Cardiovascular Disease

Cardiovascular Disease
Cardiovascular Disease
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Cardiovascular disease (CVD) is a class of disease that involves the heart or blood vessels.

The underlying mechanisms vary according to the disease. Includes coronary artery disease, stroke and peripheral artery disease, atherosclerosis. This may be due to high blood pressure, smoking, diabetes, mellitus, lack of exercise, obesity, high blood cholesterol, poor diet and excessive alcohol consumption. While high blood pressure is estimated to constitute about 13% of CVD deaths, tobacco is 9%, diabetes 6%, lack of exercise 6% and obesity 5%.

It is estimated that up to 90% of CVD can be prevented. Prevention of CVD includes improving risk factors by eating a healthy diet, exercising, avoiding tobacco smoke and limiting alcohol intake. It is also helpful to treat risk factors such as high blood pressure, blood lipids, and diabetes. Treating people with sore throats with antibiotics can reduce the risk of rheumatic heart disease. There is no clear benefit to using aspirin in otherwise healthy people.


There are many cardiovascular diseases involving blood vessels. They are known as vascular diseases.

  • Coronary artery disease (also known as coronary heart disease and ischemic heart disease)
  • Peripheral artery disease - a disease of the blood vessels that supply blood to the arms and legs
  • Cerebrovascular disease - disease of the blood vessels that supply blood to the brain (including stroke)
  • Renal artery stenosis
  • Aortic aneurysm
  • Cardiomyopathy - heart muscle diseases
  • Hypertensive heart disease - heart disease due to high blood pressure or hypertension
  • Heart failure - clinical syndrome caused by the heart's inability to supply enough blood to meet its metabolic needs to tissues
  • Pulmonary heart disease - a failure of the right side of the heart with respiratory system involvement
  • Cardiac dysrhythmias - abnormalities in the heart rhythm
  • Inflammatory heart disease
  • Endocarditis - inflammation of the inner layer of the heart, endocardium. The most commonly involved structures are heart valves.
  • Inflammatory cardiomegaly
  • Myocarditis - inflammation of the myocardium, the muscular part of the heart, most often caused by viral infections and less often by bacterial infections, certain drugs, toxins and autoimmune disorders. It is partially characterized by infiltration of the heart by lymphocyte and monocyte types by white blood cells.
  • Eosinophilic myocarditis - inflammation of the myocardium caused by pathologically activated eosinophilic white blood cells. This disorder differs from myocarditis in its causes and treatment.
  • Heart valve disease
  • Congenital heart disease - malformations of the heart structure present at birth
  • Rheumatic heart disease - damage to the heart muscles and valves due to rheumatic fever caused by a group A streptococcal infection from Streptococcus pyogenes.

Risk Factors

There are many risk factors for heart disease: age, gender, tobacco use, physical inactivity, excessive alcohol consumption, unhealthy diet, obesity, genetic predisposition and family history of cardiovascular disease, high blood pressure (hypertension), high blood sugar (diabetes mellitus). ), high blood cholesterol (hyperlipidemia), undiagnosed celiac disease, psychosocial factors, poverty and low educational status, and air pollution. While the individual contribution of each risk factor varies between different communities or ethnic groups, the overall contribution of these risk factors is very consistent. Some of these risk factors are invariant, such as age, gender, or family history / genetic predisposition; however, many important cardiovascular risk factors can be altered by lifestyle modification, social change, medication (eg prevention of hypertension, hyperlipidemia and diabetes). Obesity patients are at high risk for atherosclerosis of the coronary arteries.


Genetic factors affect the development of cardiovascular disease in men under 55 and women under 65. Cardiovascular disease in a person's parents increases his risk 3 times. Multiple single nucleotide polymorphisms (SNPs) have been found to be associated with cardiovascular disease in genetic association studies, but generally their individual effects are small and their genetic contribution to cardiovascular disease is not fully understood.


Age is the most important risk factor for the development of cardiovascular or heart disease, and the risk nearly triples in every decade of life. Coronary fat lines may begin to form during puberty. It is estimated that 82 percent of those who die from coronary heart disease are 65 years of age or older. At the same time, the risk of stroke doubles every decade after the age of 55.

Multiple explanations are suggested to explain why age increases the risk of cardiovascular / heart disease. One of these concerns the serum cholesterol level. In most populations, the level of total cholesterol increases with increasing age. In men this rises between the ages of 45 and 50. The increase in women continues sharply until the age of 60-65.

Aging is also associated with changes in the mechanical and structural properties of the vascular wall, which leads to loss of arterial elasticity and reduced arterial compliance and can subsequently lead to coronary artery disease.


Cigarettes are the main form of smoking tobacco. Health risks from tobacco use arise not only from direct tobacco consumption but also from exposure to second-hand cigarette smoke. About 10% of cardiovascular diseases are attributed to smoking; however, those who quit by age 30 have almost as low risk of death as non-smokers.


High dietary intake of saturated fat, trans fat, and salt and low intake of fruits, vegetables, and fish are linked to cardiovascular risk, but whether all these associations show causes is controversial. The World Health Organization attributes approximately 1.7 million deaths worldwide to low consumption of fruit and vegetables. Frequent consumption of high-energy foods, such as processed foods high in fat and sugar, promotes obesity and may increase cardiovascular risk.

