Cardiovascular disease: Wikis

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Cardiovascular disease
Classification and external resources
ICD-10 I51.6
DiseasesDB 28808
MeSH D002318

Cardiovascular disease or cardiovascular diseases is the class of diseases that involve the heart or blood vessels (arteries and veins). [1] While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH), it is usually used to refer to those related to atherosclerosis (arterial disease). These conditions have similar causes, mechanisms, and treatments. In practice, cardiovascular disease is treated by cardiologists, thoracic surgeons, vascular surgeons, neurologists, and interventional radiologists, depending on the organ system that is being treated. There is considerable overlap in the specialties, and it is common for certain procedures to be performed by different types of specialists in the same hospital.

Most countries face high and increasing rates of cardiovascular disease. Each year, heart disease kills more Americans than cancer.[2]

It is the number one cause of death and disability in the United States and most European countries (data available through 2005). A large histological study (PDAY) showed vascular injury accumulates from adolescence, making primary prevention efforts necessary from childhood.[3][4]

By the time that heart problems are detected, the underlying cause (atherosclerosis) is usually quite advanced, having progressed for decades. There is therefore increased emphasis on preventing atherosclerosis by modifying risk factors, such as healthy eating, exercise and avoidance of smoking.

Contents

Classification

Causes

In his book "The Heart Healthy Program", the cardiologist Dr Richard M. Fleming has identified several key dietary factors that can lower the risk of heart disease, including:

  • Lowering of LDL cholesterol by reducing saturated fat intake.
  • Lowering of Triglyceride levels by reducing consumption of sugary and processed foods.
  • Reduction of Homocysteine levels by supplementation with Vitamins B6 and B12, and folic acid.
  • Increased antioxidant activity by higher consumption of fruits and vegetables.
  • Lowering of fibrinogen and growth factors by cutting back on foods such as red meat, dairy products, poultry and eggs.

Pathophysiology

Population based studies in the youth show that the precursors of heart disease start in adolescence. The process of atherosclerosis evolves over decades, and begins as early as childhood. The Pathobiological Determinants of Atherosclerosis in Youth Study demonstrated that intimal lesions appear in all the aortas and more than half of the right coronary arteries of youths aged 7–9 years. However, most adolescents are more concerned about other risks such as HIV, accidents, and cancer than cardiovascular disease.[5] This is extremely important considering that 1 in 3 people will die from complications attributable to atherosclerosis. In order to stem the tide of cardiovascular disease, primary prevention is needed. Primary prevention starts with education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken

Diagnosis

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Associated diagnostic markers

Screening

Some biomarkers are thought to offer a more detailed risk of cardiovascular disease. However, the clinical value of these biomarkers is questionable.[6] Currently, biomarkers which may reflect a higher risk of cardiovascular disease include:

Management

Unlike many other chronic medical conditions, Cardiovascular disease is treatable and reversible, even after a long history of disease. Treatment is primarily focused on diet and stress reduction.[4] [8] [9] [10] [11]

Epidemiology

Disability-adjusted life year for cardiovascular diseases per 100,000 inhabitants in 2004.[12]
     no data      less than 900      900-1650      1650-2300      2300-3000      3000-3700      3700-4400      4400-5100      5100-5800      5800-6500      6500-7200      7200-7900      Over 7900

Research

The first studies on cardiovascular health were performed in 1949 by Jerry Morris (physician) using occupational health data and were published in 1958.[13] The causes, prevention, and/or treatment of all forms of cardiovascular disease remain active fields of biomedical research, with hundreds of scientific studies being published on a weekly basis.

A fairly recent emphasis is on the link between low-grade inflammation that hallmarks atherosclerosis and its possible interventions. C-reactive protein (CRP) is an inflammatory marker that may be present in increased levels in the blood in patients at risk for cardiovascular disease. Its exact role in predicting disease is the subject of debate.

