Cardiovascular disease ( CVD ) is a class of diseases involving the heart or blood vessels. Cardiovascular diseases include coronary artery disease (CAD) such as angina and myocardial infarction (commonly known as heart attack). Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, cardiac arrhythmia, congenital heart disease, valvular disease, carditis, aortic aneurysm, peripheral artery disease, thromboembolic disease, and venous thrombosis.
The underlying mechanisms vary depending on the disease. Coronary artery disease, stroke, and peripheral artery disease involve atherosclerosis. It may be caused by high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol consumption, among others. High blood pressure produces 13% of CVD deaths, while tobacco results in 9%, diabetes 6%, exercise less 6% and obesity 5%. Rheumatic heart disease can occur after untreated strep throat.
An estimated 90% CVD can be prevented. Prevention of atherosclerosis involves increased risk factors through: healthy eating, exercise, avoiding tobacco smoke and limiting alcohol intake. Treating risk factors, such as high blood pressure, blood lipids and diabetes is also beneficial. Treating people who have a sore throat with antibiotics can reduce the risk of rheumatic heart disease. The use of aspirin in humans, which is otherwise healthy, has no clear benefits.
Cardiovascular disease is the leading cause of death globally. This is true in all regions of the world except Africa. Together they generate 17.9 million deaths (32.1%) by 2015, up from 12.3 million (25.8%) in 1990. Death, at some age, of CVD is more common and has increased in many developing countries, while rates have declined in most developed countries since the 1970s. Coronary artery disease and stroke cause 80% of CVD deaths in men and 75% of CVD deaths in women. Most cardiovascular diseases affect older adults. In the United States 11% of people between 20 and 40 have CVD, while 37% between 40 and 60, 71% of people between 60 and 80, and 85% of people over 80 have CVD. The average age of deaths from coronary artery disease in developed countries is around 80 while it is about 68 in developing countries. Onset disease is usually seven to ten years earlier in men compared with women.
Video Cardiovascular disease
Type
There are many cardiovascular diseases involving blood vessels. They are known as vascular disease.
- Coronary artery disease (also known as coronary heart disease and ischemic heart disease)
- Peripheral artery disease - vascular disease that supplies blood to the arms and legs
- Cerebrovascular disease - vascular disease that supplies blood to the brain (including strokes)
- Renal artery stenosis
- Aortic aneurysm
There are also many cardiovascular diseases involving the heart.
- Cardiomyopathy - heart muscle disease
- Heart disease hypertension - heart disease secondary to high blood pressure or hypertension
- Heart failure - a clinical syndrome caused by the inability of the heart to supply enough blood to the tissues to meet their metabolic needs
- Pulmonary heart disease - failure on the right side of the heart with respiratory system involvement
- Cardiac dysrhythmias - heart rhythm abnormalities
- Inflammatory heart disease
- Endocarditis - inflammation of the inner lining of the heart, the endocardium. The most common structure involved is the heart valve.
- Inflammatory cardiomegaly
- Myocarditis - myocardial inflammation, the heart muscle part, is most commonly caused by viral infections and less frequently by bacterial infections, certain drugs, toxins, and autoimmune disorders. It is characterized in part by heart infiltration by lymphocytes and monocyte types of white blood cells.
- Eosinophilic myocarditis - myocardial inflammation caused by pathologically active eosinophilic white blood cells. This disorder differs from myocarditis in its cause and treatment.
- Valvular heart disease
- Congenital heart disease - an existing cardiac malformation heart structure
- Rheumatic heart disease - heart muscle and valve damage due to rheumatic fever caused by Streptococcus pyogenes Group A streptococcal infection
Maps Cardiovascular disease
Risk factors
There are many risk factors for heart disease: age, gender, tobacco use, physical activity, excessive alcohol consumption, unhealthy diet, obesity, genetic predisposition and family history of cardiovascular disease, elevated blood pressure (hypertension), elevated blood sugar diabetes mellitus), increased blood cholesterol (hyperlipidemia), undiagnosed celiac disease, psychosocial factors, poverty and low education status, and air pollution. While the individual contribution of each risk factor varies between different communities or ethnic groups, the overall contribution of these risk factors is highly consistent. Some of these risk factors, such as age, gender or family history/genetic predisposition, can not be changed; However, many important cardiovascular risk factors may be modified by lifestyle changes, social changes, medication treatments (eg prevention of hypertension, hyperlipidemia, and diabetes). People with obesity are at higher risk of developing atherosclerosis in the coronary arteries.
