Keep quit smoking!

Cigarette smoking is a chronic and relapsing addictive trait harmful to public health. According to statistics from the World Health Organization (WHO 2013), smoking kills approximately six million people worldwide each year, with more than five million of those deaths resulting from direct cigarette smoking and more than 600,000 from secondary or passive smoke exposure. The number of smokingrelated deaths is expected to increase to more than eight million annually by 2030 if the current pattern of smoking continues unabated (Eriksen et al. 2013). 

The main deadly effect of smoking is a variety of severe diseases, such as cancers and psychiatric disorders. More than 25% of all cancer deaths can be attributed to smoking, especially those from lung cancer, for which about 80% are caused by tobacco smoking (CDC 2010). Moreover, multiple lines of evidence show that a large amount of the morbidity and premature deaths in schizophrenia patients can be attributed to smoking-related diseases (Brady et al. 1993; Crump et al. 2013). Extremely high healthcare expenditures are associated with smoking-related illnesses worldwide. It is estimated that globally, more than US$500 billion in economic damage is caused annually by tobacco smoking. In the United States, the total of public and private healthcare costs related to tobacco smoking were estimated to be about US$170 billion each year (Ekpu and Brown 2015), and in the United Kingdom, the direct expenditures of the British National Health Service (NHS) attributable to smoking have been estimated at between £2.7 billion and £5.2 billion, about 5% of the total annual NHS budget (Allender et al. 2009; Callum et al. 2011; Ekpu and Brown 2015). 

Furthermore, in some developing countries, the economic damage from smoking has substantially increased in the past decade. For example, in China, about USD 6.2 billion was spent for direct smoking-attributed healthcare costs and USD 22.7 billion for indirect economic costs in 2008, the direct and indirect costs were rose by 154% and 376%, respectively, compared with the costs in 2000 (Yang et al. 2011). Prevention of smoking initiation and promotion of smoking cessation, coupled with regulations and legislation, remain to be effective ways to control tobacco use (Koplan and Eriksen 2015; Yang et al. 2015; Zhu et al. 2012). Although abundant benefits accrue from smoking cessation, the cessation rate is still low in many countries. 

A variety of factors have been proposed as causes of the difficulties of obtaining and maintaining smoking cessation, including psychological, genetic, pharmacologic, and social factors (Li and Burmeister 2009). One of the most important factors is nicotine dependence (ND), which is the main contributor to the persistence of smoking (Gunby 1988). Growing evidence (Baker et al. 2007; Branstetter et al. 2015; Branstetter and Muscat 2013; Mercincavage et al. 2013) has shown that time to the first cigarette of the day, one of the best indicators of ND (Fagerstrom 2003), is associated with the likelihood of smoking relapse and with withdrawal symptoms, nicotine intake, tobacco-related carcinogen exposure, and cancer risk. Furthermore, many twin and family studies have shown consistently that the risk of ND is heritable, with an average heritability of 0.59 in male and 0.46 in female smokers (see Chap. 3 for details).

 In light of the severe impact of smoking on the individual and society, many studies have examined the epidemic pattern of smoking and its associated diseases. To help control the trend to more smoking, a battery of effective systemic and scientific measures should be implemented with the hope of assisting in the implementation of current cessation methods and accommodating the specific conditions of particular countries in order to reduce the demand for tobacco. In the following sections, we briefly review the prevalence of smoking in the world and summarize the harmful influence of smoking on people’s health. 

 The Global Prevalence of Smoking There are about one billion cigarette smokers worldwide (Mackay et  al. 2013), amounting to approximately 30% of men and 7% of women (Gowing et al. 2015). Smoking rates differ widely between populations across the world (Fig.  1.1). A series of factors impact the prevalence of smoking and trends in prevalence, such as individuals’ educational level, national economic development, and tobacco control policies. In developed countries, such as the United States and the United Kingdom,  the prevalence of smoking increased sharply in the earlier twentieth century, partly as a result of the low prices of cigarettes. The prevalence of smoking has been estimated to have been 37% among men and 25% among women. However, because of better public awareness of smoking as a hazard and the implementation of stringent legislation against smoking in the Western European countries and the United States, smoking prevalence has been greatly reduced. From 1990 to 2009, tobacco consumption in Western Europe declined by about 26% (Brathwaite et al. 2015). In the United States, the proportion of smokers declined from 20.9% in 2005 to 15.1% in 2015 (Jamal 2016). In contrast, the prevalence of smoking has increased remarkably in low- and middle-income countries (Benowitz 2008). 

During the years 1990 to 2009, tobacco consumption increased by 57% in Africa and some Middle Eastern countries (Brathwaite et al. 2015). Throughout the world, more than 80% of smokers now reside in poor countries, especially in Eastern and Southeastern Asia and Africa (Stewart 2014). For example, in China, cigarette consumption in 2016 is approximately twofold higher than it was in 1998 (Gilmore et al. 2015). As the largest user of tobacco worldwide, the smoking rate in China remains high. The nation consumes more than 30% of the world’s cigarettes, and two-thirds of men smoke (Chen et al. 2015; Li et al. 2011; Yang 2014). In China, many smokers do not fully understand the damaging consequences of smoking, and social conventions have linked smoking with a positive image (Yang et al. 2015; Zhang et al. 2011), which plays an important role in preventing smoking cessation. The prevalence of smoking in men and women differs greatly in different regions of the world (Gowing et al. 2015). 

Globally, smoking prevalence in men is more than four times that in women (West 2017). In developing countries, the prevalence of smoking in men is much higher than that in women. For example, there was an estimated prevalence ratio of 22 to 1 for men to women in China (Li et al. 2011). In Eastern, Southeastern, and Western Asia, the prevalence is estimated to be approximately 40% in men, whereas only approximately 4% of women smoke (West 2017). One reason for this phenomenon is that female smoking is considered socially unacceptable (Giovino et al. 2012; Jung-Choi et al. 2012). The difference is much less in most developed countries (West 2017). For example, the prevalence of tobacco smoking among women in the United States is estimated to be 13.6%, which is close to the prevalence of 16.7% among men (Jamal 2016). Moreover, the total number of male smokers in the leading three tobacco-using countries, e.g., China, India, and Indonesia, accounted for 51.4% of the world’s male smokers in 2015, whereas the United States, China, and India were the leading three countries in the total number of female smokers, yet they accounted for only 27.3% of the world’s female smokers (Ali and Hay 2017), suggesting that the epidemic of smoking is less geographically concentrated for women than for men.

