Cardiovascular Disease
Cardiovascular disease refers to disorders that affect the coronary system, but often means coronary heart disease, heart failure and stroke, taken together. However, CVD can also mean cerebrovascular, or disease of brain circulation.
Coronary heart disease and stroke are mainly consequences of overweight, sedentary lifestyle , smoking, poorly controlled diabetes, high intake of saturated fat, trans fatty acids, or cholesterol, and metabolic syndrome, as indicated by at least 3 of the following:
Heart failure is the impairment of the pumping function of the heart as the result of coronary heart disease. It often causes physical disability, ischemic stroke or transient ischemic attack (TIA) and cerebrovascular accident ( CVA), coronary artery bypass graft ( CABG) An impressive body of evidence amassed over the last 37 years has established that blood lipids, blood pressure, obesity, sedentary lifestyle and diabetes can be modified and controlled.
Three approaches to prevent cardiovascular disease: first, detect and treat risk factors for people with risk factors but no evidence of disease. Second, reduce subsequent heart attacks or strokes by treating CVD and the risk factors. Third, intervene early before the risk factors ever begin to develop through a healthy lifestyle, during childhood or even during gestation.
Myths About Cardiovascular Disease
Heart attacks only affect the elderly.
CVD is a disease whose antecedents lie in the health behaviors of individuals in their youth, and preventive interventions might best be initiated in childhood or young adulthood to forestall the onset of CVD later in life. Moreover, statistics and projections from the WHO in 1990, based on mortality rates of individuals aged 30-69 years, show CVD to be the major cause of death in that age group. This 39-year span includes the young adult and middle-aged years, or "prime of life."
Although the manifestations of coronary artery disease typically occur during the middle and later years of life, the roots of coronary artery disease lie in childhood. Using heart-healthy lifestyle measures not only will help but also will enable one to set an example for the next generation.
Only males develop CVD.
Although the number of deaths in men outnumber those in women, it is important to note that women contributed 42% of the deaths due to CVD . Women are six to ten times more likely to die of heart disease than breast cancer (which women fear more). When cardiovascular disease and stroke are combined, these two diseases claim more female lives every year than the next 16 causes of death combined.
If you're having chest pain, the best thing you can do is wait and see whether it goes away.
Ignoring the symptoms of acute heart disease is a bad idea. The longer the delay before treatment of a heart attack begins, the greater the potential heart damage. If one is having significant chest discomfort, shortness of breath, or any other symptoms that suggest a heart attack, see a physician immediately.
CVD causes "death not disability.
According to the World Health Organization (WHO), the Disability Adjusted Life Years (DALYS) for CVD will climb in the developing world such that coronary heart disease and stroke combined will be the leading cause of disability and death in developing countries by the year 2020 .
Only the rich develop CVD
In a national study in the US of men and women aged 45-64 years from 1979-89, ischemic heart disease was highest for those in lower socioeconomic groups . Socioeconomic status (SES) refers to an individual's social position relative to other members of a society. Low SES is associated with large increases in cardiovascular disease (CVD) risk in men and women.
Heart attack can be “fixed” with modern medical and surgical technology.
Only for those who survive long enough to receive treatment; but of no help to those who die suddenly following their first CVD event. There is no complete “cure” once a heart attack or stroke has occurred.
Most Frequently Asked Questions
How do I know if I have heart disease?
Heart disease often has no symptoms. But, there are some signs to watch for. Chest or arm pain can be a symptom of heart disease and a warning sign of a heart attack. Shortness of breath (feeling like you can't get enough air), dizziness, nausea (feeling sick to your stomach), abnormal heartbeats, or feeling very tired are signs, too.
What's the difference between "Good" and "Bad" cholesterol?
HDL (high density lipoprotein) cholesterol is known as good cholesterol. HDL takes the bad cholesterol out of your blood and keeps it from building up in your arteries. LDL (low density lipoprotein) cholesterol is known as bad cholesterol because it can build up on the walls of arteries and increase the chances of blood clots . When being tested for high cholesterol, one wants a high HDL number and a low LDL number ( ≤ 100 mg /100 ml ).
How can I increase my “good” ( HDL) cholesterol?
Through increased physical activity/ exercise and a diet rich in monounsaturated fatty acids like olive oil, avocado, and nuts like macadamia, hazelnuts, pecans, almonds, brazilnuts, peanuts, cashews ( content in descending order) and possibly
“ pili nuts.” Trans fatty acids in partially hydrogenated fats and high triglycerides tend to lower HDL. American Heart Association recommends HDL of ≥ 45 for men and ≥ 55 for women.
What makes “bad” ( LDL) cholesterol levels to go up?
Eating foods such as meats, whole milk dairy products, egg yolks, organ meats, and shellfish can make cholesterol levels to go up. Being overweight, too, increases bad cholesterol and reduces good cholesterol . Also, after women go through menopause, their bad cholesterol levels tend to go up. To reduce “bad cholesterol”, go for lean white cuts of meat, poultry without skin, fatty fish, low fat dairy products, trans fat –free pastries and baked products, high fiber cereals and grains, lots of fruits and vegetables, and nuts rich in omega-3 like walnuts, in plant sterols like pistachio, almonds, and macadamia (content in descending order).
What is the difference between cholesterol and triglycerides?
Cholesterol is a waxy, fat-like substance used by the body to build cell walls. The liver produces cholesterol from the animal fats one eats. Cholesterol is carried through the blood by particles called lipoproteins. There are two types: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). The former carries the cholesterol around the body in the blood and the latter transports cholesterol out of the blood into the liver. When cholesterol is too high, or the levels of the two types are out of balance (dyslipidemia), the cholesterol can clog the arteries affecting the flow of the blood.
Triglycerides are fats found in the blood that are important for muscle energy. They travel through the blood in lipoproteins. As triglyceride levels rise, the good HDL cholesterol levels fall. Very high levels of triglycerides can lead to diabetes, pancreatitis, chronic kidney disease and stroke or transient ischemic attack (TIA). The American Heart Association recommends ≤ 150 mg/dl for adults.
Where do triglycerides come from ?
Triglycerides in the blood come from two sources: from the food eaten, mainly sugar, animal products, and saturated fat; in the liver from any excess sugar which have not been used for energy. High triglycerides in the blood inhibit the action of insulin resulting in insulin resistance, which slows down the accumulation of body fat, but allows the blood sugars to rise and trigger onset of diabetes. A diet high in complex carbohydrates (starches and vegetables), omega-3 and monounsaturated fatty acids, nuts, low in simple sugars and alcohol have been found to lower blood triglycerides. Exercise and weight loss further control hypertriglyceridemia.
References/Links
National Cholesterol Education Program. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults ( Adult Treatment Panel) www.nhlbi.nih.gov/guidelines
www.nutritioncaremanual.org
National Center for Chronic Disease Prevention and Health Promotion. 2003. www.cdc.gov/cvh
Brown,K and T Pearson. Commentary: Cardiovascular disease in the developing world—myths and realities. www.procor.org
Nature Reviews Cardiology 6, 712-722 (November 2009) | doi:10.1038/nrcardio.2009.163
National Women’s Health Information Center. www.women’shealth.gov
www.world-health-federation.org
The McDougall Newsletter. Vol2 No.1. Jan 2003 www.drmcdougall.com
www.healingdaily.com