Wednesday, October 11, 2017

Environmental Factors

               When one thinks of the common risk factors for developing heart disease, they think of age, gender, and many of the other risk factors stated above. However, environmental exposure plays a significant role in heart disease, both leading up to and while having heart disease. Both the heart and the vascular system are susceptible to many toxic agents found in the environment. These agents can include, but are not limited to, air pollution, arsenic, cadmium, and lead. Other things that pollute the air, such as smoking, play a key role in the development of heart disease as well. Exposure to agents such as these can “initiate” the start of the progression of heart disease or enhance the effects in those already diagnosed (Cesselman et. al, 2015). 


              Environmental factors do not just play a role in the development of heart disease. They are also significant in stroke and arterial disease as well. Metals, such as arsenic, that are found in polluted air have a detrimental effect on the blood vessels. Metals tend to damage the endothelial walls of the vessels. This, in turn, can cause scarring and may thicken the vessels, as seen in atherosclerosis. When vessels are thickened, less blood flow is occurring, which can lead to many problems including increased blood pressure and clogged vessels.
            In a study done by the American Heart Association, various factors were investigated in 2 groups. It was found that the incidence of heart disease was much higher in the urban and upper socioeconomic classes (Krishna, 1960). This can be, as stated above, due to the increased pollution of environmental air in urban areas.

              The body responses quickly to changes in the environment. For example, these changes include fluctuations in blood pressure. An increase in blood pressure significantly elevates a patient’s 

risk in developing heart disease by causes arteriosclerosis, or hardening of the arterial walls, and 

atherosclerosis, or plaque formation in the arterial walls. A consideration for patients who live in 

urban or heavily polluted areas would be to modify their hypertension factors, including 

medications, diet, exercise, and having a diet low in sodium and fats.
            
              Another environmental risk factor in developing heart disease is one’s diet. As stated before, there is a higher incidence of CAD in urban or low economic areas. In areas such as these, proper nutrition can be difficult to come across, especially in low economic communities. The population will be eating unhealthy meals that contain numerous saturated fats, carbohydrates, and excessive sodium. In combination with other risk factors, this can increase the fatty plaque formation in the arterial walls and cause occlusion, leading to higher incidences of heart disease. Diet is one of the number one modifiable risk factors, however, and should be taken into consideration in the populations stated above. Access to healthy meals, such as local food banks, would be an excellent resource for patients experiencing these difficulties.
            Exposure to secondhand smoke can be just as deadly to an individual as smoking the cigarette themselves. Smoking causes vasoconstriction in the body, which narrows the blood vessels. This decreases blood flow to the heart. Smoking also causes an increase in fatty plaque build-up. These two body mechanisms increase the risk for developing heart disease, as stated before. In areas of high pollution, it can be difficult to avoid exposure to secondhand smoke. Something that those at risk for heart disease can do would be to wear masks out in public. The mask can filter the air that the body is breathing and provide a more pure air to breathe. It is very important to note your family history of heart disease when choosing your location to live and work.
            It is important to be able to modify this risk to a patient’s best ability. If there is a strong like to heart disease in the family, a patient should consider living in a pollution-free environment or rural area. Although it can be inconvenient at times, it is better to slow or prevent the progression of a deadly disease than to stack risk factors on top of one another until the disease is no longer in control. 



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