Coronary Heart Disease

Epidemiologic Reviews Copyright © 2000 by The Johns Hopkins University School of Hygiene and truth Health All rights reserved Vol. 22, No. 1 Printed in U.S.A. DISEASES AND wellness PROBLEMS Coronary Heart Disease Epidemiology in the twenty-first Century Herman A. Tyroler INTRODUCTION cognition of the determinants, distribution, and sequelae of coronary heart ailment (CHD) in populations of the worlds demonstrable nations is extensive, is maturation rapidly, and extends from the molecular level of unmarried persons to total societies. Lifestyle changes as well as world health and medical perplexity advances in the prevention and sermon of CHD from the 1950s to the 1980s were accompanied by a 50 percent dec air in CHD mortality rate in countries such as the United States (1). CHD thus far be the leading cause of death in developed nations and is predicted to touch that status worldwide within decades (2). The clinical manifestations, morbidity, and mortal ity of CHD ar end-stage events triggered after decades of progression of asymptomatic, subclinical coronary atherosclerosis. The determinants of some(prenominal) the subclinical and clinical stages of the disease are numerous and varied, including put on the line factors for individual persons, group characteristics of entire populations, and environmental exposures. Broad, multilevel categories of CHD determinants and their interrelations are illustrated in figure 1. In this conceptualization, the determinants are categorized as follows: inherited genes and culture; biomedical, lifestyle, and psychosocial risk factors at the individual level; social, political, and economic factors at the group and aggregate levels; and social, medical care, physicochemical, and biological exposures at the environmental level. Each interactively influences population levels of and trends in CHD solely over time. CHD susceptibility is transmitted intergenerationally, is conditioned environme ntally, evolves and is manifest clinically o! ver the time scale of...If you want to get a in full essay, order it on our website: BestEssayCheap.com

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