Coronary artery disease

Ischemic heart disease (IHD) is the commonest cause of death worldwide. The primary pathological process that leads to IHD is atherosclerosis, an inflammatory disease of the arteries associated with lipid deposition and metabolic alterations due to multiple risk factors. More than 70% of at-risk individuals have multiple risk factors for IHD, and only 2-7% of the general population has no risk factors. Coronary risk factors include diabetes, hypertension, socioeconomic factors, lifestyle factors and family history. Emotional stress or acute physical exertion may also trigger coronary events. Acute coronary syndrome is often the first clinical manifestation of IHD. Mortality due to IHD increases with advancing age, and death rates are higher among males compared to females. There is a significant regional variation in IHD related mortality both within and between countries.