The Stages of Change

 You can't make a change until you are ready to change. 
Sometimes, the ''getting ready" takes a long time. 
Let's look at this process of changing. 
A year after you started smoking, you probably didn't think you needed to quit. 
Young smokers often say:
 "Cancer and emphysema are a long way off." 
"Most of my friends smoke."
 "Smoking makes me feel older and more mature."
 "My parents smoke and they don't care if I do."
 "My parents don't smoke and they don't want me to."
"Smoking is a cheap buzz." 
"Who cares?" 
Were some of these your reasons for smoking when you were young? 
As the years passed and you matured, quitting became more important. 
You became more responsible. You didn't have the endurance you once had. Many of your friends quit smoking. Your doctor advised you to quit. And gradually, you began to consider quitting smoking. Consider, yes; quit, no. 
You were thinking about it, wondering about it, maybe even asking for information about itbut you weren't ready to quit just yet.
 That first stage, where smokers refuse to quit or don't see any need to quit, is called the "Precontemplation Stage." 
The second stage, where they think about quitting but aren't quite ready, is called the "Contemplation Stage."
 About 40 percent of all smokers are in each of these two stages at any time. 
The other 20 percent have decided to quit; they are in the "Preparation Stage." 
Which stage are you in today? If you are in the Precontemplation Stage but know you need to quit "some day," Quit and Stay Quit or the first Clean and Free workbook ("Get Ready") can help you make progress. 
Few people in Precontemplation will read this far, so you probably aren't in that stage. People in Contemplation are ambivalent; they want to quit, and they don't want to quit. They know they'd be better off if they quit, but they don't feel ready. 
They anticipate failing and expect to suffer, so they hesitate. They want to be convinced (sort of), but they also wish people would leave them alone.
Are you in the Contemplation Stage? 
If you are barely past Precontemplation, Quit and Stay Quit or the second Clean and Free workbook ("Get Set") will help you make faster progress. 
If you are further along than that, the information in the next section, "Getting Ready to Get Ready," will help you move ahead. People in the Preparation Stage have resolved their ambivalence about quitting. 
They are ready to quit; they want suggestions and solutions to their problems. They're ready to go. Are you in the Preparation Stage? 
If you are, you can find helpful information in Quit and Stay Quit, in the third Clean and Free workbook ("Go"), or in the Countdown to Quit Cards. 
Getting Ready to Get Ready People have probably been telling you that you need to quit smoking for some time. 
In your life, how many different people have advised you or told you to quit smoking?
 Most smokers say "hundreds," and name their relatives and family members, their friends, their co-workers, their doctor, and the surgeon general. 
Who are some of the people that come to your mind? 
Over the years, each of these people (and many others) have given you their reasons for quitting smoking. These reasons may or may not have also been your reasons. 
You might quit for someone else's reasons for a little while, but the chances are good that you would start smoking again if they were not your reasons too. 
Why did those people want you to quit smoking? 
Were any of these reasons your reasons to quit smoking too? 
The problem is that since you have heard these reasons over and over again, you have begun to think that they are your reasons.
 Some of them make perfect sense; we call these reasons logical reasonssuch as "To avoid getting lung cancer" or "To save money." 
These are excellent reasons to quit smoking, but you have known for years that smoking causes lung cancer and that it costs you money. These logical reasons were not enough to get you to quit smoking, because they were not personal reasons. 
You will only be able to quit smoking and recover from your dependence on nicotine and tobacco when you are doing it for your own, very personal reasons. Take a few moments to answer these questions: 
1. How would you be better off if you quit smoking?
 2. If you quit smoking, you might live an extra ten years; what would you want to do with those years? 3. What sort of impression do you want to make on the people you love? 
4.What kind of person are you? 5. What kind of person do you want to become?
5.  What would you be able to accomplish as a nonsmoker that you cannot accomplish as a smoker? 
6. Would you like yourself better if you could quit smoking? 
7. Besides quitting smoking, what other changes do you want to make in your life? 
8. Are you willing to ask yourself these questions?
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Lung cancer and air pollution

Air pollution episodes that occurred in the middle of the twentieth century were responsible for deaths that ranged from a few excess deaths to several thousand, depending to a large extent on the size of the population exposed. In the most well-known of these episodes, the London Fog of 1952, an estimated 3,500 excess deaths occurred over a period of a few days, with possibly several thousand more in the ensuing weeks. 

While the pollution mix in London during this fog was complex, it is likely that particulate air pollution was largely responsible for the excess deaths. These episodes demonstrate that exposure to urban air pollution can, in extreme cases, cause death. Epidemiological Studies Several studies have confirmed associations between increased PM concentrations and increased cardiopulmonary mortality. They found that for each 10 mg/m3 increase in PM10, mortality increased by a fraction of a percent (2, 3, 4, 5, 6, 7, 8, 9). In spite of the small effect of PM increases, the public health impact could be large if seen across broad populations. Thus, increasing ambient PM concentrations represent a fairly significant risk in terms of mortality. Similar studies have established other health dangers that are associated with increased PM, including increased for lung cancer and heart disease. The American Cancer Society Air Pollution Study was initiated by C. Arden Pope and colleagues based upon a cohort of 1.2 million individuals enrolled in the fall of 1982.1 A subgroup of 552,138 adults lived in 151 United States metropolitan areas that could be matched to air pollution data collected under the auspices of the Environmental Protection Agency (EPA).

 The relationships of sulfate and particulate matter air pollution to all-cause, lung cancer, and cardiopulmonary mortality were examined in this subgroup using multivariate analysis controlling for smoking, education, and other risk factors up to 1989. Deaths due to air pollution were 15%–17% more prevalent in the most polluted communities as compared to the least polluted ones. In a follow-up of this cohort until 1998, when 22.5% of the cohort died, PM2.5 data were collected and estimated with mortality risk ratios estimated by a Cox proportional hazard regression model. Significant mortality associations were found for each 10 mg/m3 increase in PM2.5 for ischemic heart disease, dysrhythmias, heart failure, and cardiac arrest, and in nonsmokers, pneumonia and influenza.2 Each 10 mg/m3 elevation in fine particulate air pollution was associated with approximately a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer mortality, respectively3 (see Figure 2.3). Since PM has fallen over the past two decades, Pope and colleagues compiled data on life expectancy, socioeconomic status, and demographic characteristics for fifty-one U.S. metropolitan areas with matching data on fine particulate air pollution for the late 1970s and early 1980s and the late 1990s and early 2000s.4 They found that a decrease of 10 mg/m3 in PM2.5 was associated with an estimated increase in mean (SE) life expectancy of 0.610.20 year (p ¼ 0.004). Reductions in air pollution accounted for as much as 15% of the overall increase in life expectancy in the study areas.

At the same time the American Cancer Society cohort was being assembled, investigators at the Harvard School of Public Health established a longitudinal study on the health effects of air pollution in six cities. The Harvard Six Cities Study was a sixteen-year prospective cohort study of 8,111 adults living in the northeastern and midwestern United States beginning in the 1970s. The study reported that PM2.5 was positively associated with overall mortality, cardiopulmonary causes, and lung cancer. 

Lung cancer is the most common cause of cancer death in the United States, with more than 200,000 new cases and 160,000 annual deaths. It is estimated that lung cancer causes about 1.2 million deaths annually worldwide. Approximately 90% of lung cancer cases are due to cigarette smoking in populations with prolonged cigarette use. The strongest determinant of lung cancer in smokers is duration of smoking; risk also increases with the number of cigarettes smoked. Smoking causes lung cancer in both men and women. 

