Understanding Coronary Heart Disease

  • 13 Pages
  • Published On: 15-12-2023

Key Risk factors of CHD

CHD is developed while coronary arteries are narrowed down to an extent that blood flow to the heart is blocked. Sometimes a clot can create and obstruct the entire blood flow process and damage the coronary arteries that supply oxygen and blood to the heart. Coronary arteries there form a network of blood vessels on the surface of the heart that associates with oxygen. Once these arteries become narrow, blood might not flow correctly, while physical activity is in process and might cause the death of a person (Ageron, Benzidia, and Bourlakis, 2018). Every year, in the United States, common death issues are seen over 37000 times due to this particular disease. CHD is developed after an injury or damage is caused to the inner layer of the coronary artery and fatty deposits of plaque are built up at the injury site. This buildup is identified as atherosclerosis. CHD indulges in symptoms of the feeling around the chest such as aching, tightening, heaviness, sneezing, pressure, and burning. Health factors are associated with an appropriate linking of lifestyle choices and helping others with healthy lifestyles.

Heartburn, cramping, sweating, and nausea are other symptoms that lead to Angina developed by CHD. Some risk factors associated with this disease development are:

Developing high blood pressure and hypertension

High levels of bad cholesterol

Low levels of good cholesterol

Becoming a patient of obesity due to lack of physical activity

Having diagnosed with diabetes as the body is effectively removing sugar from body cells


Some factors that might lead to the risks of CHD are identified as having high levels of amino acids homocysteine. Higher levels of fibrinogen can cause this disease. This protein encourages the "clumping of platelets to form blood clots". Women going through menopause can also develop this disease along persons with a tendency of smoking are prone to inflammation and risk under development of CHD (Fernández-Sanlés et al. 2017). It is also identified that stress has been a great contributor to the risks of developing such disease. Stress influences the amount of blood clotting that circulates in a person's blood and causes discomfort. At times when people are stressed, nervous systems release extra hormones, mostly adrenaline. Now, blood pressure is increased that can injure the lining of the arteries. Once arteries are healed they become hardened leaving enough space for developing a plaque that causes a heart attack.

Features of CHD in terms of aetiology, diagnosis, and disease management

Cigarette smoking approximately doubles the risk of morbidity and mortality. CHD can also be developed through heredity if they are prone to unhealthy lifestyles and moderate low physical activities. In case of risk factors identified for CHD, there might be checking done of heart attacks and stroke. A blood test is mainly important to test cholesterol levels. Further tests are done to confirm CHD is associated with heart-related problems are associated with:


MRI scans



Coronary Angiography

CT scans

Cardiac catheterization and MRI methods are useful for detecting this particular type of disease. Uses of nuclear ventriculography along with performing CT scans have been helpful to help create an image of the heart chambers using tracers injected into blood vessels by doctors. Treatment of this primarily requires quitting smoking (Hajar, 2017). Some healthy lifestyle changes along with a healthful diet and regular exercise can reduce the chances of death by this disease. Medications that reduce the risk impact of CHD are included in terms of beta-blockers and they reduce the blood pressure and heart rate. Calcium channel blockers are identified to be indulged in widening coronary arteries and hence improving blood flow. This is identified to be reducing hypertension. A positive impact is seen to be used by “Angiotensin-converting enzyme inhibitors". These medications help to bring down the blood pressure and the progression of CHD is slowed down as well. To help widen the arteries and reduce the heart's demand for blood along with chest pain relief, a nitroglycerin patch and tablet are suggested. Commonly used mediation also includes Statins that reduce the blood pressure and stimulate the overall risks of dying from this disease CHD. However, people with cholesterol disorders such as hyperlipidemia are not effectively treated by this medicine.

Finally, there is one singular root left, that indulges in surgery which opens all blocked arteries in case medication is not working (Hussain et al. 2018). Laser surgery indulges in making small holes in the heart muscle that encourage a total formation of new vessels. In the case of angioplasty and stent placement, a catheter is inserted into the narrowed part of the artery and a deflated balloon is passed through the catheter in the area. With inflation of the balloon, fatty deposits are compressed against artery walls and ventilation is created. Moreover, in the case of coronary bypass surgery, a surgeon is going to create a graft that will bypass blocked arteries and help in the blood circulation process. This graft can be taken from any part of the body.

