does not receive enough blood) · After treatment there may be side effects from the medication

12.  · There may also be psychological effects of having a heart attack/nearly dying/the thought that it could happen again.  Some people become depressed or anxious and are referred to have professional counselling or relaxation therapy as this can increase the patient’s risk of having a heart attack.

13.  The economic costs of CHD include the cost to the individual and to the family of healthcare and time off work, the cost to the government of healthcare and the cost to the country of lost productivity. All of these are difficult to quantify:  Cost to NHS, £8.5 bn, 6% of total budget  ‘Health problems related to obesity, such as CHD, cost the USA an estimated US$177 billion a year’ WHO

14.  ‘Expenditure in OECD countries on CHD medications increased from 9.4% in 1989 to 11% in 1997’ WHO  Cost to the individual of having time off work  Cost to the employer  Cost of lost productivity to the country

15.  Decrease in physical activity  Change of job(?)  Depression  Curb in habits, stop smoking, drinking, etc

16.  Regular physical activity  Taking prescribed medicines on a daily basis  Following a healthy eating plan  Watching ones weight  Not smoking  Not drinking too much alcohol  Regular check ups with doctor  Health education at school  Government legislation