Cessation of smoking at any age avoids the further increase in risk of lung cancer caused by continued smoking. However, the risk of ex-smokers for lung cancer remains elevated for years after cessation, compared to the risk of never smokers. The impact of smoking on lung cancer in the twentieth century in the United States can be seen in Figure 5.5. Cigarette smoking was rare in the early part of the twentieth century, as was lung cancer. Smoking increased due to mass production of cigarettes, increased advertising, and pervasive use of cigarettes by military personnel during World War I. During the twentieth century, smoking rose first among males and then with a twenty- to thirty-year delay among females. Cigarette smoking peaked in the 1950s and 1960s and began to decline after the wave of studies documenting its risks appeared and the publication of the first Surgeon General’s report in 1964. Mortality due to lung cancer in men can be seen to follow the curve for smoking prevalence by about thirty years, beginning to decrease in the mid-1990s. Lung cancer became the most common cause of cancer death in U.S. women, surpassing breast cancer in 1988.

The range of total carcinogen exposure in smokers is approximately 1.4–2.2 mg/cigarette, which can be compared to the current sales-weighted average nicotine delivery of about 0.8 mg/cigarette. Some of the strongest carcinogens, such as polycyclic aromatic hydrocarbons (PAH), N-nitrosamines, and aromatic amines, occur in the lowest amounts, while some of the weaker carcinogens (such as acetaldehyde and isoprene) occur in the highest amounts. PAH are incomplete combustion products that were first identified as carcinogenic constituents of coal tar.49 They occur as mixtures in tars, soots, broiled foods, automobile engine exhaust and other materials generated by incomplete combustion. N-nitrosamines are a large class of carcinogens with demonstrated activity in at least thirty animal species. Considerable evidence favors PAH and N-nitrosamines as major etiological factors in lung cancer. PAH are strong, locally acting carcinogens, and tobacco smoke fractions enriched in these compounds are carcinogenic. PAH-DNA adducts have been detected in the human lung, and mutations in the TP53 tumor suppressor gene isolated from lung tumors are similar to those produced in vitro by PAH diol epoxide metabolites and in cell culture by Benzo(a)pyrene.  Persistent DNA adducts can cause miscoding during replication when DNA polymerase enzymes process them incorrectly.52 There is considerable specificity in the relationship between specific DNA adducts caused by cigarette smoke carcinogens and the types of mutations which they cause. G to T and G to A mutations are frequently observed.53 Mutations have been frequently observed in the K-ras oncogene in smokers with lung cancer and in the TP53 tumor suppressor gene in a variety of cigarette smoke-induced cancers. The cancer-causing role of mutations in these genes has been firmly established in animal studies. The K-ras and TP53 mutations observed in lung cancer in smokers appear to reflect DNA damage by metabolically activated PAH, although acrolein can also cause p53 adducts in lung cancer hot spots, and there is far more acrolein in cigarette smoke than PAH. In addition, numerous cytogenetic changes have been observed in lung cancer, and chromosome damage throughout the aerodigestive tract is strongly linked with cigarette smoke exposure. Gene mutations can cause loss of normal cellular growth control functions via a complex process of signal transduction pathways, ultimately resulting in cellular proliferation and cancer. The most commonly mutated gene found in human cancers is the TP53 tumor suppresser gene.51 Among the tobacco related cancers, the most extensive database exists for lung cancer, in which mutations in the TP53 gene have been detected in approximately 70% of tumors. In smokers, the mutations are focused in the central part of the gene, which is the DNA binding region that is essential for its function. Smokers have mutations in hot spots of this region that are a characteristic signature, for example, codons 157, 176, 248, 249, 273. Exposure of lung fibroblasts or epithelial cells in vitro to activated PAH results in DNA adducts on the same codons.

Smoking Cessation

 Mark Twain stated, ‘‘Giving up smoking is easy. I’ve done it a hundred times.’’ In 2008 it was noted that social networks amplify smoking cessation, with one’s spouse, sibling, friend, or coworker, in descending order, influencing a smoker’s possibility of smoking cessation, and that smokers over time are increasingly marginalized socially.  The Lung Health Study was a randomized clinical trial of smoking cessation and inhaled bronchodilator (ipratropium) therapy in smokers 35 to 60 years of age who were in good health but had evidence of mild to moderate airway obstruction.  They enrolled 5,887 smokers at ten clinical centers, with an intervention group of twelve smoking cessation sessions and nicotine gum; the intervention group had smaller declines in FEV1 than the control group. At five years, 21.7% of special intervention participants had stopped smoking since study entry, compared with 5.4% of usual care participants. At 14.5 years’ follow-up, there was a lower mortality in the intervention group, with the hazard ratio for usual care 1.18 (95% CI 1.02–1.37), and differences in death rates were greatest for lung cancer and cardiovascular disease. Tobacco cessation programs have difficulty exceeding sustained quit rates above 15%, which is the typical success rate of those attempting to stop ‘‘cold turkey.’’ Treatment of tobacco dependence with nicotine gum and patches may double this rate.   Nicotine is the addictive substance in tobacco, and cigarette manufacturers are very sophisticated at mixing tobacco blends to achieve maximal nicotine delivery via the cigarette. Nicotine has a rather short half-life of about 20 minutes, requiring another cigarette to be smoked to keep blood levels of nicotine at sufficient levels to prevent withdrawal symptoms. Smoking provides an immediate delivery of nicotine to the blood and to the brain, where nicotinic acetylcholine receptors are critical for the development of dependence. The highest levels of these receptors, the a4b2, are in the reward center of the brain. A treatment strategy is to have a competitor for this receptor that doesn’t or only partially activates it; varenicline, a plant alkaloid cytisine, is such a drug.  This drug had a higher sustained quit rate in comparative clinical trials with bupropion or nicotine-replacement therapy.