Linking concepts and definitions of health with the progression of chronic disease

WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity ”. Good health is identified as a positive concept that emphasizes social and personal resources as well as physical capacities. A person who is in good health provides successful options of leading life with appropriate meaning. On the other hand, health inequities affect each individual (Khan et al. 2018). Bad health denotes a lack of potential and energy in working and participating in physical activities along with living life on medications. Chronic diseases are identified as the ones that persist over quite a long time and cause an immense threat to life. CHD comes with different types such as obstructive, nonobstructive, and coronary microvascular disease. All this leads toward living a healthy lifestyle and being physically active. The solution is quitting smoking and helping coronary vessels to function properly without any blockage and clot.

i) Impact of international, economic environmental and political issues on the diagnosis of CHD

Health is associated with the development of good relations with family, workplace, and friends. Health factors are associated with an appropriate linking of lifestyle choices and helping others with healthy lifestyles. Chosen developed country is Australia and there are several impacts of international, economical, and environmental components seen.

Diagnosis: Globalization and lower perception of health is associated with the international, environmental aspects of Australia in the development of this specific threat. People in Australia are usually diagnosed with high blood pressure issues. This is caused by an unhealthy lifestyle and lack of physical activity (Mikkonen et al. 2019). High cholesterol and diabetes are leading towards Australia-based health issues and increasing the probability of CHD development. In countries like Australia, access to healthcare policies is easy and they have developed hospitals and medical practitioners available in hand. Government-sponsored health plans are there that helps in the improvement of medication. This is expected to help people with this disease. Australia however, has a mixed healthcare working system. This system accompanies the continual cost of improving non-health industries and specifying the types of government budgets. Here, approximately 30% of expenditure derived from the private sector. The cost of technology, aging population are some potential barriers identified as political issues indulged within the healthcare sector (Mousa, and Othman, 2020). Hence, all the factors prevent the diagnosis from being inexpensive. "Australian government to seek market-based mechanisms in addressing the larger budgetary pressures on successive governments that includes medical services, GP surcharges as well”. The issue can lessen the number of treatments and people with lower income will not be able to afford such treatments.

Prevalence: An estimation of 580000 Australians aged 18 and are diagnosed with CHD in Australia. There are over 2.8% of the population that suffers from CHD identified by a National health survey. Prevalence refers to the number of cases of a particular disease that is present in a particular population at a time. The issue of drinking and smoking is identified as a social one that impacts largely on this disease increase. 41.9% of Australians are living with high cholesterol and this is identified as a factor behind the increase of prevalence (Pothineni et al. 2017). Australians are by nature consuming lesser vegetables and this causes high cholesterol. "The prevalence of CHD increases rapidly with age, affecting around 1 in 7 adults (14%) aged 75 and over". In the case of chronic disease management, NHS has failed to show its competencies and the difference in the regulation of health between Australian and Torres island people is becoming an increased cause of death buy CHD due to lack of treatment in them.

Disease Management: Economic issues are found out in the aboriginal people of Australia. “Australia spends the lowest amount of money on healthcare as a percentage (9.4%) of its gross domestic product (GDP) while its annual growth rate of healthcare spending (2.42%) was the highest during the period 2009–2013”. Hence, it becomes a political issue to hold back disease management and limit it.

Aetiology and assessment of the prevalence of CHD in a developing country

A chosen developing country, in this case, is India and it is Asia's one of the most populated countries with a rate of 10.19% to 13.91%. In rural areas, more than the levels of rates increased in urban areas. High indulgence of this disease is associated with a particular socio-economic group.

