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Cardiovascular disease

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Cardiovascular disease
Classification and external resources
ICD-10 I51.6
ICD-9 429.2
DiseasesDB 28808
MeSH D002318

Heart disease or cardiovascular disease are 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 C14), it is usually used to refer to those related to atherosclerosis (arterial disease). These conditions usually have similar causes, mechanisms, and treatments.

Most countries face high and increasing rates of cardiovascular disease. Each year, heart disease kills more Americans than cancer. In recent years, cardiovascular risk in women has been increasing and has killed more women than breast cancer.[2] 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.


Population based studies 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 education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken.

Obesity and diabetes mellitus are often linked to cardiovascular disease [6], as are a history of chronic kidney disease and hypercholesterolaemia [7]. In fact, cardiovascular disease is the most life threatening of the diabetic complications and diabetics are two- to four-fold more likely to die of cardiovascular-related causes than nondiabetics.[8][9][10]


Associated diagnostic markers

Template:Expand section


Some biomarkers are thought to offer a more detailed risk of cardiovascular disease. However, the clinical value of these biomarkers is questionable.[11] Currently, biomarkers which may reflect a higher risk of cardiovascular disease include:


Evidence shows that the Mediterranean diet improves cardiovascular outcomes.[13] As of 2010 however vitamins have not been found to be effective at preventing cardiovascular disease.[14]

Modifiable risk factors to improve or prevent atherosclerosis include:

  • diet high in fibers from vegetables and nuts while low in saturated fat and cholesterol;
  • tobacco cessation and avoidance of second-hand smoke[citation needed];
  • decreased alcohol consumption;
  • lower blood pressures if elevated through the use of antihypertensive medications;
  • strict diabetes management;
  • decrease BMI if overweight or obese;
  • increase daily activity to 30 minutes of moderate to vigorous exercise; and
  • decrease emotional stress in day to day life[citation needed]. (Sources:, medical source


Cardiovascular disease is treatable with initial treatment primarily focused on diet and lifestyle interventions. [15] [16] [17] Medication may also be useful for prevention.


File:Cardiovascular diseases world map - DALY - WHO2004.svg
Disability-adjusted life year for cardiovascular diseases per 100,000 inhabitants in 2004.[18]
  no data
  less than 900
  Over 7900

The first studies on cardiovascular health were performed in 1949 by Jerry Morris using occupational health data and were published in 1958.[19] 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 trend has emerged, particularly in the early 2000s, in which numerous studies have revealed a link between fast food and an increase in heart disease. These studies include those conducted by the Ryan Mackey Memorial Research Institute, Harvard University and the Sydney Center for Cardiovascular Health. Many major fast food chains, particularly McDonald's, have protested the methods used in these studies and have responded with healthier menu options.

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 common inflammatory marker that has been found to be present in increased levels in patients at risk for cardiovascular disease.[20] Also osteoprotegerin which involved with regulation of a key inflammatory transcription factor called NF-κB has been found to be a risk factor of cardiovascular disease and mortality.[21][22]

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.[23]

See also


  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. 
  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. 
  4. 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. 
  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. Highlander P, Shaw GP: Current pharmacotherapeutic concepts for the treatment of cardiovascular disease in diabetics. Ther Adv Cardiovasc Dis. 4: 43-54, 2010.
  7. NPS Medicinewise (1 March 2011). "NPS Prescribing Practice Review 53: Managing lipids". Retrieved 1 August 2011. 
  8. Kvan, E., Pettersen, K.I., Sandvik, L. and Reikvam, A. (2007) High mortality in diabetic patient with acute myocardial infarction: cardiovascular co-morbidities contribute most to the high risk. Int J Cardiol 121: 184�188.
  9. Norhammar, A., Malmberg, K., Diderhol, E., Lagerqvist, B., Lindahl, B., Ryde´n, L. et al. (2004) Diabetes mellitus: the major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization. J Am Coll Cardiol 43: 585�591.
  10. DECODE study group on behalf of the European Diabetes Epidemiology Group (1999) Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. Lancet 354: 617�621.
  11. 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. 
  12. Wang TJ, Larson MG, Levy D, et al. (Feb 2004). "Plasma natriuretic peptide levels and the risk of cardiovascular events and death". N Engl J Med. 350 (7): 655–63. doi:10.1056/NEJMoa031994. PMID 14960742. 
  13. Walker C, Reamy BV (April 2009). "Diets for cardiovascular disease prevention: what is the evidence?". Am Fam Physician 79 (7): 571–8. PMID 19378874. 
  14. "Vitamins and minerals: not for cancer or cardiovascular prevention". Prescrire Int 19 (108): 182. August 2010. PMID 20939459. 
  15. 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. PMID 1973470. 
  16. 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. PMID 6336794. 
  17. 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 (23): 2001–7. doi:10.1001/jama.280.23.2001. PMID 9863851. 
  18. "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved Nov. 11, 2009. 
  19. 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]
  20. PMID:20024640
  21. 20448212
  22. PMID: 20447527
  23. 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


Public information

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