SO2 Health Effects 

In several studies, SO2 exposure has been linked with increased mortality due to all causes and to lung cancer specifically. For example, the study of the American Cancer Society cohort that reported the link between mortality and criteria air pollutants, the relative risk (RR) of all-cause mortality from sulfate exposure was 1.25 (95% CI [confidence interval] 1.13–1.37) and was higher at the county level with an RR of 1.5.2 The National Mortality and Morbidity Air Pollution Study (NMMAPS) also analyzed SO2 and found no significant associations with total mortality.3 An international study of pulp and paper workers with 40,704 SO2-exposed workers found a reduced overall standardized mortality ratio of 0.89 (95% CI 0.87–0.96) but a marginally increased rate of 1.08 for lung cancer (95% CI 0.98–1.18).4 After adjustment for occupational co-exposures, the lung cancer risk was increased compared with unexposed workers (rate ratio ¼ 1.49; 95% CI 1.14–1.96). There was a suggestion of a positive relationship between weighted cumulative SO2 exposure and lung cancer mortality. These confirm that SO2 exposure increases mortality. SO2 is a respiratory irritant with exposures at 10 ppm, causing cough, dyspnea, irritation of the eyes and throat, and reflex bronchial constriction. In July 1990, Hong Kong introduced a requirement that all power plants and road vehicles had to use fuel oil with a sulfur content no greater than 0.5% by weight.5 In the ensuing twelve months, there was a reduction in seasonal deaths followed by a peak in the cool season death rate between thirteen and twenty-four months, returning to the expected pattern during years 3–5. There were declines in the average annual trend in deaths from all causes (2.1%, p ¼ 0.001), respiratory 3.9%, and cardiovascular 2.0%. The average gain in life expectancy per year of exposure to the lower pollutant concentration was twenty days for females and forty-one days for males. In the two years after the intervention, there was a reduction in chronic bronchitic symptoms and bronchial hyperresponsiveness in children. SO2 declined 45% over five years and respirable particulates declined for two years. In twelve Canadian cities, daily SO2 concentrations were significantly associated with daily mortality, with an average concentration of only 5 mg/ m3 . 6 In a district of Chongqing, China, daily mortality was analyzed from January through December 1995 for associations with daily ambient sulfur dioxide and fine particles.7 Particulate matter less than 2.5 mm in diameter (PM2.5) was monitored for seven months, while SO2 was monitored for the entire year. The investigators found positive associations between daily ambient SO2 concentrations and mortality from respiratory and cardiovascular disease. For example, the effect of a 100 mg/m3 (0.04 ppm) increase in daily SO2 concentrations was a relative risk of 1.20 (95% CI 1.11–1.30) for cardiovascular mortality, with up to a three-day lag. The SO2 association remained robust when controlled for PM2.5. No associations were observed between daily ambient PM2.5 concentration and any cause of mortality. A weakness of this study was the absence of measurements of carbon monoxide, ozone, or nitrogen dioxide. Chongqing is surrounded by mountains, is one of China’s largest cities at 30 million people, and uses high-sulfur coal for energy, with sulfur ranging from 4% to 12%.

What Is Cholesterol?

I. What is cholesterol?

Cholesterol  is a fat-like complex, most manufactured by the liver. Our bodies need a certain amount of cholesterol to maintain normal function, but too much is harmful. Every cell in the body contains cholesterol. It is the manufacture of important hormones and vitamins essential substances. Cholesterol and lipoproteins need to be transported to various parts of the body. There are two lipoprotein cholesterol transport, namely low-density lipoprotein (LDL) and high density lipoprotein (HDL).

Low-density lipoprotein cholesterol is the culprit causing blood clots, is considered “bad” cholesterol. As for the high-density lipoprotein cholesterol, as cholesterol within the blood vessels to remove, it is considered “good” cholesterol.

II. Where cholesterol come from?

Body’s cells, especially liver cells, can produce cholesterol to maintain normal function, such as the manufacture of hormones and vitamins and so on.

In addition, cholesterol can be absorbed from food. Cholesterol content in different foods, such as Westerners like to eat animal foods, like whole milk, eggs and food oils, are of high cholesterol food. Fat, especially saturated fat, cholesterol levels can lead to even more enhanced. Usually saturated fat from animal food more than poultry and fish. On the other hand, from plant foods are mostly unsaturated fatty acids.

III. What is the relationship of cholesterol and heart disease?

When the body than the body needs cholesterol, it will accumulate in the blood vessel wall, causing blood vessels gradually harden and narrow, but on the surface, the body for a long time does not have any symptoms.

After years and years, deposition of cholesterol in the blood vessel walls, blocking blood vessels becoming more serious, will make the blood flow to vital organs slowly reduced. Therefore, when organs from the blood can not get enough oxygen and nutrients, will be very easy to necrotic.

If the supply of nutrient blood vessels blocking the heart, it is easy to cause coronary heart disease, including angina, myocardial ischemia, myocardial infarction; If the supply of nutrients the brain blood vessel blockage, will be a stroke.

IV. Heart disease common?

Heart disease is the world’s major diseases leading to death one, but if compliance with physician instructions, good diet, exercise control, the risk of heart disease can be greatly reduced.

1.            To prevent high blood pressure

2.            Is the movement to maintain

3.            A regular exercise schedule

4.            To maintain the concentration of cholesterol in moderate

High cholesterol is not uncommon, integrated all over the world statistics show that about fifteen to twenty-five percent of the people, cholesterol concentration above 240mg/dl, in other words, they get the opportunity to greatly increase coronary heart disease.

Therefore, high cholesterol, said health is a red light, are greatly increased risk of coronary heart disease. But the frightening thing is, even if high cholesterol, most people have no symptoms. Therefore, regular check-ups and keep the concentration of cholesterol in the moderate concentration of cholesterol is very important.

V. Normal cholesterol levels, reference values

Normal reference value of cholesterol is about 110 ~ 200mg/dl, if the 200 ~ 239 mg / dl are at high risk are close to the edge, and cholesterol concentration greater than 240 mg / dl, compared with high-risk range.

Cholesterol Level Recommendations
< 200 mg/dl <200 mg / dl Belongs to the ideal range
200~ 239 mg/dl 200 ~ 239 mg / dl Close to the edge of high risk, ask physicians about the diet instructions. Recommended cholesterol levels checked once a year. Has been suffering from a heart attack or if there are two or more risk factors, then it should belong to the high risk range.
> 240 mg/dl A high-risk range, three to six weeks, remember to check again to physicians. If still so, physicians need to do to comply with instructions.

VI. Easily lead to heart disease risk factors

    Hypertension
    Weight seriously overweight (overweight more than thirty percent)
    Smoking (more than ten per day)
    High-density lipoprotein cholesterol (HDL-C) is too low
    Someone in the family had suffered from coronary heart disease before age 55
    Diabetes
    Suffered from heart disease or vascular disease
    Men

VII. How to control cholesterol?

Lower cholesterol levels, can reduce fat deposition in the vessel wall, thereby reducing the risk of heart attack. According to the study, adults with high cholesterol, cholesterol levels, reduced by 1%, 2% lower risk of coronary heart disease.

Here are several ways to help you lower your cholesterol:

    Maintain a proper diet
    Weight control
    Proper exercise

VIII. How to maintain through diet moderate cholesterol levels?

Diet on cholesterol levels remain moderate, and increase heart health, it is very important. Only foods of animal origin contain cholesterol, such as beef, eggs, cheese and other dairy products, cholesterol in food causes the body to increase cholesterol, saturated fat, which is mainly caused by coronary heart disease. American Heart Association recommends that the heat obtained from the fatty foods, daily intake should not exceed 30% of total calories, while the daily intake of cholesterol should not exceed 300mg.

