Prognosis
The course of coronary heart disease (CHD) is influenced by several factors: The annual mortality rate without therapeutic measures increases with the number of affected vessels and is highest (over 30%) for the narrowing of the main stem of the left coronary artery. The prognosis of coronary artery disease also depends on the extent to which the heart muscle is undersupplied. With the frequency, duration and severity of angina pectoris attacks, the risk of suffering a heart attack increases.
If the pumping function of the left ventricle decreases with the existing or increasing oxygen deprivation (ischemia), the patient’s prognosis deteriorates and the implantation of a defibrillator may become necessary. The progression of coronary arteriosclerosis (atherosclerosis of the coronary arteries) is largely dependent on the risk factors the patient has. Nicotine withdrawal, weight reduction and blood pressure normalization, as well as the reduction of total cholesterol in the blood are important factors in preventing CHD worsening.
Prophylaxis
The prophylaxis of coronary heart disease (CHD) consists of the above-mentioned primary and secondary prevention and essentially consists of avoiding risk factors that promote or favour the development of CHD.
Which factors positively influence the prognosis of coronary heart disease?
For the prognosis of coronary artery disease (CHD), the degree of stenosis (degree of blockage) of the coronary arteries is initially important. The lower the stenosis, the better the heart can compensate for the restrictions. This improves the prognosis.
The stenosis is divided into four different degrees of severity: 0 to 40% means a low risk, with 40 to 70% there is an incipient restriction in physical activity. These limitations are more noticeable in 70 to 90% stenosis. A stenosis of more than 90% can be expected to cause symptoms even at rest.
Especially concomitant diseases also play a major role in the prognosis. The healthier an affected person is and the fewer other diseases there are, the more positive the prognosis looks. Among the particularly critical diseases are high blood pressure, a heart attack, stroke, peripheral arterial occlusive disease (blockage in the leg arteries) or an aortic aneurysm (bagging of the aorta).
But metabolic diseases are also important factors. For example, a balanced ratio of cholesterol is an important prognostic factor. The more HDL cholesterol and the less LDL cholesterol a person has, the more positive is the prognosis of CHD.
Last but not least, the biological prognosis factors should not be neglected. The younger a person is, the better his prognosis is. Statistically speaking, the prognosis is better for women than for men.
Genetics also play a role. People who do not have ancestors who suffered from heart disease have a better prognosis. It is assumed that there are no genetic patterns in these families that promote CHD or its rapid progression.
Those who want to take action themselves to achieve a positive prognosis for coronary heart disease should pay particular attention to a balanced diet. Here, the so-called Mediterranean diet is recommended, which includes a lot of vegetables and fish. Red meat in particular should be avoided if possible.
Even high-fat food has no positive effect. Furthermore, alcohol consumption and smoking should be avoided to improve the prognosis. An improvement of CHD can also be achieved through regular sport and exercise. Depending on the severity of the disease, however, the beginning of physical activity should be done under regular medical supervision.
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