Cardiovascular Disease (Heart and blood vessel disease)
Learning about cardiovascular disease can be critical to your long-lasting health. Here you have the opportunity to learn about this important disease of our time. When we talk about cardiovascular disease, it usually includes heart disease, stroke, peripheral vascular disease, hypertension and heart failure (weak heart muscles).
I’m happy to report that the number of patients with cardiovascular disease has been continuously decreasing over the past decades. This development is probably the result of improved blood pressure and cholesterol control, in addition to better acute care interventions.
Let’s begin with some statistics
According to the American Heart Association, by 2030 almost 40% of the U.S. population is going to have some sort of cardiovascular disease. Despite a decline in number of deaths due to cardiovascular disease, the number of hospitalizations is continuing to rise and consequently the cost of care for these patients has also been rising exponentially.
Cardiovascular disease, or heart and blood vessel disease, is the most common cause of death through a medical disorder in the United States and most developed countries. In the United States, each year around 525,000 individuals have their first incident and 210,000 experience a recurrent event. Roughly every 34 seconds, one American has a heart-related event, and approximately every minute, an American will die of one.
The number of patients suffering from heart failure is rising as well. There are currently estimated to be 5.1 million Americans with a diagnosis of heart failure. Most of the individuals diagnosed with cardiovascular disease, especially heart failure, have a history of high blood pressure/ hypertension. Almost 50% of patients diagnosed with heart failure die from the consequences of this condition within five years.
Major risk factors for heart disease
Several risk factors have been associated with coronary heart disease. The following is a list of these risk factors
Male: ≥45 years
Female: ≥55 years
Elevated blood lipid levels (sum of bad cholesterol)
Family history of early heart disease
Low good blood cholesterol level (HDL < 40 mg/dl))
Some of the above risk factors are modifiable and can be improved through lifestyle changes and medications. These risk factors include smoking, physical inactivity, unhealthy diet, elevated blood pressure and cholesterol level and obesity. Almost 90% of the heart attack risk has been attributed to modifiable risk factors. This number is important because it tells you the power of lifestyle changes. If the lifestyle modifications are started early and done the right way, they can be effective in lowering heart attack risks. Others risk factors are non-modifiable and cannot be changed or improved, such as age and family history.
Cardiovascular disease in different ethnicities
American Indians and Alaska natives have the highest rate of heart disease among all ethnicities followed by whites, blacks or African Americans, Hispanics or Latinos, and Asians.
African Americans are most affected by heart failure, followed by Hispanics, whites and Chinese Americans.
Furthermore, the rate of hypertension is highest in African Americans. Black women have a higher prevalence than black men.
Population studies have shown that immigrants from countries with a low rate of cardiovascular disease will have a higher level of risks after adoption of Western eating habits.
Cardiovascular disease in women
In my experience, most people aren’t aware that the number of deaths from cardiovascular disease has been greater for women than men. Among women, blacks have a higher rate of death than females of other races.
It’s known that women have a higher number of risk factors for cardiovascular disease compared to men, except for tobacco use. They have a much higher rate of uncontrolled hypertension, high blood cholesterol and diabetes.
The presentation of heart disease in women is more complicated and confusing than in men. Most of the time, female patients present with atypical signs such as nausea, fatigue and shortness of breath. This atypical presentation of heart disease related symptoms might be a reason why many women receive the care that they need much later than the men.
Family history of premature heart disease
As mentioned above, family history is one of the non-modifiable risk factors for heart disease and is directly related to our genes. If you have a first degree male family member who was diagnosed with heart disease or had a heart attack and was younger than 45 years of age, then your chance of suffering from heart disease is much higher than the population without a family history of heart disease. The process of developing heart disease in female patients lags almost 10 years behind their male counterparts. Therefore, your risk of heart disease will increase, if you have a first degree female relative with heart disease who was younger than 55 years old.
How to Prevent Cardiovascular Disease
The majority of people who have atherosclerosis or hardening of their arteries don’t have any symptoms initially; that’s why many people don’t take care of themselves and wait too long to get treatment. This disease is a slowly progressing one and can be hidden for far too long.
Prevention works: Managing risk factors and avoiding harmful behavior can postpone and sometimes diminish the risk for cardiovascular disease.
Clinical data have clearly shown that managing and controlling high cholesterol, high blood pressure and other risk factors can reduce the risk of cardiovascular disease. For instance, cholesterol-lowering measures, beginning with life style changes and escalating to medication therapy, if necessary, can improve the outcome of patients at risk of a heart attack.