IX. Should be avoided to the types of fat foods?

Fat can be divided into three categories: saturated, polyunsaturated, monounsaturated fat. Avoid eating saturated fat, use monounsaturated fat, or multiple. Moderate consumption of multiple or monounsaturated fat, help to reduce the concentration of cholesterol in the body. A variety of foods contain different types of fat, so must know what kind of food, the highest content of saturated fat.

Saturated fat Oil, whether animal or vegetable oils, where the normal room temperature into a solid contains a high amount of saturated fat. Common are meat fat, butter, cream margarine and non-dairy products, coconut oil, “hydrogenated” or “partially hydrogenated” oil and so on.

Unsaturated fat Unsaturated fats come mainly from plants, can basically be divided into polyunsaturated and monounsaturated fat categories.

Polyunsaturated fat Polyunsaturated fat in the normal room temperature liquid. Are: safflower seed oil, cotton oil, sunflower seed oil, soybean oil, corn oil, nuts and seeds, fish fat, this fat calorie intake calories a day should not exceed ten percent.

Monounsaturated fat This type of fat in normal room temperature, but also in liquid form, the intake of calories a day should not exceed ten percent of total. Generally include: olive oil, peanut oil, Canoia oil.

X. Conclusion

If the cholesterol level higher than the normal reference range, periodically check the concentration of cholesterol, and consult a physician diet and life habits of the instructions actually make food, life control, for example, both the amount of fat intake, the type must be restrained to maintain the ideal weight, controlling blood pressure, continuous abstinence, etc., so that it can be suffering from vascular obstruction, greatly reduce the chance of coronary heart disease.

You can find recepies from American Heart Association here.

How to lower cholesterol fast and naturally!

Cholesterol is really a soft, fatty substance produced in liver and also present in some foods. Although the body needs cholesterol, too much cholesterol can lead to serious problems for example disease heart. Cardiovascular disease is the leading cause of deaths in both women and men in the United States.

Excess cholesterol adheres to the walls of the arteries. Your arteries become narrow, slowing or blocking blood is the oxygen flow to his heart. This can lead to a increased risk of heart attack. The blood and oxygen they are able to not reach your brain also increase their risk of stroke. Have you checked your cholesterol High cholesterol does not cause symptoms, so many people know that their levels are extremely high until it's past too far. It is important for adults to them look at your cholesterol at least one time every 5 years. A blood test called a lipoprotein profile tells on the levels of total cholesterol, lipoprotein cholesterol low density (LDL, because of its acronym in English), cholesterol high density lipoprotein (HDL, for its acronym in English) on triglycerides. Cholesterols levels is known as the "Bad cholesterol" since it is the biggest source of compliance and blockage within the arteries, while HDL cholesterol is called the "Good" cholesterol since it helps remove extra cholesterol your body. Triglycerides are a kind of blood fat.

Your nurse practitioner will be able to analyze their blood tests and let you know if your cholesterol levels are extremely high. Changes in lifestyle, together with the possible addition of the prescription, might help to reduce their levels of cholesterol.

Risk factors

Several factors can result in high-cholesterol within your body. You cannot control some of these factors. For instance, high cholesterol can be hereditary, which means that genetically inherited from generation to generation. Age and sex could also play a role in levels high cholesterol levels. To the extent that men and women age, their levels of cholesterol rise. In addition, LDL cholesterol amounts of women often increase after menopause.

Risk factors you can control include the next:

- Diet: Intake of high levels of cholesterol and fats saturated and trans fats in foods lift up your levels of cholesterol.
- Weight: Being overweight or obese has a tendency to increase levels of cholesterol.
- Exercise: Deficiencies in physical activity can help to eliminate HDL cholesterol level.
- Smoking: The smoking damages the walls of blood vessels which make them more prone to accumulate fatty deposits. In addition, smoking lowers HDL cholesterol in the body. Changes in lifestyle maintaining a healthy diet might help decrease your cholesterol. It is important to consume less food saturated fats, fat and cholesterol. Read food labels to understand how much fat and cholesterol you're consuming.

Listed here are some healthy changes you can perform:
- Eat foods with soluble fiber, like beans, oats and cereal grains, which could help reduce total cholesterol level.
- Eat fish for example salmon, mackerel or herring, which contain large amounts of omega-3 fatty acids, a unsaturated fat can lower your triglyceride level.
- Try healthy alternatives such as low fat milk or skim milk rather than dairy, the whites from the eggs or egg substitutes instead of eggs and beans peas, lentils or tofu and soy meat substitutes.
- Limit the amount of alcohol consumed, and consumption still moderate levels can raise your HDL cholesterol.
- Use extension foodstuffs such as margarine or orange juice containing plant sterols added or plant esters, which can reduce cholesterol.

Exercise and weight loss are part of a lifestyle healthy. Adding exercise for thirty minutes a day in most times of the week might help raise HDL cholesterol and reducing LDL cholesterol. Gradually, set time and frequency of the workouts. And when you smoke, quit now. If you do not smoke, don't start.

What is a Heart Attack?

What is a Heart Attack?

Have you ever asked yourself the question what is a heart attack? We all know that it can be deadly and that you need immediate attention if you are having one. However, many people do not know exactly what is going on with the heart during a heart attack. Unfortunately, if more people knew exactly what a heart attack was, as well as the warning signs, then there would not be so many heart attack related deaths.

A heart attack is when the blood flow to part of the heart muscle becomes blocked. When the blood flow becomes blocked it must be restored quickly or the part of the heart that is deprived of blood can die. If you think that you, or someone around you, is having a heart attack then it is important to seek out help immediately. If treatment for a heart attack is started within one hour of when the symptoms start then there is a better chance of the treatment working. Since the heart is the muscle that supplies the rest of your body with oxygen rich blood it is crucial that it is functioning properly. Even a few moments without blood flow to the rest of the body can cause major damage to other organs.

Every year over a million people in the United States have heart attacks. Most of the heart attacks can be attributed to the lifestyle of the person. For instance things such as smoking cigarettes, a lot of stress and a poor diet can contribute to the likelihood that a heart attack will occur. The above mentioned factors can put unnecessary strain on the heart muscle thus causing you to have a heart attack. It is important to call an ambulance if you feel like you are having a heart attack. Since the symptoms can come on suddenly it is best to not wait around before getting help. If you wait too long it may be too late.

Over half of the people who suffer a heart attack die. This is because they did not recognize the warning signs and seek out immediate help. Many people could make a full recover from a heart attack if they would just act a little bit quicker. When the heart is involved it is important to know the details. Being able to answer the question what is a heart attack will ensure that you know what is going on if you begin to feel symptomatic.

Experiencing Heart Symptoms? Read This for Tips

Experiencing Heart Symptoms? Read This for Tips

Heart attack symptoms or also known as a myocardial infarction is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen. Blockage of a coronary artery deprives the heart muscle of blood and oxygen thus causing injury to the heart muscle.

This injury to the heart muscle causes chest pain and chest pressure sensation and if the blood flow is not restored to the heart muscle within 20 to 40 minutes irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack usually is “complete.” The dead heart muscle is eventually replaced by scar tissue.