Genetics
Genetic factors affect the development of cardiovascular disease in men less than 55 years and in women less than 65 years. Cardiovascular disease in a person's parents increases the risk by 3-fold. Several single nucleotide polymorphisms (SNPs) have been found to be associated with cardiovascular disease in the study of genetic relationships, but usually their individual influences are small, and the genetic contributions to cardiovascular disease are poorly understood.
Age
Age is the most important risk factor in developing heart or heart disease, with about three times the risk with every decade of life. The coronary fat layer can begin to form in adolescence. It is estimated that 82 percent of people who die of coronary heart disease are 65 and older. Simultaneously, the risk of stroke doubles every decade after age 55.
Several explanations were put forward to explain why age increases the risk of cardiovascular/heart disease. One of them is associated with serum cholesterol levels. In most populations, serum total cholesterol levels increase with age. In men, this increase decreases around the age of 45 to 50 years. In women, the increase continues sharply until the age of 60 to 65 years.
Aging is also associated with changes in the mechanical and structural properties of blood vessel walls, leading to loss of arterial elasticity and reduced arterial adherence and may further lead to coronary artery disease.
Sex
Men are at greater risk of heart disease than pre-menopausal women. After passing through menopause, it has been argued that a woman's risk is similar to that of a man despite recent data from WHO and the UN denied it. If a woman has diabetes, she is more likely to develop heart disease than men with diabetes.
Coronary heart disease is 2 to 5 times more common among middle-aged men than women. In a study conducted by the World Health Organization, sex contributed about 40% of the variation in the sex ratio of coronary heart disease deaths. Another study reported similar results found that gender differences explain nearly half the risks associated with cardiovascular disease One proposed explanation for gender differences in cardiovascular disease is hormonal differences. Among women, estrogen is the dominant sex hormone. Estrogens may have protective effects on glucose metabolism and hemostatic systems, and may have a direct effect in enhancing endothelial cell function. Estrogen production decreases after menopause, and this may alter the lipid metabolism of women into more atherogenic forms by lowering HDL cholesterol levels while increasing LDL and total cholesterol levels.
Among men and women, there are striking differences in weight, height, body fat distribution, heart rate, stroke volume, and arterial adherence. In the elderly, large arterial pulses associated with age and stiffness are more prominent among women than men. This may be due to a smaller female body size and an arterial dimension that does not depend on menopause.
Tobacco
Cigarettes are the main form of smoky tobacco. Health risks from tobacco use not only from the direct consumption of tobacco, but also from exposure to secondhand smoke. About 10% of cardiovascular diseases are associated with smoking; However, people who quit smoking at the age of 30 years have the risk of death almost the same as never smokers.
Physical activity
Inadequate physical activity (defined as less than 5 x 30 minutes of moderate activity per week, or less than 3 x 20 minutes of strenuous activity per week) is currently the fourth major risk factor for death worldwide. In 2008, 31.3% of adults aged 15 years or older (28.2% of men and 34.4% of women) were not physically active. The risk of ischemic heart disease and diabetes mellitus is reduced by almost a third in adults who participated in 150 minutes of moderate physical activity each week (or equivalent). In addition, physical activity helps to lose weight and improve blood glucose control, blood pressure, lipid profile and insulin sensitivity. This effect can, at least in part, explain its cardiovascular benefits.
Diet
Dietary intakes are high in saturated fats, trans fats and salts, and low intake of fruits, vegetables and fish is linked to cardiovascular risk, although whether all of these associations are the cause is moot. The World Health Organization links about 1.7 million deaths worldwide with low fruit and vegetable consumption. The amount of food salt consumed is also an important determinant of blood pressure levels and overall cardiovascular risk. Often consuming high-energy foods, such as processed foods high in fat and sugar, increases obesity and may increase cardiovascular risk. A Cochrane review found that replacing saturated fats with polyunsaturated fats (plant-based oils) reduced the risk of cardiovascular disease. Reducing saturated fats reduces the risk of cardiovascular disease by 17% including heart disease and stroke.
High trans-fat intake has a detrimental effect on blood lipids and circulating inflammatory markers, and the elimination of trans-fats from the diet has been widely advocated. In 2018, the World Health Organization estimates that trans fats are the cause of more than half a million deaths per year.
