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Cardiovascular disease

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Cardiovascular disease
SpecialtyCardiology Edit this on Wikidata

Cardiovascular disease or cardiovascular diseases refers to 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), it is usually used to refer to those related to atherosclerosis (arterial disease). These conditions have similar causes, mechanisms, and treatments. In practice, cardiovascular disease is treated by cardiologists, thoracic surgeons, vascular surgeons, neurologists, and interventional radiologists, depending on the organ system that is being treated. There is considerable overlap in the specialties, and it is common for certain procedures to be performed by different types of specialists in the same hospital.

Most countries face high and increasing rates of cardiovascular disease. Each year, heart disease kills more Americans than cancer.[2].

It is the number one cause of death and disability in the United States and most European countries (data available through 2005). 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.

Biomarkers

Some biomarkers are thought to offer a more detailed risk of cardiovascular disease. However, the clinical value of these biomarkers is questionable.[5] Currently, biomarkers which may reflect a higher risk of cardiovascular disease include:

Awareness

Despite the success of the Dean Ornish studies in the eighties and nineties, most people and doctors are still unaware of the extensive research showing that stress reduction and diet can prevent, eliminate, and reduce nearly all forms of heart disease. At the same time many people rely on medications (such as aspirin) which may decrease certain risk factors such as heart attacks, but increase others such as hemorrhaging, and in the end often have no impact on long term morbidity.

Treatment

Unlike many other chronic medical conditions, Cardiovascular disease is treatable and reversible, even after a long history of disease. Treatment is primarily focused on diet and stress reduction. [7] [8] [9] [10] [11]

Starts Young

Population based studies in the youth 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.[12] This is extremely important considering that 1 in 3 people will die from complications attributable to atherosclerosis. In order to stem the tide of cardiovascular disease, primary prevention is needed. Primary prevention starts with education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken.

Detection

Platelet and Fibrin complexes can be seen with the technique of dark field microscopy. They are much bigger than red blood cells and easily block capillaries. These complexes are clearly visible in dark field but not in stained bright field samples because the different staining methods disburse them. However, they are not visible in unstained blood smears. This method of early detection allows to identify people at risk and take appropriate measures.

Types of cardiovascular diseases

Research

The causes, prevention, and/or treatment of all forms of cardiovascular disease are active fields of biomedical research, with hundreds of scientific studies being published on a weekly basis.

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 inflammatory marker that may be present in increased levels in the blood in patients at risk for cardiovascular disease. Its exact role in predicting disease is the subject of debate.

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.[13]

See also

References

  1. ^ Maton, Anthea (1993). Human Biology and Health. Englewood Cliffs, New Jersey: Prentice Hall. ISBN 0-13-981176-1. {{cite book}}: Cite has empty unknown parameter: |coauthors= (help)
  2. ^ United States (1999). "Chronic Disease Overview". United States Government. Retrieved 2007-02-07.
  3. ^ Rainwater DL, McMahan CA, Malcom GT; et al. (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. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  4. ^ McGill HC, McMahan CA, Zieske AW; et al. (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. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  5. ^ 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): 2631–9. doi:10.1056/NEJMoa055373. PMID 17182988.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ^ Wang TJ, Larson MG, Levy D; et al. (2004). "Plasma natriuretic peptide alksdjalkdj levels and the risk of cardiovascular events and death". N Engl J Med. 350 (7): 655–63. doi:10.1056/NEJMoa031994. PMID 14960742. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help); line feed character in |title= at position 27 (help)CS1 maint: multiple names: authors list (link)
  7. ^ McGill HC, McMahan CA, Zieske AW; et al. (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. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Ornish Dean (1996). Dean Dr. Dean Ornish's Programme for Reversing Heart Disease Ivy Books. ISBN 0-8041-1038-7. {{cite book}}: Unknown parameter |month= ignored (help)
  9. ^ Ornish, Dean; et al. (1990). "'Can lifestyle changes reverse coronary heart disease?' The Lifestyle Heart Trial". Lancet. 336 (8708): 129–33. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)
  10. ^ 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). {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  11. ^ 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). {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  12. ^ Vanhecke TE, Miller WM, Franklin BA, Weber JE, McCullough PA (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. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  13. ^ Andraws R, Berger JS, Brown DL (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. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

Informational

Organizations

Public information

  • HeartFailureMatters.org Informations website for patients, families and care givers with animations, interviews and glossary - Created by the Heart Failure Association of the European Society of Cardiology.

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