Heart Symptoms Causes:

Atherosclerosis is process by which plaques of cholesterol are deposited in the walls of arteries. Cholesterol plaques cause hardening of the arterial walls and narrowing of the inner channel of the artery.

Arteries that are narrowed by atherosclerosis cannot deliver enough blood to maintain normal function of the parts of the body they supply. Atherosclerosis of the arteries that furnish blood to the brain can lead to vascular dementia or stroke.

Atherosclerosis can remain silent in a lot of people for years or decades. It can begin as early as the teenage years but symptoms or health problems usually do not arise until later in adulthood when the arterial narrowing becomes severe.

Smoking cigarettes, high blood pressure, elevated cholesterol, and diabetes mellitus can accelerate atherosclerosis and lead to the earlier onset of symptoms and complications, particularly in those people who have a family history of early atherosclerosis.

Coronary atherosclerosis is the atherosclerosis that causes hardening and narrowing of the coronary arteries. Diseases caused by the reduced blood supply to the heart muscle from coronary atherosclerosis are called coronary heart diseases (CHD).

Coronary heart diseases include heart attacks, sudden unexpected death, chest pain (angina), abnormal heart rhythms, and heart failure due to weakening of the heart muscle.

Conclusion:

At the first sign of heart attack symptoms acting fast can save lives and limit damage to the heart. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone may be having a heart attack it is advice to call your emergency numbers within a few minutes or 5 at the most of the start of symptoms.

In case the symptoms stop completely in less than 5 minutes still call your doctor. Take a nitroglycerin pill if your doctor has prescribed this type of medicine.

If you’re looking for a natural solution to prevent heart attack and stroke, the we recommend you to check EDTA Oral Chelation Therapy, which has proven to be very effective in removing arterial plaque that accumulated on your arteries wall.

What causes heart attacks? Myocardial Infractions Explained

Heart attack

Heart attack, or myocardial infarction as they are commonly referred to by doctors, occur when blood flow to a part of the heart that  is blocked for an extended period of time leading to the damage or death of tissues in that area which can lead to the heart muscles getting damaged and dying. And that is what causes heart attacks.

The main cause of heart attacks is the blockage of the coronary arteries that deliver blood to the heart. This blockage is caused mainly by the buildup of a substance called plaque which is mainly made up of cholesterol and other cells along the walls of the arteries stopping the flow of blood to the muscles starving them of oxygen and causing them to die. The actual causes of heart attacks are not well known, but they can be triggered by heavy physical activity, being active outside in the cold weather or by severe emotional and physical stress.

Causes of heart failure:

One contributing factor for heart attacks is coronary heart disease. This is governed by your heart disease risk factor. These are habits or conditions that increase your risk of getting coronary heart disease and these factors also increase the risk of coronary heart disease worsening.

The main heart disease risk factors are high blood cholesterol, high blood pressure, obesity, diabetes, smoking, unhealthy diet and lack of physical activity. Any one of or any combination of these factors greatly increases your likelihood of getting coronary heart disease.

Heart problems are another factor that causes heart attacks. These are related to cardiac heart disease. The main one is the clogging of the coronary arteries due to the buildup of plaque.

Heart failure is when the heart stops functioning properly leading to the heart attack. It’s caused when blood flow is restricted to the cardiac muscles; this means the muscles are deprived of oxygen which they need to function. The muscles gradually stop working and may die, this means that the heart can’t pump blood properly and hence causing heart failure.

Heart failure is normally preceded by certain signs that if spotted in time, can be vital in preventing a heart attack. The most common signs are shortness of breath, coughing or wheezing, tightness around the chest, and buildup of fluids in body tissues, dizziness, nausea, fatigue and anxiety. These signs once seen should be acted upon immediately to avert any impending heart attack.

what causes heart attacks

Here are some facts about heart attacks that show how major an issue it is;

In the US in 2008, heart attacks accounted for 616000 deaths, almost 25% of the deaths, making it the leading killer in the US. It accounts for 25.1% of the deaths in whites making it the leading cause of death among white adults and is estimated to cost the US government $108.9 billion in treatment, medication and lost productivity.

Having answered the question what causes heart attacks with these causes and signs of an impending heart attack, one sees the need to change their lifestyle to lower their risk of heart attack and live a healthy productive life.

Causes of Heart Disease

Causes of Heart Disease

Coronary artery disease, the most common form of cardiovascular disease, is one of the leading causes of death today. But thanks to many studies involving thousands of patients, researchers that have been able to shortlist certain factors that are the Causes of Heart Disease in a person. These are called risk factors. These risk factors contribute to two categories: major and contributing. The major Causes of Heart Disease are:

High Blood Pressure (Hypertension): High blood pressure increases your risk of heart disease, heart attack, and stroke. Though other risk factors can lead to high blood pressure, you can have it without having other risk factors. Blood pressure can vary with activity and with age. A healthy adult who is resting generally has a systolic pressure reading between 120 and 130 and a diastolic pressure reading between 80 and 90.

High Blood Cholesterol: this is another risk factor that causes of Heart Disease is high blood cholesterol. Cholesterol is a fat-like substance carried in your blood. This is found in all of your body cells. Your liver produces all of the cholesterol your body needs to form cell membranes and to make certain hormones. Extra cholesterol enters your body when you eat foods that come from animals

Diabetes: Heart problems are the leading cause of death among people with diabetes, especially in the case of adult-onset. If you know that you have diabetes, you should already be under a doctor's care, because good control of blood sugar levels can reduce your risk. If you think you may have diabetes but not sure, you must consult your doctor for tests.

Obesity and Overweight: Extra weight is thought to lead to increased total cholesterol levels. High blood pressure, increased risk of coronary artery disease. Obesity increases your chances of developing other risk factors for example, heart disease, especially high blood pressure, diabetes and high blood cholesterol.

Smoking: Most people realize that cigarette and tabacco smoking increases your risk of lung cancer, but fewer realize that it is one of the causes of Heart Disease and also other peripheral vascular disease.

Heredity: Heart disease tends to run in families. For example, if your siblings or parents had a heart or circulatory problem before the age of 55. But then you are at greater risk of heart disease than someone who does not have complains for heart disease in their family history.

Age: Older age is a risk factor for heart disease. In fact, about 4 out of every 5 deaths occur due to heart diseases that occur in people older than 65.

In addition to this, there are also certain contributing factor that enhances the causes of Heart Disease. They are: Stress, Sex hormones, Birth control pills and Alcohol. Stress is considered an important contributing risk factor for heart disease. The effects of behavior habits, emotional stress, and socioeconomic status on the risk of heart disease and heart attack have not been proven

Coronary heart disease

Coronary heart disease

Coronary heart disease is also known by some other names such as coronary artery disease, ischemic heart disease and atherosclerotic heart disease. Among the various types of heart disease, Coronary heart disease is one of the most common one. It is caused when the atheromatous plaques are accumulated in the the artery walls. As a result of this accumulations atheromatous plaques , the supply of oxygen as well as the nutrients to the muscles of the heart is ceased.