There is evidence that higher sugar consumption is associated with higher blood pressure and poorer blood lipids, and sugar intake also increases the risk of diabetes mellitus. High consumption of processed meats is associated with an increased risk of cardiovascular disease, probably in part due to an increase in dietary salt intake.
The relationship between alcohol consumption and cardiovascular disease is very complex, and may depend on the amount of alcohol consumed. There is a direct correlation between high levels of alcohol consumption and the risk of cardiovascular disease. Drinking at low levels without heavy drinking episodes can be attributed to a reduced risk of cardiovascular disease. Consumption of alcohol as a whole at the population level is associated with some health risks that exceed the potential benefits.
Celiac disease
Untreated celiac disease can lead to the development of many types of cardiovascular disease, most of which improve or resolve with a gluten-free diet and intestinal healing. However, delaying the introduction and diagnosis of celiac disease can lead to irreversible cardiac damage.
Socio-economic loss
Cardiovascular disease affects low- and middle-income countries even more than high-income countries. There is relatively little information on the social patterns of cardiovascular disease in low- and middle-income countries, but in high-income countries, low incomes and low education status are consistently associated with a greater risk of cardiovascular disease. Policies that have resulted in increased socio-economic inequalities have been linked to larger socio-economic differences in cardiovascular disease that imply causality. Psychosocial factors, environmental exposure, health behavior, and access and quality of health services contribute to socioeconomic differences in cardiovascular disease. The Healthcare Determinant Commission recommends that a more equal distribution of power, wealth, education, housing, environmental, nutrition, and healthcare factors is needed to address inequalities in cardiovascular disease and non-communicable diseases.
Air pollution
Particulate material has been studied for the effects of short-term and long-term exposure to cardiovascular disease. Currently, PM 2.5 is the main focus, where gradients are used to determine CVD risk. For every 10? G/m 3 of PM 2.5 long-term exposure, there is about 8-18% risk of CVD death. Women had a relatively higher risk (RR) (1.42) for PM 2.5 which induced coronary artery disease than males (0.90). Overall, long-term PM exposure increases the rate of atherosclerosis and inflammation. In terms of short-term exposure (2 hours), every 25? G/m 3 of PM 2.5 resulted in a 48% increase in CVD mortality risk. In addition, after just 5 days of exposure, an increase in systolic blood pressure (2.8 mmHg) and diastolic (2.7 mmHg) occurred for every 10.5? G/m 3 from PM 2.5 . Other studies have involved PM 2.5 in irregular heart rhythms, reduced heart rate variability (decreased vagal tone), and especially heart failure. PM 2.5 is also associated with carotid artery thickening and an increased risk of acute myocardial infarction.
Cardiovascular risk assessment
Existing cardiovascular disease or previous cardiovascular events, such as heart attack or stroke, are the strongest predictors of future cardiovascular events. Age, sex, smoking, blood pressure, blood lipids and diabetes are important predictors of future cardiovascular disease in people with no known cardiovascular disease. These, and sometimes others, can be combined into a combined risk score to estimate a person's future risk for cardiovascular disease. Many risk scores are there though each benefit is debatable. Other diagnostic and biomarker tests are still under evaluation but currently there is no clear evidence to support their routine use. They include a family history, coronary artery calcification score, high sensitivity of C-reactive protein (hs-CRP), brachial ankle-pressure index, lipoprotein subclass and particle concentration, lipoprotein (a), apolipoprotein AI and B, fibrinogen, white, homocysteine, N-terminal pro B-type natriuretic peptide (NT-proBNP), and markers of renal function. High blood phosphorus is also associated with an increased risk.
Work exposure
Little is known about the relationship between occupation and cardiovascular disease, but a connection has been established between certain toxins, extreme heat and cold, exposure to tobacco smoke, and mental health problems such as stress and depression.
Chemical risk factors
The 2015 SBU report that looks at non-chemical factors finds a connection for them:
- with a stressful job with a lack of control over their work situation - with the effortless imbalance
- who experience low social support at work; who suffer injustice or experience insufficient opportunities for personal development; or those who experience job insecurity
- those working night schedules; or have a long working week
- people exposed to noise
In particular the risk of stroke also increases with exposure to ionizing radiation. Hypertension develops more frequently in those who experience job stress and who have shift work. The difference between women and men is low risk, but men are at risk of suffering and dying from heart attacks or strokes twice as often as women during the work period.
