Chapter 2

Review of Related Literature and Studies

This chapter contains relevant studies and researchers from various sources,

both from foreign and local books and journals that were gathered to serve as

background material for the research to enlighten the researchers on the topic of the

interest and provide insight on how to conduct the study. After a thought search was

made, the proponent had come out with the following literatures and studies.

State of the Art

The state of the art included literature from the books, journals and articles about

the topic. The ideas from the authors and expert are also cited to make the report more

credible. The materials that constitute the following come from the foreign and local

sources. This provides the readers information about the level of development of a

device, procedure, process, technique, or science reached at this time as a result of

modern methods related to study.

This presents the foreign and local literature related to the subject of the research

study being conducted. This also present related studies both foreign and local made to

the same.

Review of Related Literature

National Heart, Lung and Blood Institute (2009) stated that Coronary Artery

Disease was also called CAD, Coronary arteriosclerosis, Coronary atherosclerosis.

Coronary artery disease (CAD) is the most common type of heart disease. It is the

leading cause of death in the United States in both men and women.

CAD happens when the arteries that supply blood to heart muscle become

hardened and narrowed. This is due to the buildup of cholesterol and other material,

called plaque, on their inner walls. As the building grows, less blood can flow through

the arteries. As a result, the health muscle can’t get the blood or oxygen it needs. This

can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a

blood clot suddenly cuts off the heart’s blood supply, causing permanent heart damage.

Over time, CAD can also weaken the heart muscle and contribute to heart failure

and arrhythmias. Heart failure means the heart can’t pump blood well to the rest of the

body. Arrhythmias are changes in the normal beating rhythm of the heart.

Mary Ann George (2009) cited that Coronary artery disease usually results in

two conditions. One condition is called angina pectoris. Angina pectoris or angina is

pain in the chest that sometimes travels down the left arm. It is due to lack of oxygen

being carried to the heart from the arteries. The other resulting condition of CAD is

myocardial infarct or a heart attack. According to the Centers for Disease Control

(CDC), “Heart Disease Facts and Statistics”, heart attacks are leading cause of death

among adults.

The first symptoms include pain or discomfort. The pain or discomfort can be in

the chest, jaw, neck, back, arms or shoulders. Another symptoms is shortness of breath
or inability to take deep breath. Other symptoms may be weakness, dizziness, feeling

faint or lightheaded.

There was seven major health risks that can lead to coronary artery disease. The

first two factors relate directly to the blood and are high blood pressure and high

cholesterol levels. Other risk of CAD related to lifestyle. Examples of lifestyle risks are

cigarette smoking and lack of exercise or a sedentary lifestyle.

Cardiovascular Consultant, LLP (2006) enumerated different Cardiac Risk

Factors that reliably predict a person’s chances of developing atherosclerosis or

coronary artery disease. The greater the number or severity of Cardiac Risk Factors

that apply to you, the higher your chances are for cardiovascular disease. By identifying

these Cardiac Risk Factors and taking active steps to reduce their number or severity,

you help lower the risk of developing a cardiovascular condition. There are Risk Factors

for Coronary Artery Disease as modifiable risk factors and modifiable risk factors such

as Heredity, Gender, Age, Smoking, High Blood Cholesterol, High Blood, Pressure,

Obesity, Physical Inactivity, Stress and Behavior.

As asserted by, Delos Reyes (June 2005) Coronary Artery Disease is when the

coronary arteries, the blood vessels that bring oxygen to the heart become narrowed by

a build up of fatty layer called plaque in the walls of artery. The general terms for this

process are known as atherosclerosis. As a result of the blockage, blood reaching the

heart muscle is decreased. Chest pain, angina or shortness of breath may be

experienced. Many People are not aware they have coronary heart disease until tests

are performed.
 To decrease the risk of coronary artery disease and other heart conditions, first

eliminate saturated fat from your diet and control your calories – reducing cholesterol

level is very important. Exercise is also key, incorporate more physical activities such as

walking and taking the stairs into your daily routine. If you smoke, stop right away, and if

you have high blood pressure and diabetes, make sure follow your physician’s advice

and keep your condition under control. Work on maintaining a positive disposition evem

in the face of stressful situations. Remember a happy heart is a healthy one. As suggest

by (Cruz, 2005)

Anti-platelet therapy is indicated in addition to the other standard therapy for the

majority of patient who has a myocardial infarction (MI) to protect against majority of the

patient against recurrent vascular events to prevent restenosis in those who have

undergone a percutaneous coronary intervention at MI or other vascular event, as

stated by Dr. Steinhuld (2005)

Review of Related Studies

The National Nutrition and H Survey (2003 – 2004) that was conducted

through the organization, expertise and financial support of a group of 14 medical

universities. Association, DOH and food nutrition Research Institute of Department of

Science and Technology (FNRI – DOST). Collectively, three groups formed the Multi

Sectored Task force on N NHES 2003 – 2004. The survey determined the National

Prevalence of over 20 non communicable diseases and over low risk factors. This

report summarize result on 3 arteriosclerosis disease (angina, coronary heart disease,

stroke and peripheral vascular disease) 5 risk factors (hypertension, diabetes,

dyslipidemia and smoking).

