h e a l t h

Cardiovascular diseases
What are cardiovascular diseases?

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and include:

Coronary heart disease disease of the blood vessels supplying the heart muscle Cerebrovascular disease - disease of the blood vessels supplying the brain Peripheral arterial disease disease of blood vessels supplying the arms and legs Rheumatic heart disease damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria

Cardiovascular diseases
What are cardiovascular diseases?

Congenital heart disease - malformations of heart structure existing at birth. Deep vein thrombosis and pulmonary embolism blood clots in the leg veins, which can dislodge and move to the heart and lungs. Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by bleeding from a blood vessel in the brain or from blood clots.

FACTS ABOUT CARDIOVASCULAR DISEASES

CVDs are the number one cause of death globally: more people die annually from CVDs than from any other cause; An estimated 17.5 million people died from CVDs in 2005, representing 30% of all global deaths. Of these deaths, an estimated 7.6 million were due to coronary heart disease and 5.7 million were due to stroke. Over 80% of CVD deaths take place in low- and middle-income countries and occur almost equally in men and women; By 2015, almost 20 million people will die from CVDs, mainly from heart disease and stroke. These are projected to remain the single leading causes of death.

Cardiovascular diseases

MORTALITY:TEN(10) LEADING CAUSES Number and rate/100,000 Population Philippines 5-year average (2000-2004)2005
CAUSE 5year average (2000-2004) number rate 66,412 50,886 38,578 32,989 33,455 27,211 18,015 13,584 14,477 83.3 63.9 48.4 41.4 42.0 34.2 22.6 17.0 18.2 2005 number 77,060 54,372 41,697 36,510 33,327 26,588 20,951 18,441 12,368 rate 90.4 63..8 48.9 42.8 39.1 31.2 24.6 21.6 14.5

Diseases of the heart Diseases of the vascular system Malignant neoplasm pneumonia Accidents Tuberculosis, all forms Chronic respiratory diseases Diabetes mellitus Certain conditions originating in the perinatal period Nephritis,nephrotic syndrome and nephrosis

9,166

11.5

11,056

3.6

 WHAT CAUSES CARDIOVASCULAR DISEASES?

The causes of CVDs are well established and well known. The most important causes of heart disease and stroke are unhealthy diet, physical inactivity and tobacco use. These are called 'modifiable risk factors'. The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity; these are called 'intermediate risk factors'. The major modifiable risk factors are responsible for about 80% of coronary heart disease and cerebrovascular disease. There are also a number of underlying determinants of chronic diseases, or, if you like, "the causes of the causes". These are a reflection of the major forces driving social, economic and cultural change globalization, urbanization, and population ageing. Other determinants of CVDs are poverty and stress

WHAT ARE THE ECONOMIC COSTS OF CARDIOVASCULAR DISEASES? CVDs affect many people in middle age, very often severely limiting the income and savings of affected individuals and their families. Lost earnings and out of pocket healthcare payments undermine the socioeconomic development of communities and nations. CVDs place a heavy burden on the economies of countries. For example, it is estimated that over the next 10 years (2006-2015), China will lose $558 billion in foregone national income due to the combination of heart disease, stroke and diabetes. Lower socioeconomic groups in high income countries generally have a greater prevalence of risks factors, diseases and mortality,. A similar pattern is emerging as the CVD epidemic evolves in low and middle income countries

Diseases of the the Heart and Blood Vessels(Cardiovascular diseases)

1.Hypertension
Hypertension or high blood pressure is defined as a sustained elevation in mean arterial pressure. It is not a single disease state but a disorder with many causes, a variety of symptoms, an d a range of responses to therapy. It is also a major risk factor in for the development of CVDs like coronary heart disease and stroke.

Etiology/causes classified into 2types:

 Primary hypertension no definite cause. It is also called hypertension or idiopathic hypertension.  Secondary hypertension is usually the result of some other primary diseases
leading to hypertension such as RENAL DISEASE.

Risk Factors:
Family history Age High salt intake Obesity Excessive alcohol intake

Key areas for prevention :

Encourage proper nutrition - reduce salt intake Prevent becoming overweight or obese through proper nutrition and exercise. Smoking cessation tobacco use promotes atherosclerosis that may contribute to hypertension; quitting smoking anytime is beneficial; this refers to both active and passive smokers. Identify people with risk factors and encourage regular check-ups for possible hypertension and modification of risk factors.