Non-chemical risk factors
The 2017 SBU report finds evidence that exposure in the workplace to silica dust, engine disposal or welding fumes is associated with heart disease. Associations also exist for exposure to arsenic, benzoprenin, lead, dynamite, carbon disulfide, carbon monoxide, metalworking fluids and occupational exposure to tobacco smoke. Working with aluminum electrolytic production or paper production when the sulfate stripping process is used is associated with heart disease. An association is also found between heart disease and exposure to compounds that are no longer allowed in certain working environments, such as phenoxy acids containing TCDD (dioxin) or asbestos.
Workplace exposure to silica or asbestos dust is also associated with pulmonary heart disease. There is evidence that occupational exposure to lead, carbon disulfide, phenoxyacids contains TCDD, and works in environments where aluminum is being produced electrolytically, linked to stroke.
Somatic mutation
By 2017, evidence suggests that certain leukemia-related mutations in blood cells may also lead to an increased risk of cardiovascular disease. Several large-scale research projects that look at human genetic data have found a strong link between the presence of this mutation, a condition known as clonal hematopoiesis, and the incidence and mortality associated with cardiovascular disease.
Pathophysiology
Population-based studies show that atherosclerosis, the main precursor of cardiovascular disease, begins in childhood. The Pathobiological Determinants of Atherosclerosis in Adolescence (PDAY) studies show that intimal lesions appear in all aorta and more than half of the right coronary artery of 7-9 year old adolescents.
This is very important considering 1 in 3 people died from complications caused by atherosclerosis. To stem the flow, education and awareness that cardiovascular disease is the greatest threat, and measures to prevent or reverse this disease should be taken.
Obesity and diabetes mellitus are often associated with cardiovascular disease, as well as a history of chronic kidney disease and hypercholesterolaemia. In fact, cardiovascular disease is the most life-threatening complication of diabetes and diabetics are two to four times more likely to die of cardiovascular causes than non-diabetics.
Screening
EKG screening (either at rest or with exercise) is not recommended in those with no low-risk symptoms. This includes those who are young without risk factors. In those at high risk, evidence for screening with ECG can not be inferred.
Additionally echocardiography, imaging of myocardial perfusion, and cardiac stress tests are not recommended in those at low risk who have no symptoms.
Some biomarkers may increase conventional cardiovascular risk factors in predicting future cardiovascular disease risk; However, the clinical value of some biomarkers is questionable.
NIH recommends lipid testing in children starting at 2 years of age if there is a family history of heart disease or lipid problems. It is hoped that early tests will increase lifestyle factors in those at risk such as diet and exercise.
Screening and selection for primary prevention interventions has traditionally been done through absolute risk using multiple scores (eg Framingham or Reynolds risk scores). This stratification has separated people who receive lifestyle interventions (lower and lower general risk) of the drug (high risk). The number and variety of risk scores available for use has doubled, but its efficacy based on the 2016 review is not clear because of the lack of external validation or impact analysis. The risk stratification model often lacks sensitivity for population groups and does not take into account the large number of negative events among the low and medium risk groups. As a result, future prevention screening appears to be shifting toward prevention prevention according to randomized trials of each intervention rather than a large-scale risk assessment.
Prevention
Up to 90% of cardiovascular disease can be prevented if the established risk factors are avoided. Current measures to prevent cardiovascular disease include:
- Tobacco cessation and passive smoking avoidance. Cessation of smoking reduces the risk by about 35%.
- Low-fat, low-sugar, high-fiber diet including whole grains and fruits and vegetables. Dietary interventions are effective in reducing cardiovascular risk factors for a year, but the long-term effects of such interventions and their impact on the incidence of cardiovascular disease are uncertain.
- At least 150 minutes (2 hours and 30 minutes) of moderate exercise per week. Cardiovascular-based rehabilitation reduces the risk of subsequent cardiovascular events by 26%, but there are some high-quality studies on the benefits of exercise in people with increased cardiovascular risk but no history of cardiovascular disease.
- Limit your alcohol consumption to the recommended daily limit; People who consume enough alcohol have a 25-30% lower risk of cardiovascular disease. However, people who genetically tend to consume less alcohol have lower rates of cardiovascular disease that indicate that the alcohol itself may not be protective. Excessive alcohol intake increases the risk of cardiovascular disease and alcohol consumption is associated with an increased risk of cardiovascular events on days after consumption.