The amount of dietary salt consumed can also be an important determinant of blood pressure levels and overall cardiovascular risk. There is moderate-quality evidence that reducing saturated fat intake for at least two years reduces the risk of cardiovascular disease. High trans fat intake has negative effects on blood lipids and circulating inflammatory markers, and elimination of trans fat from diets has been widely advocated. In 2018, the World Health Organization estimated that trans fats caused more than half a million deaths a year. There is evidence that high sugar intake is associated with higher blood pressure and unsuitable blood lipids, and that sugar intake also increases the risk of diabetes mellitus. High consumption of processed meats is associated with an increased risk of cardiovascular disease, possibly due in part to increased dietary salt intake.


The relationship between alcohol consumption and cardiovascular disease is complex and may depend on the amount of alcohol consumed. There is a direct relationship between high alcohol consumption and cardiovascular disease. Low levels of drinking without heavy drinking episodes may be associated with a reduced risk of cardiovascular disease, but there is evidence that the associations between moderate alcohol consumption and stroke prevention are not causal. At the population level, the health risks of drinking alcohol exceed any potential benefits.

Celiac Disease

Untreated celiac disease can lead to the development of many cardiovascular diseases, most of which improve or improve with gluten-free diets and bowel healing. However, delays in the recognition and diagnosis of celiac disease may cause irreversible heart damage.


Sleep disturbances, as well as sleep disturbances such as breathing and insomnia, have been found to be associated with a higher cardiometabolic risk, particularly short sleep duration or particularly long sleep duration.

Socioeconomic Disadvantage

Cardiovascular disease affects low- and middle-income countries even more than high-income countries. There is relatively little information about the social patterns of cardiovascular disease in low- and middle-income countries, but low income and low educational status in high-income countries are consistently associated with a higher risk of cardiovascular disease. Policies that resulted in increased socio-economic inequalities have been associated with greater subsequent socio-economic differences in cardiovascular disease implying a cause-effect relationship. Psychosocial factors, environmental exposures, health behaviors, and access to health services and quality contribute to socio-economic differences in cardiovascular disease. The Commission on Social Determinants of Health recommended that more equitable distribution of power, well-being, education, housing, environmental factors, nutrition and health services is needed to address inequalities in cardiovascular and noncommunicable diseases.

Depression and Traumatic Stress

There is evidence that mental health issues, particularly depression and traumatic stress, are linked to cardiovascular disease. While it is known that mental health problems are associated with risk factors for cardiovascular diseases such as smoking, malnutrition and sedentary lifestyle, these factors alone do not explain the increased risk of cardiovascular disease seen in depression, stress, and anxiety. Moreover, post-traumatic stress disorder is independently associated with increased risk for coronary heart disease, even after adjustment for depression and other variables.

Occupational Exposure

Occupational cardiovascular disease. Little is known about the relationship between work and cardiovascular disease, but links have been established between certain toxins, extreme heat and cold, exposure to tobacco smoke, and mental health issues such as stress and depression.

The 2015 SBU report looking at non-chemical factors found a relationship for:

  • With mentally stressful work and lack of control over working situations and with an effort-reward imbalance
    people with low social support experience at work; those who experience injustice or insufficient opportunities for personal growth; or have job insecurity
  • Those working on night programs; or having long working weeks
  • Exposed to noise

Specifically, the risk of stroke is also increased with exposure to ionizing radiation. Hypertension develops more frequently in those who have work stress and shift workers. The differences between men and women at risk are small, but men are twice as likely to have a heart attack or stroke and die during their working life.

Somatic Mutations

As of 2017, evidence suggests that certain mutations associated with leukemia in blood cells may also lead to an increased risk of cardiovascular disease. Several large-scale research projects looking at human genetic data have found a solid link between the presence of these mutations, a condition known as clonal hematopoiesis, and cardiovascular disease-related events and mortality.

Radiation Therapy (RT)

Radiation treatments for cancer can increase the risk of heart disease and death, as observed in previous breast RT regimens. Therapeutic radiation increases the risk of a subsequent cardiovascular event (i.e. heart attack or stroke) by 1.5 to 4 times the normal rate.


Up to 90% of cardiovascular diseases can be prevented if identified risk factors are avoided. Measures currently implemented to prevent cardiovascular disease include:

  • Decrease in saturated fat: There is moderate-quality evidence that reducing the amount of saturated fat in the diet and replacing it with unsaturated fats or carbohydrates over a period of at least two years leads to a reduction in cardiovascular disease risk.
  • Quitting smoking and avoiding secondhand smoke. Quitting smoking reduces the risk by about 35%.
    Follow a healthy diet, such as the Mediterranean diet. Dietary interventions are effective in reducing cardiovascular risk factors within a year, but the long-term effects of such interventions and their effects on cardiovascular disease events are uncertain.
  • At least 150 minutes (2 hours and 30 minutes) of moderate exercise per week.
  • Limit alcohol consumption within the recommended daily limits; People who consume moderately alcoholic beverages have a 25-30% lower risk of cardiovascular disease. However, lower rates of cardiovascular disease in people genetically predisposed to consuming less alcohol suggest that alcohol itself may not be protective. Excessive alcohol intake increases the risk of cardiovascular disease [96] [94] and alcohol consumption is associated with an increased risk of cardiovascular events the day following consumption.
  • If high, lower blood pressure. A decrease of 10 mmHg in blood pressure reduces the risk by about 20%.
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