The signs of coronary heart disease can easily be identified in the early stage. But the problems remain that in spite of the signs, no proof or evidence of coronary heart disease is found in its early stage. It therefore, very often results in heart attack all of a sudden. Coronary heart disease has been found to be one of the most common causes of heart or cardiac attacks, often leading to sudden death.

The records in the Guinness Book of Records reveal that Northern Ireland happens to be the most affected country by coronary heart disease, in comparison to the other countries in the world. One more interesting thing related to the coronary heart disease is that in the United State of America, one in every three women, aged 40 or above, and one in every two men, aged 40 and above, are found to be affected by coronary heart disease, either severely or mildly.

The risk factors related to coronary heart disease, are excessive smoking, hypercholesterolemia, hypertension, type A behavioral patterns and hyperglycemia. There are also other risk factors of coronary heart disease. One of them is high levels of fibrinogen, also known as hemostatic factors. Hariditaru factors have also been found to be responsible for coronary heart disease.

There are some indirect risk factors of coronary heart disease. In spite of their being indirectly related to coronary heart disease, they prove to be very much significant. Some of such indirect, and yet, significant factors of coronary heart disease are obesity, lowness of diet in antioxidants, richly saturated fat diets, excess of stress and the absences or lack of physical exercise. Men who are aged over 60 and women who are aged more than 65 are very much prone to coronary heart disease. It is one of the commonest diseases in the Western countries.

Prevention of coronary heart disease is not very much unique. If the risk factors can be avoided, coronary heart disease can automatically be avoided. Keep your body in regular exercise. Do not grow the habit of smoking or consuming alcohols. Even if you have the habit, do try to give it up. Addiction to any kind of drugs will be most welcoming for the coronary heart disease. Always try to keep your mind calm and cool. A person with a routined life with less mental stress, is very hard to be affected by coronary heart disease.

Ischemic Cardiomyopathy

Ischemic Cardiomyopathy

Ischemic Cardiomyopathy is a common type of heart disease caused by the congestive heart failure due to coronary artery disease. There are many names given to this heart disease like Ischemic heart disease. This disease is one of the main causes of congestive heart failure. In United States maximum number of people suffer from this disease. This disease happens when the arteries are blocked and results in inadequate supply of blood to the oxygen. Ischemic cardiomyopathy when the cholesterol level of the body increases and create plaque in the arteries. Arteries are one of the major parts of the body which brings blood and oxygen to the body. The patients suffering from this disease can experience angina, heart attack and unstable angina. In many cases the symptoms are unnoticed which can be very dangerous in future. The reasons why this heart disease happens are obesity, diabetes, high cholesterol, high fat diet, smoking, high blood pressure, etc. The symptoms of Ischemic Cardiomyopathy are breathing difficulty, decreased urine output, fatigue weakness, shortness of breath, irregular pulse, chest pain and cough.

If the patient is found with these symptoms then immediate check up is required. The patient should be frequently under medical supervision of the doctor. Tests must be done in every months to know about the status. Improper diet is also one of the main causes of ischemic cardiomyopathy. The patients of Ischemic cardiomyopathy are suggested to lay more emphasis on diet and exercise. Usually doctor perform many tests on the patients of ischemic cardiomyopathy. This disease is one of the types of cardiomyopathy. Cardiomyopathy is one of the types of heart disease in which the heart becomes enlarged and eventually results in the improper ability of muscles to pump the blood. Abnormalities in ischemic cardiomyopathy is common to see. The disease can be diagnosed physical exam and the patients medical history test. The tests done by the doctor include CT scan, radionuclide studies, cardiac catheterization, chest X-ray, MRI scan, blood tests, exercise stress test, electrocardiogram (ECG) and echocardiogram. ALL these tests are necessary to detect the risk and complications. These tests will help the doctor to see the depth of the disease. There are many medications available which will improve the heart conditions. But it is suggested to take the medications after the tests are done.

Medications for the patients of ischemic cardiomyopathy are given for two reasons to treat the symptoms and to improve the cardiac function. Whatever may be the medications and tests but if the patient improve his or her diet it can help to remove many symptoms and complications. Regular exercise and maintaining healthy diet is necessary to improve the heart condition. Some patients also undergo many therapies to improve the cardiac conditions. If the disease is extreme then emergency necessary must be done. The rate of heart patients is increasing with each year especially in developed countries. One of the main reasons for the increasing heart risk is the change in the lifestyle.

What is cardiovascular disease?

We read very often about cardiovascular disease, about heart failure, heart attack, stroke and many other disorders, but we don’t know for sure what is cardiovascular disease, why and how it occurs and what changes occur in our body. Next, we will try to explain what is cardiovascular disease in the society of nowadays and how much did medicine advanced in this research field.

What is cardiovascular disease

A question that scientists succeeded to answer but failed to cure.

Nowadays, when more and more people are suffering from heart disease we may wonder what is cardiovascular disease and why is it the first cause of death in most of the countries. We invest millions of dollars on research, looking and testing a lot of drugs, we even found out what is causing AIDS (and we succeeded to transform it in a „chronic” disease) and many other disease with strange names. But all the time there is a new disease, a new virus or bacteria that gives us trouble to treat and sometimes it feels that the more drugs we discover, the more diseases occur. Even so, the most frequent cause of death are
cardiovascular disease, a group of diseases that seem to be entirely understood, with lots of article and medical research, that could make some wonder what else is left to discover. The truth it is far from being so, as with the medical treatment we have at this moment we can only slow down these disease and not cure. Even the prophylaxis of cardiovascular disease is not very promising as we live in the century of unhealthy foods, McDonald’s food, alcohol consumption, smoking, stress, sedentariness and we spend all out time watching TV and working on computer.
After we established how important these diseases are, now let’s finally find out what is cardiovascular disease.

What is cardiovascular disease? A group of disorders that affect heart, brain and blood vessels.

The most frequent cardiovascular diseases:

• hypertension: high blood pressure affects both brain and heart as it can determine bleeding (stroke) or small infarcts in the brain and also determine or worsen heart failure. Beside heart and brain, hypertension also affects eyes and kidneys.
• heart valve disease: valves fail to close or open properly and in time they can cause heart failure,
• irregular heart beats can cause fainting, shortness of breath, chest pain, fatigue or even heart failure,
• other heart tissues disorders: infection, metabolic disorders that affect heart (different disorders that can determine deposits of some substances in heart tissues like iron, copper etc)
• strokes: a blood cloth can block one of the brain blood vessels and make a variable brain area to die or a blood vessel may break and let blood flow into the brain (this usually occurs in patients with hypertension or with blood vessel malformations).
• atherosclerosis: fat deposits in the blood vessels wall that in time can determine strokes, heart attack, chest pain, arterial disorder with legs pain during walking and even during rest, in advanced cases, neurologic symptoms: dizziness, fatigue, fainting, drowsiness, memory and concentration dysfunction etc.

