23/02/2021 / Heart & Vascular
Cardiovascular disease (CVD) is a general term that describes the diseases of the heart as well as blood vessels. Coronary Heart Disease is the most common form of CVD and is caused by atherosclerosis. Atherosclerosis, also called atherosclerotic cardiovascular disease refers to the building up of cholesterol, fats, and other substances in the arteries (blood vessels that supply oxygen). All the cardiovascular diseases and terms come under Cardiology department.
Cardiovascular disease is the leading cause of death in many countries of the world. In India, the onset of CVD is at an early age and it is more severe with rapid and aggressive progression. The incidence of CVD is 47% in developing countries and 27% in developed countries amongst people below seventy years of age.
Atherosclerosis partially or totally blocks the arteries. The atherosclerotic lesions lead to the formation of thrombosis (blood clot) which is a major cause of angina (pain in the chest), myocardial infarction (death of the heart tissues), and ischaemic death (insufficient blood supply). Over time, the cholesterol and other substances continue to accumulate in the artery which is called plaque. Plaque may progress from a fatty streak to a fibrous streak and then to a complicated clot that results in various serious problems of the heart and its vessels.
Impairment of the heart and arteries can cause shortness of breath, pain, and weakness in the chest region. The circulation of the blood through the kidney also gets affected resulting in sodium and water retention in the nearby tissue spaces, causing edema. The fluid first starts collecting in the extremities but with increasing failure, it accumulates in the chest and abdominal cavity which is referred to as Congestive Heart Failure.
The risk factors of CVD have been classified into four categories:
Category I: This category includes the factors which are proven to lower the CVD risk with proper intervention. These include cigarette smoking, a high-fat diet, high LDL cholesterol in the diet, and high blood pressure.
Category II: This category includes the factors which are likely to lower the CVD risk. These include diabetes, lack of physical activity (sedentary lifestyle), triglycerides and HDL cholesterol in the diet, and obesity.
Category III: This category includes the factors that are associated with increased CVD risk which might lower the risk if modified. These include psychological factors, oxidative stress, and limiting alcohol consumption.
Category IV: These include the factors associated with increased risk of CVD which cannot be modified such as age, male gender, and family history.
Fats are very much interconnected and responsible for the development of CVD. The main forms of fat traveling through the blood in the human body are cholesterol and triglycerides. These fats and lipids are not only consumed by food but the body also produces its own fat molecules in the liver. Fats are not soluble in water; therefore, they cannot easily travel through the blood. Lipoproteins help in carrying the digested fat from the liver to various parts of the body through the blood vessels. The lipoproteins then return back to the liver and repeat their job. If too much fat is consumed with the diet, the liver produces extra lipoprotein to carry fat. More lipoproteins along with fat molecules get stuck in the blood vessels, thereby blocking the normal flow of blood. This may result in various heart diseases including heart attack.
The common symptoms of heart diseases may include chest pain, pressure on the chest, chest tightness or discomfort in the chest region (angina), shortness of breath, weakness or numbness in the legs or arms, pain in the throat, neck, jaw, and upper abdomen.
The principle of treating CVD is based on the following factors:
1. Dietary management: The patients suffering from CVD should follow a strict cardiovascular diet with a very limited amount of fat in the diet. The patient should increase the fiber intake, particularly the soluble fiber and soy-based products. The sugar and salt intake must be restricted. The patient should also avoid alcohol consumption and cigarette smoking.
2. Physical activity: Exercise is very much beneficial for CVD patients as it protects the heart against the progression of the disease. Aerobic exercise elevates the strength of the heart and its size. Being physically active also enhances the circulatory system by increasing the oxygen-carrying capacity of the blood.
3. Stress management: Stress of all kinds (physical, social, and emotional) causes the heart to beat faster, elevates the blood pressure, makes the muscles tensed, and results in coronary artery spasm. Several chronic diseases including heart and blood vessel diseases can be modified by managing stress. Stress can be managed by stretching, breathing exercises, relaxation, meditation, and yoga.
4. Medications: Certain medicine helps in lowering the total cholesterol. Statins, fibrates, HMG CoA reductase inhibitors, and niacinamide are some drugs that reduce the amount of lipid deposited in the arterial walls, reduce the risk of heart attacks, unstable angina, and stroke. However, it should be noted that the drugs are not a substitute for diet and lifestyle modifications. The patient should stop smoking and reduce the stress level as part of the treatment of CVD.
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