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In Korea, the number one cause of death is cancer, but in the West, cardiovascular disease has long been the highest cause. In Korea, where lifestyle diseases that increase the risk of cardiovascular disease, such as obesity, high blood pressure, diabetes, and hyperlipidemia, are gradually increasing, it is predicted that heart disease will soon become the number one cause of death. In Korea, the number of cardiovascular diseases caused by narrowing (angina) or blockage (myocardial infarction) of the so-called coronary arteries that supply blood to the heart muscle is increasing significantly. According to data from the Health Insurance Review and Assessment Service, the number of patients visiting hospitals with angina, which causes sudden pain or discomfort in the chest and difficulty breathing due to narrowing of the coronary arteries, exceeded 700,000 for the first time in 2021. If there is a problem with the blood vessels that supply blood to the heart muscle, the heart does not work properly and cannot send blood to all parts of the body. In particular, if blood is not supplied to important tissues such as the brain, it can lead to coma or death. Looking at recent trends in the occurrence of cardiovascular disease, the risk of developing it increases with age, with more men than women. To prevent angina and maintain cardiovascular health, regular exercise, appropriate weight management, smoking cessation, and stress management are essential. In particular, if you have risk factors for cardiovascular disease, you should manage it more thoroughly.
Women need to be careful after menopause
The number of angina patients increased by 25% in five years, from 645,000 in 2017 to 704,000 in 2021. The number of patients decreased slightly in 2020, which is believed to be due to a decrease in hospital visits due to the COVID-19 pandemic. In terms of gender, male patients accounted for 60% as of 2021. By age, more than 9 out of 10 angina patients were over 50 years old for both men and women. Among men, the share of patients with angina pectoris was 18.4% in their 50s, but the highest rate was recorded in those in their 60s at 34.1%. Those in their 70s also accounted for more than those in their 50s at 27.8%. Women had more patients at a later age than men. The share of patients in their 50s remained at 11.6%, but those in their 60s and 70s recorded 28.6% and 32.8%, respectively. There were more female patients than male patients in their 70s. Female hormones are cited as the reason why women develop angina later than men. Female hormones, which are secreted in large quantities before menopause, reduce the risk of developing cardiovascular disease. The share of cardiovascular disease in women is about 15% in those in their 40s and 50s, but it accounts for 82% in those in their 60s or older. Female hormones reduce the risk of developing cardiovascular disease until the age of 40, but this effect is presumed to disappear as secretion decreases significantly with menopause. This is why, in the case of women, lifestyle management to prevent angina is more necessary before and after menopause. There are three main reasons why angina, a narrowing of the coronary artery, or myocardial infarction, which is completely blocked, occurs. First, this is a case where arteriosclerosis appears in the coronary arteries. This is a case where blood vessels are chronically narrowed due to various risk factors that can cause arteries to narrow, such as high blood pressure or diabetes, for a long time. This type of angina is called ‘stable’ type. Although the cause and countermeasures can be identified to some extent, in angina caused by arteriosclerosis, not only the coronary arteries but also other blood vessels can be at risk. Second, it is ‘unstable’ angina, in which a blood clot forms and suddenly blocks part of the coronary artery. Third, it occurs due to blood flow disorders rather than structural problems in blood vessels, which is called ‘variant’ angina. Whatever the cause, blood flow in the coronary arteries is interrupted and blood is not supplied properly to the heart muscle, causing chest pain. The pain may spread to the left shoulder or arm. In particular, when you move your body, such as exercising, your heart muscle needs more blood, so symptoms may appear more often. The same goes for when you experience sudden stress. Unlike general pain, chest pain is often expressed as ‘pain as if it is being squeezed.’ Some people say, ‘I feel like my chest is full,’ ‘I can’t digest my food,’ or ‘my solar plexus or the tip of my chin hurts.’ Men tend to complain of the classic symptom of ‘squeezing pain’ more than women, and women often complain of anxiety, chest tightness, and difficulty breathing. Even if you are elderly or have diabetes, you may complain of symptoms other than chest pain, such as feeling like you cannot digest food, or may not show any symptoms at all.
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If you experience chest pain for more than 30 minutes, go to the hospital.
In most cases, chest pain from angina goes away within 5 minutes. If you experience chest pain due to insufficient blood supply to the heart muscle while exercising, you will stop exercising. When exercising, the amount of blood needed for the heart muscle returns to its original state and the pain is relieved. Pain from angina usually does not last longer than 30 minutes. Treatment of angina includes treatment of various lifestyle diseases that increase the risk of developing angina, as well as drug treatment that prevents blood clots from forming or dilates blood vessels. Additionally, you may need surgical treatment to insert a stent to widen narrowed blood vessels. But myocardial infarction is different. At this time, the coronary artery is completely blocked and blood is not supplied to the heart muscle, so chest pain continues. Even if you suffer from angina or not, if chest pain continues for more than 30 minutes, you should suspect the possibility of a myocardial infarction. In the case of myocardial infarction, treatment to open blocked blood vessels must be received within 6 hours. If this time is exceeded, not only the heart muscle but also other tissues such as the brain will be damaged, leading to death or falling into a coma, and even if one wakes up, severe aftereffects may remain. The first risk factor for heart disease is old age, and if a family member has experience with heart disease, the likelihood of developing heart disease increases. Representative bad habits include smoking and lack of exercise, and high blood pressure and diabetes also increase the risk of developing the disease. The same goes for obesity. To prevent heart disease, you should exercise regularly at least three times a week for more than 30 minutes at a time, and reduce high-calorie and salty foods to manage your weight. Eating fish and fresh fruit is recommended because it can improve cholesterol levels. It is said that one or two glasses of alcohol can help prevent heart disease, but recently there has been a lot of controversy over its effectiveness. Even small amounts of alcohol increase the risk of developing other diseases, so it should be moderated. Kim Yang-joong, a full-time evaluation member at the Health Insurance Review and Assessment Service, worked as a public health doctor in a rural village in Gyeongbuk after graduating from medical school. While he was a medical reporter for the Hankyoreh, he wrote articles for better medical services, and is now in charge of improving the quality of medical services at the Health Insurance Review and Assessment Service.
2023-10-14 01:00:28
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