Diagnosis: India is identified as a poor country and there is a diverse lifestyle. People are found to be having a low quality of life along with drinking and smoking habits that develop such diseases. Due to staff shortage in covid situations and economically unstable actions taken in the case of aboriginal people the disease is not managed properly. There are public-private mixtures of structures identified within a medical sector, which leaves an impact of inequity in gaining government-delivered health care services (Walpole et al. 2017). However, in India, health care policies are not easily accessible. Lack of modern quality care hospitals, lack of doctors with high knowledge in public health care is becoming an obstacle to diagnosis. Basic insurance policies are lagged in the case of rural people and they don't even qualify under the income group to afford those media claims. Private healthcare in India is quite a premium and expensive affair as a large section of society can’t afford it. Distance to healthcare and poverty matters in fighting chronic diseases.

Prevalence: Lack of beds in hospitals for serving emergency patients is seen in many urban and rural areas. India is spending only 1% of health over GDP, which is the lowest in the world. Large and persistent health gaps among the states have been identified as a reason behind the falling health care system. Mortality due to CHD is seen to be the highest as a proportion of standardization is increased with strokes of mortality. According to the report, “about 79.5% of those in rural areas and 83.7% in urban areas paid for medical expenses from their savings” (Zhan et al. 2017). Hence, it shows the difference in healthcare achievement pretty well between a developed and developing country. In comparison to prevalence, developing countries are at more risk of increasing disease.

Disease management: Not only does the poor funding, but a lack of awareness also snatching away precious lives. CHD can be prevented by making small lifestyle changes. In both developed and developing countries, it is observed that people are behaving unconsciously with their health and they are not interested in the development of a healthy regime. The developed country is ahead of the developing country in terms of disease management. As compared to the developed and developing country, a patient in Australia will get better healthcare in case of an emergency is raised (Zhan et al. 2017). Budgetary allocation in India along with staffing systems is identified as one of the main reasons for failure in effective disease management. Moreover, there is no prevention campaign taken on this disease which leads to more deaths as in the time of emergence the disease management will not be done appropriately.

Strengths and limitations of Global strategies stopping CHD

Underfunded health care is causing the prevalence of this disease to be increased in countries. WHO has identified one strategy that stops CHD and this is identified as the model environmental factor management. In terms of global data, the estimated cases are 59.7 million in 2019 that is doubling the number of cases identified in the year 1990. The global burden of cardiovascular disease will indulge in maintaining a healthy weight and avoiding tobacco use. The total number of deaths is identified as 14.1% in every quarter by this disease. WHO is globally working on disease prevention and morbidity management. The goals addressed by

WHO are:

Effective reduction in CHD risk factors and determinants

Monitoring the trends of CHD and risk factors

Development of cost-effective and equitable health care innovations for the management of CHD

Development of feasible surveillance methods to assess the patterns and trends of CHD

Development an inter-country and effective global network partnership for concentrated global actions

Plan of goals achievement:

Starting the work at developing countries

Finding put social and economical consequences and approaching respected government to deal with them

Developing community-based programs in spreading the awareness of records and technical alignment of components

Setting up programs for lessening tobacco consumption and indulging in risk factor

Involved person:

In this case, WHO is involving the governments of different countries and the health ministry and volunteers. There should be an intense discussion done on the effectiveness of interventions within global citizenship (Pothineni et al. 2017). Healthcare accessibility and interventions are required to be revisited for developing a set of rules that helps in taking care of such patients effectively. Stakeholders are private nursing homes that are participating in this program.


Effective outcomes will include a complete intervention of records management and quality delivery of healthcare rules in defeating the disease CHD. A lessened percentage of this disease is also expected to be seen.

Strength and limitation:

This strategy undertaken is quite generalized and this will require a focus on achieving real and authentic results. This strategy could do well in terms of setting up programs and spreading awareness against the disease present. This certain improvement in people’s way of thinking and quitting smoking can be effective in management because such diseases require prevention more than medication. This strategic idea will have limitations due to the covid situations. There is a lack of staff in maximum countries as most of them are serving in covid care units. Moreover, health care staff cannot be gathered together due to the restriction of pandemic rules. Hence, the entire process has to be online that requires planning and tremendous investment. Resource identification and involvement are also part of this process (Walpole et al. 2017). Moreover, one global strategy is not applicable for both developed and developing countries. They have their own set of issues to overcome as there are different healthcare policies indulged within availability. All rules and regulations are not the same in different countries and it would be foolish to apply them. First of all, it is required to generate a healthcare policies forum that will see whether all countries are following the healthcare norms or not.