- Lowering blood pressure, if it increases. A 10 mm Hg reduction in blood pressure reduces the risk by about 20%.
- Lower non-HDL cholesterol. Statin treament reduced cardiovascular mortality by 31%.
- Lower body fat if overweight or obese. The effects of weight loss are often difficult to distinguish from dietary changes, and evidence of dietary restricted weight is limited. In observational studies of people with severe obesity, weight loss after bariatric surgery was associated with a 46% reduction in cardiovascular risk.
- Reduce psychosocial stress. This measure can be complicated by the imprecise definition of what constitutes psychosocial intervention. Stress-induced myocardial ischemia is associated with an increased risk of heart problems in those with previous heart disease. Severe emotional and physical stress causes a form of heart dysfunction known as Takotsubo syndrome in some people. Stress, however, plays a relatively minor role in hypertension. Special relaxation therapy does not provide clear benefits.
Most guidelines recommend incorporating prevention strategies. The 2015 Cochrane Review found some evidence that interventions aimed at reducing more than one cardiovascular risk factor may have beneficial effects on blood pressure, body mass index and waist circumference; However, the evidence is limited and the authors can not draw strong conclusions about the effects on cardiovascular events and mortality. For unknown adolescents the diagnosis of hypertension, diabetes, hyperlipidemia, or cardiovascular disease, routine counseling to advise them to improve their diet and increase their physical activity has not been found to change behavior significantly, and thus is not recommended. Another Cochrane review suggests that only providing people with a cardiovascular disease risk score can reduce the risk factor for cardiovascular disease by a small amount compared with usual care. However, there is some uncertainty as to whether this scoring has any effect on the incidence of cardiovascular disease. It is unclear whether dental treatment in those with periodontitis affects the risk of cardiovascular disease.
Diet
A diet high in fruits and vegetables lowers the risk of cardiovascular disease and death. Evidence suggests that the Mediterranean diet can improve cardiovascular outcomes. There is also evidence that the Mediterranean diet may be more effective than a low-fat diet in bringing long-term changes to cardiovascular risk factors (eg, lowering cholesterol and blood pressure). The DASH diet (high in nuts, fish, fruits and vegetables, and low in candy, red meat and fat) has been shown to reduce blood pressure, lower low-density lipoprotein cholesterol and increase metabolic syndrome; but long-term benefits beyond the context of questionable clinical trials. High-fiber diets seem to lower the risk.
Total fat intake does not seem to be an important risk factor. Diets high in trans fatty acids, however, increase the rate of cardiovascular disease. Around the world, dietary guidelines recommend reducing saturated fats. However, there are some questions surrounding the effects of saturated fat on cardiovascular disease in medical literature. Reviews from 2014 and 2015 found no evidence of harm from saturated fats. A review of Cochrane 2012 found convincing evidence of the small benefits of replacing saturated fats with unsaturated fats. The 2013 meta-analysis concludes that substitution with omega 6 linoleic acids may increase cardiovascular risk. Substitution of saturated fat with carbohydrates has not changed or may increase the risk. The benefits of replacement with polyunsaturated fat look greatest; However, supplementation with omega-3 fatty acids (a type of fat polisaturation) does not seem to have any effect.
The 2014 Cochrane Review found an unclear benefit from recommending a low-salt diet in people with high or normal blood pressure. In those with heart failure, after one study was abandoned, the remaining trials showed a tendency to benefit. Other reviews of dietary salt conclude that there is strong evidence that high dietary salt intake increases blood pressure and aggravates hypertension, and increases the incidence of cardiovascular disease; both as a result of increased blood pressure and , most probably, through other mechanisms. Moderate evidence found that high salt intake increased cardiovascular death; and some evidence was found to increase overall mortality, stroke, and left ventricular hypertrophy.
Medication
Blood pressure drugs reduce cardiovascular disease in people at risk, regardless of age, baseline level of cardiovascular risk, or baseline blood pressure. Commonly used drug regimens have the same efficacy in reducing the risk of all major cardiovascular events, although there may be differences between drugs in their ability to prevent specific outcomes. A greater drop in blood pressure results in greater risk reduction, and most people with high blood pressure require more than one drug to achieve adequate blood pressure reduction.