Some areas currently being researched include possible links between infection with Chlamydophila pneumoniae and coronary artery disease. The Chlamydia link has become less plausible with the absence of improvement after antibiotic use.[14]

See also

References

  1. ^ Maton, Anthea (1993). Human Biology and Health. Englewood Cliffs, New Jersey: Prentice Hall. ISBN 0-13-981176-1. 
  2. ^ United States (1999). "Chronic Disease Overview". United States Government. http://www.cdc.gov/nccdphp/overview_text.htm. Retrieved 2007-02-07. 
  3. ^ Rainwater DL, McMahan CA, Malcom GT, et al. (Mar 1999). "Lipid and apolipoprotein predictors of atherosclerosis in youth: apolipoprotein concentrations do not materially improve prediction of arterial lesions in PDAY subjects. The PDAY Research Group". Arterioscler Thromb Vasc Biol. 19 (3): 753–61. PMID 10073983. http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=10073983. 
  4. ^ a b McGill HC, McMahan CA, Zieske AW, et al. (Aug 2000). "Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group". Arterioscler Thromb Vasc Biol. 20 (8): 1998–2004. PMID 10938023. http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=10938023. 
  5. ^ Vanhecke TE, Miller WM, Franklin BA, Weber JE, McCullough PA (Oct 2006). "Awareness, knowledge, and perception of heart disease among adolescents". Eur J Cardiovasc Prev Rehabil. 13 (5): 718–23. doi:10.1097/01.hjr.0000214611.91490.5e. PMID 17001210. 
  6. ^ Wang TJ, Gona P, Larson MG, Tofler GH, Levy D, Newton-Cheh C, Jacques PF, Rifai N, Selhub J, Robins SJ, Benjamin EJ, D'Agostino RB, Vasan RS (2006). "Multiple biomarkers for the prediction of first major cardiovascular events and death". N. Engl. J. Med. 355 (25): 2631–billy bob joe9. doi:10.1056/NEJMoa055373. PMID 17182988. 
  7. ^ Wang TJ, Larson MG, Levy D, et al. (Feb 2004). "Plasma natriuretic peptide alksdjalkdj levels and the risk of cardiovascular events and death". N Engl J Med. 350 (7): 655–63. doi:10.1056/NEJMoa031994. PMID 14960742. <!kjk-- Pls confirm this ref-->
  8. ^ Ornish Dean (Jan 1996). Dean Dr. Dean Ornish's Programme for Reversing Heart Disease Ivy Books. New York: Ivy Books. ISBN 0-8041-1038-7. 
  9. ^ Ornish, Dean, "et al." (Jul 1990). "'Can lifestyle changes reverse coronary heart disease?' The Lifestyle Heart Trial.". Lancet 336 (8708): 129–33. doi:10.1016/0140-6736(90)91656-U. 
  10. ^ Ornish, D., Scherwitz, L. W., Doody, R. S., Kesten, D., McLanahan, S. M., Brown, S. E. "et al." (1983). "Effects of stress management training and dietary changes in treating ischemic heart disease". JAMA 249 (54): 54. doi:10.1001/jama.249.1.54. 
  11. ^ Ornish, D., Scherwitz, L. W., Billings, J. H., Brown, S. E., Gould, K. L., Merritt, T. A. "et al." (1998). "Intensive lifestyle changes for reversal of coronary heart disease". JAMA 280 (280): 2001. doi:10.1001/jama.280.23.2001. PMID 9863851. 
  12. ^ "WHO Disease and injury country estimates". World Health Organization. 2009. http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html. Retrieved Nov. 11, 2009. 
  13. ^ Coronary Heart Disease and Physical Activity of Work by J. N. Morris and Margaret D. Crawford, British Medical Journal 1958 ; 2(5111): 1485–1496 [1]
  14. ^ Andraws R, Berger JS, Brown DL (Jun 2005). "Effects of antibiotic therapy on outcomes of patients with coronary artery disease: a meta-analysis of randomized controlled trials". JAMA 293 (21): 2641–7. doi:10.1001/jama.293.21.2641. PMID 15928286. 

External links

Informational

Risk Assessment

  • www.HeartScore.org Cardiovascular disease risk assessment and management tool for health professionals - developed by the European Society of Cardiology

Public information

  • HeartFailureMatters.org Informations website for patients, families and care givers with animations, interviews and glossary - Created by the Heart Failure Association of the European Society of Cardiology.
  • Health-EU Portal Cardiovascular Diseases in the EU

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