Furthermore, a comprehensive dietary and behavior change has potential to reduce this risk (Check out my article series about reducing cholesterol and triglycerides with diet). There is no question that lifestyle changes should be the primary option for patients with any of the above contributing factors, especially if the management and preventive measures have been initiated early.
Currently, statins remain one of the major medications of choice for lowering blood cholesterol. These drugs have the ability not only to reduce the low-density lipoproteins (LDL) and increase high-density lipoproteins (HDL), but can also improve triglycerides and reduce inflammation.
High blood pressure
High blood pressure can also be treated more easily if managed early. This condition also responds well to behavior changes such as dietary changes, an increase in exercise, a discontinuation of smoking, and stress management.
According to the Centers of Disease Control and Prevention, only one-third of patients with hypertension have their blood pressure under control; in other words, the rest of the population (two-thirds) comprises possible candidates for undergoing cardiovascular events in the future.
In my opinion, this statistic is sad and horrifying at the same time. Please read the article about the ways of reducing blood pressure with diet (Foods that Lower Blood Pressure).
Blood cholesterol and heart disease
It is well-known that an elevated bad cholesterol level can increase the risk of heart disease. Numerous studies have reported that every 1% decrease in LDL cholesterol- (bad cholesterol level), results in a corresponding 1% decrease in the risk for heart disease.
In most cases, diabetes is also a preventable disease. Because of our society’s lifestyle changes (and rising obesity rates), the number of diabetic patients has risen from 1.5 million in 1958 to 18.8 million in 2010. It is estimated that 79 million Americans age 20 and above have pre-diabetes.
Pre-diabetes is a condition where a person has a high blood-glucose level, but not enough to diagnose that person with diabetes. In other words, it’s one step away from full-blown diabetes. Seventy-nine million people have pre-diabetes and most of them are waiting to be diagnosed with diabetes, a disease that can result in serious health related problems for the individual in addition to significant costs for society.
We now have a good understanding of the relationship between smoking and cardiovascular disease. We know that tobacco use increases the risk of cardiovascular disease, including heart disease and stroke. American Indians / Alaska natives have the highest rate of smoking in the United States.
Smoking can increase the risk of cardiovascular disease by two to three times.
It also increases the risk of having a stroke by two to four times.
Unfortunately, those who are exposed to second-hand smoke are not safe either. Living next to a smoker can increase your risk of having cardiovascular disease by 25% to 30%. The good news is that people who decide to stop smoking can enjoy the benefits within two years. Their increased risk for cardiovascular disease declines to non-smoker levels within 5 years.
I don’t want to talk about smoking too much; I believe that most people are well educated about the terrifying consequences of smoking. Smoking has absolutely no benefits and is bad for your body; please stop poisoning yourself.
Don’t wait until it’s too late; you don’t have always to experience bad things before you know how harmful they really are.
Family history of premature heart disease
As mentioned above, family history is one of the non-modifiable risk factors for heart disease and is directly related to our genes. If you have a first degree male family member who was diagnosed with heart disease or had a heart attack and was younger than 45 years of age, then your chance of suffering from heart disease is much higher than the population without a family history of heart disease.
The process of developing heart disease in female patients lags almost 10 years behind their male counterparts. Therefore, your risk of heart disease will increase, if you have a first degree female relative with heart disease who was younger than 55 years old.
Chronic kidney (renal) disease
Another group of patients who have a higher risk of dying from heart and vascular disease are patients with chronic kidney problems. This number increases when the kidney function deteriorates and the patients are put on dialysis. Most patients with chronic kidney disease also have high blood pressure and diabetes. To avoid kidney failure, individuals need to have excellent blood pressure and diabetes control. The control of blood pressure, cholesterol and sugar levels, will also help to prevent mild kidney failure to progress to more severe forms of kidney failure. Therefore, it is vital to manage these risk factors at all times.
Must read articles
- Familial Hypercholesterolemia (High Blood Cholesterol): Too Often Ignored and Untreated
- What is CRP or C-reactive protein?
- Lowering LDL-cholesterol and Triglycerides through Diet (Part 3)-Fiber
- Could Mammography be a Valid Tool for Predicting the Development of Heart Disease in Women?
- What is “white coat” Hypertension?
- What is HDL?
- Lowering LDL-cholesterol and Triglycerides through Diet (Part 1)-Fish Oil
- Hypertension: What Everybody Ought to Know
- Triglycerides: A Seldom-Acknowledged Part of Lipids
- Fish Oil: Take it or Stop it, that’s the Question
- Could Statins Cause Diabetes?
Read all the above articles and share your thoughts on my Google + page with other readers. I would love to hear your questions and how some of these information and strategies are helping you.
Keep on Reading,
H. L. Daneschvar, MD, FACP