Now that we found out what is cardiovascular disease, let’s see how is treated. As we’ve seen, it is easy to answer what is cardiovascular disease, but is difficult to treat it. Treatment has two parts and two partners: the patient and the doctor. The patient should respect a healthy diet, with no salt, fats and sweets, attend regular exercise (jogging, running or any kind of sport), no smoking or alcohol consumption, keep a normal weight, control blood pressure and blood sugar. Doctors have a large number of drugs they can use, the purpose of this treatment is to slow down the disease and treat other disorders that may worsen cardiovascular diseases like high blood pressure, diabetes, high level of fats in the blood, infections, irregular heart beats etc. It is also important to prevent other cardiovascular events from happening, that’s why antiplatelet medication like aspirin is prescribed in patients that are suffering from cardiovascular disease.
We hope this article can offer a brief answer to the question what is cardiovascular disease and why this medical problem is so important in nowadays society.

Heart palpitations at night

Why do we have heart palpitations at night?

Before we discuss the matter of heart palpitations at night, we have to clarify the meaning of the word “palpitation” in general. Palpitations refer to irregular heart beats, usually the heart beats to fast, or with pauses from time to time and gives us an abnormal sensation, sometimes associated with dizziness, light-headed sensation, shortness of breath, chest pain etc.
We all had palpitation at least once in our life, and this doesn’t mean we have a heart disease, because these symptoms occur in healthy people during exercise or associated to stress, smoking, coffee. Even so, if the palpitation persist or are associated with shortness of breath, chest pain, fainting, dizziness, a doctor should be consulted as soon as possible.
Some patients complain they have heart palpitations at night, which prevent them from falling asleep or wake them up in the middle of the night.

Heart palpitations at night -causes:

Normal heart rate for an adult is 60-90 beats/minute. If the heart rate is higher the 90 beats per minute, then the condition is called tachycardia and can provoke palpitation. Not only rapid heart rate can cause palpitation but also irregular heart beats, known as arrhythmia, which is the main cause behind palpitation. Why some patients experience heart palpitations at night, during rest, when heart labor is smaller?
Heart palpitations at night can be determined by one of the following cause:

• too much stress and anxiety gathered during the daytime. It is a habit now that every time we go to sleep, we think again at the daily problems and try to find a solution, as it is said night is a good adviser. If your mind is concerned about certain problems happening in your life, you may be lying down and think about it over and over again, but the emotions and the psychical tension can generate palpitation.
• excessive consumption of caffeine before sleeping can generate insomnia and palpitation, if you drink a lot of coffee, especially before sleeping, you may consider giving up.
• smoking
• alcohol consumption
• medication-some drugs used to treat different diseases (like asthma, heart diseases, high blood pressure, cold) can determine palpitation: pseudoephedrine used in cold medication, theophylline for asthma etc.
• pregnancy
• fever-it is well known that body temperature elevation is associated with rapid heart beats and sometimes with palpitations
• vigorous exercise before sleeping
• breathing problems determined by lung diseases determine a low level of oxygen in the body, which can lead to heart palpitations at night
• heart problem-patients with heart failure may develop paroxysmal nocturnal dyspnea (shortness of breath that occurs suddenly during night in patient with left heart failure) and palpitations, forcing them to wake up and search for an open window to get fresh air
• hyperthyroidism (a higher level of thyroid hormones can determine irregular or rapid heart beats)
• elevated blood pressure

If I have heart palpitations at night-how can my doctor discover if there is something wrong in my body?
Yes it is possible. For patients that have these symptoms only during night it is difficult to  diagnose them during a simple medical visit, but if a special device called holter ecg is used, then this is no longer a problem. Holter ECG is a portable medical device that the patient “wears” for 24 hours and it records heart activity during this period of time.
Heart palpitations at night-treatment
Heart palpitations at night can be treated only after proper tests are made in order to establish the correct diagnosis. In many cases, palpitations have no serious cause and a short time treatment associated with a life style change can be the “cure”.
Special precaution in patients with heart palpitations at night:

• avoid consumption of alcohol, coffee, drugs (marijuana, cocaine) or smoking
• avoid stress and anxiety-there are many types of techniques used against anxiety (psychotherapy, sports, taking vacation, travelling etc.)
• sometimes medication is needed in order to control anxiety
• respect your hours of sleep
• avoid if possible the intake of medication that stimulate palpitations

Heart palpitations at night can be very uncomfortable, but sometimes a simple change in the  daily habits can make them disappear.

Heart attack symptoms in women over 40

Cardiovascular diseases and especially ischemic cardiomyopathy and heart attack are some
of the causes of mortality and morbidity in both women and men, but heart attack symptoms
in women over 40 may differ from those of men.
Of certain statistical date cardiovascular disease is the first cause of the mortality in women.
Risk factors for heart attack
There are several risk factors that cause different heart attack symptoms in women over 40 :

• Obesity, high blood pressure and hypercholesterolemia (increasing the percentage of fat
  in the blood) especially triglycerides.
• Another risk factor is use of oral contraceptives and
  menopause.
• A small percentage of patients who use oral contraceptives appear hypertension
  unrelated to dose contraceptive. However, patients with controlled hypertension may use
  oral contraceptives, but under supervision. If the consumption of oral contraceptives added
  smoking the risk of heart attack increase. If we compare mortality rates of cardiovascular
  disease in men and women over 40 will see a significant increase in mortality after
  menopause.

Heart attack symptoms in women over 40

Today, there are several features of heart attack symptoms in women over 40. The main heart
attack symptoms in women over 40 is not chest pain, but dyspnea which represent shortness
of breath. This symptoms may appear a few hours, days or months before heart attack
symptoms. Most minim discomfort may be an atypical sign or a symptom for heart attack.
One of these is atypical chest pain for which women do not go to the doctor only if the is
persistent and upset the patient. Sometimes heart attack symptoms in women over 40 may be
the absence of pain. Absence of pain can be attributed to nervous or mental disorders. But,
heart attack symptoms in women over 40 like atypical chest pain have a worse prognostic
then men.
Unusual fatigue is another heart attack symptoms in women over 40. This fatigue can be felt
as a state of drowsiness. Patients may not take into account this symptom believing that it is
simply missing out of sleep, an infection with a virus or adverse effect of another drug and not
present at the doctor. Patients may be associated nausea, sweating and chills.
Pain in the calf may be a sign for deep vein thrombosis which may eventually lead to heart
attack. This is another heart attack symptoms in women over 40 which occurs predominantly
in patients with hormone therapy, smokers, who just had surgery or in patients who have
been on a plane flight. If pain is sudden or gradual, patients should consult their doctor
immediately.
Other symptoms or signs for heart attack may be serious and can lead to death of patients if they are not recognized in time.
So how do you know if you have a heart attack?

At the early signs or symptoms, the patients must go to the doctor because they can be heart attack symptoms in women over 40 and their persistence can lead to death.