INTRODUCTION


INTRODUCTION
Coronary heart disease is very old in human history, whereas in genetic inheritance share with chimpanzees (our closest evolutionary relatives) are at least 3 genes that have been associated with ischemic heart disease.

The description of cardiovascular disease in general and heart in particular is also very old. However, creating a deep understanding of its causes and mechanisms have not been easy. For centuries, was a mystery form and function of heart disease and arteries and veins, even he could unravel only with the work of countless scholars.
We can find in the early eighteenth century references linking angina and myocardial infarction with atherosclerosis in the arteries coronary, and the latter with excess nutrients.

At that time we also find that the identification of heart attacks can be triggered by anger or other emotions.
In the nineteenth century new items are added to
puzzle that explains what and why there is a heart attack. It is found that coronary arterial thickening has a component fat. Additionally, cholesterol is found, it yque, circulating in the blood, may be deposited in the arteries. In the therapeutic is discovered some nitrite can ease an attack of angina pectoris.

The scientific and technical breakthrough by humanity in the twentieth century led to the understanding of
much more accurate operation and cardiovascular diseases and also allowed study and treat the heart of healthy individuals and patients with resources such as electrocardiogram, surgery, catheterization, pacemakers, echocardiography, thrombolysis, stints, etc.. However, despite these huge scientific advances, we can say that in all human history, the twentieth century had the highest incidence and mortality from cardiovascular disease. 

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ischemic heart disease - CAUSES


ischemic heart disease
CAUSES
By 1940 the production epidemiological ischemic heart disease is limited to interesting observations linking differences in the incidence of cardiovascular disease in different regions with different patterns also supply.

After the Second World War took place between several epidemiological studies highlighting the important role of the physiologist-epidemiologist Ankle Keys, United States, who worked hard in the diet-CHD relations. 

It then works in 2 directions:
on the one hand are performed studies to compare populations from different geographical regions to examine what's different in the people and conditions in these areas to explain different incidence rates presented in them, and develop other cohort studies where it is compared to individuals in order to measure differential risk by exposure to potential causative factors. One such study, which has provided a great deal of valuable information the Framingham Heart Study began in the States in 1948.
Based on the results were obtained in these studies were developed as many studies to establish the effect on the incidence achieved with various interventions, and further studies to find factors that explain this variation does not explained by risk factors "conventional", which continues until now (in fact, the term risk factor for common use were made after be coined by the Framingham study).

The first conclusions of the studies conducted in the mid-twentieth century brought to the arterial hypertension, hypercholesterolemia and smoking

as major risk factors for IHD;
also state that the simultaneous presence of Several of them has an effect not only additive, but multiplicative risk of each factor separately. Table 1 shows the results a study by the American Heart Association published in 1973 in which this effect is seen multiplicative.

In the first epidemiological studies to have now identified more than 300 risk factors for IHD. Table 2 shows some of the most important risk factors for coronary heart disease.

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