2.Coronary artery disease

It is a heart disease caused by impaired coronary blood flow. It is also known as ISCHEMIC HEART DISEASE. When the coronary arteries become narrowed or clogged, supply of blood and oxygen to the heart muscle is affected. When there is decreased oxygen supplied to the heart muscle, chest pain (ANGINA)occurs. Etiology/causes The most common is atherosclerosis. This is the thickening of the inside walls of arteries due to deposition of a fat-like substance. Risk factors: Hyperlipidemia Hypertension Smoking Diabetes mellitus Obesity Physical inactivity/sedentary lifestyle Stress

Elevated blood lipids/cholesterol Increased blood pressure is an important risk factor in the development of CAD. Reports have shown that modest reduction in total cholesterol can significantly lessen CVD morbidity and mortality. High LDL(low density lipoprotein)level is a risk factor of CAD. It is called the bad cholesterol because it is the main carrier of cholesterol and contributes to atherosclerosis.LDL level is increased by high saturated fat intake,obesity,sedentary lifestyle,smoking,androgens,and certain drugs.

 Not all cholesterol is bad. HDL(high-density lipoprotein) is now acknowledge as a protective factor against coronary heart disease.HDL facilitates reverse transport of cholesterol to the liver where it may be excreted and therefore prevents atherosclerosis. When HDL level is below normal, this becomes a risk factors for CAD. It is decreased in smoking, obesity and diabetes mellitus. Regular exercise and moderate alcohol consumption increase HDL levels.

Smoking/tobacco Use Risk of death from CAD is 70-200 times greater for men who smoke one or more packs of cigarettes per day compared to those who do not smoke. This risk is most seen in young people, particularly those younger than 50 years old.

Key Areas of Prevention of CAD

Promote a regular physical activity and exercise; exercise increases HDL,prevents obesity and improves optimum functioning of the heart. Encourage proper nutrition particularly by limiting intake of saturated fats that increase LDL,limiting salt intake of dietary fiber by eating more vegetables,fruits,unrefined cereals and white bread. Maintain body weight and prevent obesity through proper nutrition and physical activity/exercise. Advise smoking cessation for active smokers and prevent exposure to second hand smoke by family members, friends and co-workers of active smokers. In general, promote a smoke-free environment through advocacy and community mobilization. Early diagnosis, prompt treatment and control of diabetes and hypertension; these diseases are risk factors and contribute to the development of coronary artery disease.

 3.Cerebrovascular Diseases or Stroke

Stroke is the loss or alteration of bodily function that results from an insufficient supply of blood to some parts of the brain. For human brain to function peak levels, blood must flow through its many vessels. If the blood flow is obstructed to any part, the brain loses its energy supply and becomes injured. If blood is obstructed to more than several minutes, injury to the brain cells becomes permanent and tissue dies in effected regions resulting in cerebral infarction. Stroke is one of the leading causes of disability. It can lead to weakness or paralysis usually of one side of the body.often,the person has slurring of speech one even inability to talk(aphasia).if stroke is massive and severe, it can cause death.

 Etiology/causes
there are three types of strokes based on cause:thrombotic stroke,embollic stroke and hemorrhagic stroke. Almost all strokes are caused by are caused by occlusion of cerebral vessels by either thrombi or emboli. Thrombi usually occurs in atherosclerotic blood vessels. This is usually seen in older people and may occurs in a person at rest. An embolic stroke is caused by a moving blood clot usually from a thrombus the left heart that becomes lodged in a small artery through w/c it cannot pass. Intracerebral haemorrhage this is the rupture of intracerebral blood vessels. This the most fatal type of stroke. Atherosclerosis is also the common cause of stroke. Risk factors of stroke Increasing age Sex Heredity(family history)and race Hypertension Cigarette smoking Diabetes mellitus

Heart disease High red blood cell count Season and climate Socioeconomic factors Excessive alcohol intake Certain kind of drug abuse ex. cocaine
Key Areas of Prevention of Stroke:

Treatment and control of hypertension many people believe that effective treatment of high blood pressure is a key reason for the rapid decline in the death rates of stroke Smoking cessation and promoting a smoke free environment Prevent thrombus formation in rheumatic heart disease and arrhythmias with appropriate medications. Health workers need to remind these persons to take their medications as prescribed. Limit alcohol consumption for women, not more than one drink per day, and for men, not more than two drinks per day. Avoid intravenous drug abuse and cocaine Prevent all other factors of atherosclerosis

 Rheumatic heart disease

Rheumatic heart disease is damage to the heart valves and heart muscle from the inflammation and scarring caused by rheumatic fever. Rheumatic fever is caused by streptococcal bacteria, which usually begins as a sore throat or tonsillitis in children.

Symptoms:
shortness of breath, fatigue, irregular heart beats, chest pain and fainting; fever, pain and swelling of the joints, nausea, stomach cramps and vomiting.

Treatment:
Early treatment of streptococcal sore throat can stop the development of rheumatic fever. Regular long-term penicillin treatment can prevent repeat attacks of rheumatic fever which give rise to rheumatic heart disease and can stop disease progression in people whose heart valves are already damaged by the disease.