Statins effectively prevent further cardiovascular disease in people with a history of cardiovascular disease. Because the incidence rate is higher in men than in women, the decrease in incidence is more pronounced in men than in women. In those at risk, but without a history of cardiovascular disease (primary prevention), statins reduce the risk of death and a combination of fatal and non-fatal cardiovascular disease. The United States Guidelines recommend statins in those who have a 12% or more risk of cardiovascular disease over the next ten years. Niacin, Fiber and CETP Inhibitors, while they can raise HDL cholesterol does not affect the risk of cardiovascular disease in those who already use statins.
Anti-diabetic drugs may reduce cardiovascular risk in people with Type 2 Diabetes, although the evidence is not conclusive. A meta-analysis in 2009 included 27,049 participants and 2,370 major vascular events showed a 15% relative risk reduction in cardiovascular disease with more intensive glucose lowering during the follow-up period averaging 4.4 years, but an increased risk of major hypoglycemia.
Aspirin has been found to be just a simple benefit in those who are at low risk of heart disease because the risk of serious bleeding is almost equal to the benefits with respect to cardiovascular problems. In those at very low risk it is not recommended. US Prevention Service Task Force recommends not to use aspirin for prevention in women less than 55 years and men less than 45 years of age; However, in those older ones it recommends on some individuals.
The use of vasoactive agents for people with pulmonary hypertension with left heart disease or lung disease of hypoxemia can lead to unnecessary hazards and costs.
Physical activity
A systematic review estimates that inactivity is responsible for 6% of the disease burden of coronary heart disease worldwide. The authors estimate that 121,000 deaths from coronary heart disease could have been prevented in Europe in 2008, if physical activity was removed. A Cochrane review found some evidence that yoga has a beneficial effect on blood pressure and cholesterol, but the studies included in this review are of poor quality.
Dietary supplements
While a healthy diet is beneficial, the effects of antioxidant supplementation (vitamin E, vitamin C, etc.) or vitamins have not been shown to protect against cardiovascular disease and in some cases can cause harm. Mineral supplements have also not been found beneficial. Niacin, a type of vitamin B3, may be an exception with a slight decrease in the risk of cardiovascular events in those at high risk. Magnesium supplementation lowers high blood pressure in a dose-dependent manner. Magnesium therapy is recommended for people with ventricular arrhythmias associated with torsades de pointes that come with long QT syndrome as well as for the treatment of people with digoxin intoxication regimen. There is no evidence to support supplementation of omega-3 fatty acids.
Management
Cardiovascular disease can be treated with early treatment primarily focused on dietary interventions and lifestyle. Influenza can make heart attacks and strokes more likely and therefore influenza vaccination may decrease the likelihood of cardiovascular events and death in people with heart disease.
Proper CVD management requires a focus on MI and stroke cases due to the combined high mortality rate, given the cost-effectiveness of any intervention, especially in low- or middle-income developing countries. Regarding MI, strategies using aspirin, atenolol, streptokinase or tissue plasminogen activator have been compared for QALY in low- and middle-income areas. The cost for one QALY for aspirin, atenolol, streptokinase, and t-PA is $ 25, $ 630- $ 730, and $ 16,000, respectively. Aspirin, ACE inhibitors, beta blockers, and statins used together for secondary CVD prevention in the same region show a single QALY cost of $ 300-400.
Epidemiology
Cardiovascular disease is the leading cause of death worldwide and in all regions except Africa. In 2008, 30% of all global deaths were caused by cardiovascular disease. Deaths caused by cardiovascular disease are also higher in low- and middle-income countries because more than 80% of all global deaths caused by cardiovascular disease occur in these countries. It is estimated that by 2030, more than 23 million people will die from cardiovascular disease each year.
It is estimated that 60% of the world's cardiovascular disease burden will occur in the subcontinent of South Asia despite covering only 20% of the world's population. This may be secondary to a combination of genetic and environmental predisposing factors. Organizations such as the Indian Heart Association are working with the World Heart Federation to raise awareness about the issue.
Research
There is evidence that cardiovascular disease exists in prehistory, and cardiovascular disease research originated from at least the 18th century. The causes, prevention, and/or treatment of all forms of cardiovascular disease remain active in the field of biomedical research, with hundreds of scientific studies published every week.
Recent research areas include the relationship between inflammation and atherosclerosis potential new therapeutic interventions, and genetics of coronary heart disease.
References
External links
- Cardiovascular disease in Curlie (based on DMOZ)
- European guidelines on prevention of cardiovascular disease in clinical practice (2012 version)
- MedicineNet Slide Heart Disease, photo, description
Source of the article : Wikipedia
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