Cardiovascular disease (CVD) refers to any condition which affects the heart or blood vessels. It is the leading cause of death worldwide, accounting for about 17.9 million deaths every year.
Coronary artery disease (CAD): The narrowing or blockage of the arteries that supply blood to the heart muscle, causing chest pain, heart attack, or sudden cardiac death.
Stroke: The interruption of blood flow to the brain, resulting in brain damage, paralysis, speech problems, or death.
Heart failure: The inability of the heart to pump enough blood to meet the body’s needs, causing shortness of breath, fatigue, swelling, or irregular heartbeat.
Arrhythmia: The abnormal rhythm of the heart, which can be too fast, too slow, or irregular, causing palpitations, dizziness, fainting, or cardiac arrest.
Valvular heart disease: The dysfunction of one or more of the heart valves, which regulate the flow of blood through the heart, causing murmurs, chest pain, shortness of breath, or heart failure.
Congenital heart disease: The malformation of the heart or blood vessels present at birth, which can affect the structure or function of the heart, causing cyanosis, breathlessness, fatigue, or heart failure.
The exact causes of CVD are not fully understood, but there are several factors that can increase the risk of developing CVD, such as:
Age: The risk of CVD increases with age, as the blood vessels become stiffer and narrower, and the heart becomes weaker and less efficient.
Gender: Men are more likely to develop CVD than women, especially before the age of 55. However, after menopause, the risk of CVD for women increases and becomes similar to that of men.
Family history: Having a close relative who had CVD at a young age (before 55 for men and 65 for women) can increase the risk of inheriting a genetic predisposition to CVD or having a similar lifestyle or environmental exposure.
Ethnicity: Some ethnic groups, such as African Americans, Hispanics, Native Americans, and Asians, have a higher risk of CVD than others, due to genetic, cultural, or socioeconomic factors.
Lifestyle: Certain behaviors or habits can increase the risk of CVD, such as smoking, physical inactivity, unhealthy diet, excessive alcohol consumption, or stress.
Medical conditions: Some diseases or disorders can increase the risk of CVD, such as high blood pressure, high cholesterol, diabetes, obesity, chronic kidney disease, or inflammatory conditions.
The symptoms of CVD can vary depending on the type and severity of the condition, but some of the common signs and symptoms are:
Chest pain or discomfort (angina), which may radiate to the arm, jaw, neck, or back, and may be triggered by physical or emotional stress, or occur at rest.
Shortness of breath, which may occur during exertion, at rest, or while lying down, and may be accompanied by wheezing, coughing, or a feeling of suffocation.
Fatigue, which may be persistent or intermittent, and may affect the ability to perform daily activities or exercise.
Swelling (edema) of the ankles, feet, legs, abdomen, or neck, which may be caused by fluid retention due to poor blood circulation or heart failure.
Palpitations, which are the sensation of the heart beating too fast, too slow, or irregularly, and may be accompanied by dizziness, lightheadedness, or fainting.
Numbness, weakness, or paralysis of one side of the body, which may indicate a stroke, and may be accompanied by slurred speech, confusion, vision problems, or loss of consciousness.
The diagnosis of CVD is based on the medical history, physical examination, and various tests and procedures, such as:
Electrocardiogram (ECG): A test that records the electrical activity of the heart, and can detect abnormal rhythms, signs of heart damage, or reduced blood flow to the heart.
Echocardiogram: A test that uses sound waves to create an image of the heart, and can measure the size, shape, function, and structure of the heart and its valves.
Blood tests: Tests that measure the levels of certain substances in the blood, such as cholesterol, glucose, triglycerides, or troponin, and can indicate the risk or presence of CVD or its complications.
Stress test: A test that monitors the heart’s response to physical or pharmacological stress, and can reveal signs of reduced blood flow to the heart or abnormal heart function.
Angiogram: A test that uses a dye and X-rays to visualize the blood vessels, and can detect blockages, narrowing, or abnormalities of the arteries or veins.
During cardiac catheterization, a thin tube (catheter) is inserted into a blood vessel and advanced to the heart, where it measures the pressure and oxygen levels in the chambers, injects dye for angiograms, or performs interventions such as angioplasty or stenting to open blocked arteries.
The magnetic resonance imaging (MRI) test creates detailed images of the heart and blood vessels, and can assess the structure, function, and damage of the heart.
The computed tomography scan uses X-rays and a computer to create cross-sectional images of the heart and blood vessels. It can measure calcium deposits in coronary arteries (coronary calcium score) and detect aneurysms or blockages in the aorta or other vessels.
The treatment of CVD depends on the type and severity of the condition, and the overall health and preferences of the patient, but some of the common treatment options are:
Drugs that help manage the symptoms, prevent complications, or treat the underlying causes of CVD include antiplatelets, anticoagulants, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), statins, diuretics, nitrates, and digitalis.
Surgical procedures such as coronary artery bypass grafting (CABG), valve repair or replacement, aneurysm repair, or heart transplantation can repair or replace damaged or diseased heart or blood vessels.
A procedure that opens blocked or narrowed arteries to improve blood flow to the heart, such as angioplasty, stenting, atherectomy, or laser therapy.
The term implantable devices refers to devices that regulate the heart's rhythm or support its function, such as pacemakers, implantable cardioverter defibrillators (ICDs), cardiac resynchronization therapy (CRT), and ventricular assist devices (VADs).
Changes in lifestyle that can reduce the risk or progression of CVD, such as quitting smoking, increasing physical activity, eating a healthy diet, limiting alcohol consumption, managing stress, or losing weight.
Exercise, education, counseling, and support are all part of cardiac rehabilitation, which aims to improve the physical and mental health of patients suffering from CVD.
The prevention of CVD is based on the identification and control of the risk factors, and the adoption of a healthy lifestyle, such as:
Regular check-ups: Visiting a doctor regularly to monitor the blood pressure, cholesterol, glucose, and other indicators of CVD, and to receive advice and treatment if needed.
By reducing salt intake, managing stress, or using medications, you can manage your blood pressure within the normal range, which is usually less than 120/80 mmHg.
As part of cholesterol control, one can use medications, eat fewer saturated and trans fats, increase fiber intake, or use other methods to keep cholesterol levels within the normal range, which is typically less than 200 mg/dL for total cholesterol, less than 100 mg/dL for LDL (bad) cholesterol, and more than 40 mg/dL for HDL (good) cholesterol.
Controlling glucose levels: By eating medications, eating a balanced diet, exercising regularly, or using other methods to keep them within the normal range, which is usually less than 100 mg/dL for fasting glucose and less than 140 mg/dL for postprandial glucose.
Smoking cessation: Quitting smoking or avoiding secondhand smoke, which can damage blood vessels, increase the risk of blood clots, and reduce oxygen supply to the heart.
Engaging in 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week can strengthen the heart, lower blood pressure, improve cholesterol, and burn calories.
A healthy diet consists of fruits, vegetables, whole grains, lean meats, fish, nuts, seeds, and low-fat dairy products that are low in fat, salt, and sugar, and high in fiber, vitamins, minerals, and antioxidants.
Moderation in alcohol consumption: Limiting alcohol intake to no more than one drink per day for women and two drinks per day for men can help lower blood pressure, prevent arrhythmias, and reduce stroke risk.