Reflective journal

In this case, I am using Kolb's model to discuss progression and learning. The model has four distinct stages and this includes concrete experience management along with reflective observation on experience. It derives abstract contextualization on how the responsibilities of global citizenship are occurring. Moreover, active experimentation has been incorporated inside the learning cycle.

1. Concrete experience

Healthcare systems need to be improved as there is a global crisis occurring in terms of healthcare policies equality and inequality. The concerned attributes are required to be modeled and there should be an appropriate intelligent system engaged. I found out that people are unaware of the health care facts. In developing countries, there is not much access found out to help a person find the right treatment for himself. There is a lack of funding observed as I searched the web and found that many people are not receiving good treatment due to a lack of money (Walpole et al. 2017). On the other hand, lack of awareness is causing them a disease like CHD. Awareness is something that I have come across at this stage. There are also skills required for operating in a multicultural context and I find this helpful across boundaries. In a global context, working with the attributes of knowledge is important. I feel privileged to have easy and quick access to healthcare goals.

2. Reflective observation

My progression and learning have been impacted by an identification of action that has been taken by WHO. This organization is almost responsible for all the health-related concerns faced by people. There are significant steps taken by this organization that I find quite impressive. I would like to add to the ideas of the organizational head to ask maximum people to contribute to the funds that can help save many lives in developing countries. Addressing the global burden of CHD has declared the progression of lower morals of countries while it comes to healthcare policy management by countries.

3. Abstract conceptualization

I find this quite difficult to answer the question of global citizenship. In this diverse world, a global citizen is identified as a person who is aware of and understands the wider world's needs. They are supposed to be taking active roles in the community and working towards making the planet more peaceful and sustainable (Fernández-Sanlés et al. 2017). Global citizenship often talks about people like the younger poeple and me to understand world events.

4. Active experimentation

I have participated in the search process of active cases of CHD over the internet. These need to be managed through effective optimization of records and assign responsibility towards the advocating of greater international cooperation. I believe in self-study and the organization of meaningful operations for helping the needful. It becomes a global responsibility to raise voice for the healthcare claims of the needful in today's world along with a spreading of awareness against this disease. “Global Citizenship nurtures personal respect and respect for others, wherever they live” and I have perceived these values.

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Take a deeper dive into Understanding Complexity in Practice with our additional resources.



Ageron, B., Benzidia, S. and Bourlakis, M., 2018, January. Healthcare logistics and supply chain–issues and future challenges. In Supply Chain Forum: An International Journal (Vol. 19, No. 1, pp. 1-3). Taylor & Francis.

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Hajar, R., 2017. Risk factors for coronary artery disease: historical perspectives. Heart views: the official journal of the Gulf Heart Association, 18(3), p.109.

Hussain, M., Ajmal, M.M., Gunasekaran, A. and Khan, M., 2018. Exploration of social sustainability in healthcare supply chain. Journal of Cleaner Production, 203, pp.977-989.

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Pothineni, N.V.K., Subramany, S., Kuriakose, K., Shirazi, L.F., Romeo, F., Shah, P.K. and Mehta, J.L., 2017. Infections, atherosclerosis, and coronary heart disease. European heart journal, 38(43), pp.3195-3201.

Walpole, S.C., Vyas, A., Maxwell, J., Canny, B.J., Woollard, R., Wellbery, C., Leedham-Green, K.E., Musaeus, P., Tufail-Hanif, U., Pavão Patrício, K. and Rother, H.A., 2017. Building an environmentally accountable medical curriculum through international collaboration. Medical teacher, 39(10), pp.1040-1050.

Zhan, Y., Karlsson, I.K., Karlsson, R., Tillander, A., Reynolds, C.A., Pedersen, N.L. and Hägg, S., 2017. Exploring the causal pathway from telomere length to coronary heart disease: a network Mendelian randomization study. Circulation research, 121(3), pp.214-219.

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