Chavez, Michael S. (2004) stroked is one of the important application of N

NHES in formulation of appropriate intervention program of government and private

sectors such as lifestyle modify, nutrition labeling and healthy diet campaign among

others for prevention and equally vital N NHES. It is recommended that programs on

hypertension should focus more on attitude and practice modification.

Valdes M.D. (2003), the national nutrition council claims 900,000 Filipinos are

stricken with heart disease every year making it one countries leading health problems

today next to the various cancer. It is no longer just a concern of elderly. Heart ailment

are now prevalent in Filipinos starting as young as 30- as possible reflection that

Today’s fast paced, highly competitive environment is taking its toll on the younger

generation. Lifestyle disease are truly more rampant.

Shah and Williams Kraus, M.D (2003) denoted that tiny bits of molecular “trash”

found in circulating blood appear to be good prediction of cardiovascular disease and

untimely death, say researchers at Duke University Medical Center. The discovery

comes from the largest study of its kind for cardiovascular disease, and is the first to

identify specific metabolic profiles associated with coronary artery disease, heart attacks

and death among patients who have associated with coronary catheterization. This

study analyzed metabolites, the molecular debris left over the body breaks food down

into energy sources and building blocks of cells and tissues.

 Twenty seven studies were analyzed, including one 30,000 person- years of

observation. Overall, total mortality was not significantly affected by alteration in fat

intake but there was a significant 24% reduction in cardiovascular events. Low fat or

modified fat diets mat altered protection against cardiovascular events is not as strong

as is commonly assumed and there is little evidence that such diet reduce overall

mortality. Hooper et. Al. (2002)

A study presented at the Asia Pacific Scientific (2002) showed that

psychosocial stressors are more likely to trigger cardiac arrest in women, whereas

physical exertion is more a common trigger for men. Of the 20 women participating 40%

reported the presence of psychosocial stressors before cardiac arrest, compared with

16% men, conversely 40% of men and 5% of women reported physical exertion before

the cardiac event.

Filipino-Americans have a higher prevalence of hypertension and diabetes, and a

lower prevalence of smoking and obesity compared to Caucasians. FA ethnicity is an

independent predictor of higher mortality after catheterization laboratory intervention

and increased need for late reintervention. However, the rate of late MI and death in FA

was similar to C patients. These results suggest that FA patients, especially those

presenting with diabetes fir CAD treatment, need to be followed closely after

percutaneous intervention or cardiac surgery procedures as proposed by Colman

Ryan, MD, Richard Shaw, PhD et.Al (2000)

Synthesis of the Study

As according to National Heart, Lung and Blood Institute (2009) and Mary

Ann George (2009) Coronary Artery Disease Coronary artery disease (CAD) is the

most common type of heart disease. It is the leading cause of death in the United States

in both men and women and with older people. It happens when the arteries that supply

blood to heart muscle become hardened and narrowed. Most heart attacks happen

when a blood clot suddenly cuts off the heart’s blood supply, causing permanent heart

damage.

As cited Cardiovascular Consultant, LPP (2006) and Chavez, Michael S.

(2004) Cardiac Risk Factors are characteristics or traits that reliably predict a person;s

chances of developing artherosclerosis or coronary artery disease. There are Risk

Factors and lifestyle modify, nutrition labeling and healthy diet campaign among others

for prevention and equally vital. It is recommended that programs on hypertension

should focus more on attitude and practice modification which is under the modifiable

factors of coronary heart disease.

Shah and William Kraus, M.D. (2003) stated that the largest study for

cardiovascular disease, and is the first to identify specific metabolic profiles associated

with coronary artery disease, heart attacks and death among patients who have

undergone coronary catheterization. This study analyzed metabolites, the molecular

debris left over after the body breaks food down into energy sources and building blocks

of cells and tissues.

Gaps to be bridged by the Present Study

There was no study done about the cardiac risk factors and preventive measures

among patient with coronary heart disease in selected hospital in Laguna.