Cardiovascular disease

"Heart condition" redirects here. For other uses, see Heart condition (disambiguation).
Cardiovascular disease
Micrograph of a heart with fibrosis (yellow) and amyloidosis (brown). Movat's stain.
SpecialtyCardiology
SymptomsChest pain, shortness of breath, fatigue, loss of consciousness
ComplicationsHeart failure, heart attack, stroke, aneurysm, peripheral artery disease, sudden cardiac arrest.[1]
Usual onsetOlder adults[2]
TypesCoronary artery diseases, stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy,[3][4] Arrhythmia
Risk factorsDiabetes,[3] high blood lipids, excess weight, Smoking, excessive drug use, and excessive alcohol intake
PreventionHealthy eating, exercise, avoiding tobacco smoke, limited alcohol intake,[3] Overall lifestyle changes
TreatmentTreating high blood pressure, high blood lipids, diabetes[3]
MedicationAspirin, beta blockers, blood thinners
Deaths17.9 million / 32% (2015)[5]

Cardiovascular disease (CVD) is any disease involving the heart or blood vessels.[3] CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.[3][4]

The underlying mechanisms vary depending on the disease.[3] It is estimated that dietary risk factors are associated with 53% of CVD deaths.[6] Coronary artery disease, stroke, and peripheral artery disease involve atherosclerosis.[3] This may be caused by high blood pressure, smoking, diabetes mellitus, lack of exercise, obesity, high blood cholesterol, poor diet, excessive alcohol consumption,[3] and poor sleep,[7][8] among other things. High blood pressure is estimated to account for approximately 13% of CVD deaths, while tobacco accounts for 9%, diabetes 6%, lack of exercise 6%, and obesity 5%.[3] Rheumatic heart disease may follow untreated strep throat.[3]

It is estimated that up to 90% of CVD may be preventable.[9][10] Prevention of CVD involves improving risk factors through: healthy eating, exercise, avoidance of tobacco smoke and limiting alcohol intake.[3] Treating risk factors, such as high blood pressure, blood lipids and diabetes is also beneficial.[3] Treating people who have strep throat with antibiotics can decrease the risk of rheumatic heart disease.[11] The use of aspirin in people who are otherwise healthy is of unclear benefit.[12][13]

Cardiovascular diseases are the leading cause of death worldwide except Africa.[3] Together CVD resulted in 17.9 million deaths (32.1%) in 2015, up from 12.3 million (25.8%) in 1990.[5][4] Deaths, at a given age, from CVD are more common and have been increasing in much of the developing world, while rates have declined in most of the developed world since the 1970s.[14][15] Coronary artery disease and stroke account for 80% of CVD deaths in males and 75% of CVD deaths in females.[3] Most cardiovascular disease affects 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.[2] The average age of death from coronary artery disease in the developed world is around 80, while it is around 68 in the developing world.[14] CVD is typically diagnosed seven to ten years earlier in men than in women.[3]: 48 

  1. ^ "Heart disease". Mayo Clinic. 2022-08-25.
  2. ^ a b Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. (January 2013). "Heart disease and stroke statistics--2013 update: a report from the American Heart Association". Circulation. 127 (1): e6–e245. doi:10.1161/cir.0b013e31828124ad. PMC 5408511. PMID 23239837.
  3. ^ a b c d e f g h i j k l m n o p Shanthi M, Pekka P, Norrving B (2011). Global Atlas on Cardiovascular Disease Prevention and Control (PDF). World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. pp. 3–18. ISBN 978-92-4-156437-3. Archived (PDF) from the original on 2014-08-17.
  4. ^ a b c Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. (GBD 2013 Mortality and Causes of Death Collaborators) (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
  5. ^ a b Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  6. ^ Petersen KS, Kris-Etherton PM (2021-11-28). "Diet quality assessment and the relationship between diet quality and cardiovascular disease risk". Nutrients. 13 (12): 4305. doi:10.3390/nu13124305. ISSN 2072-6643. PMC 8706326. PMID 34959857.
  7. ^ Cite error: The named reference Jackson was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference Wang was invoked but never defined (see the help page).
  9. ^ McGill HC, McMahan CA, Gidding SS (March 2008). "Preventing heart disease in the 21st century: implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study". Circulation. 117 (9): 1216–27. doi:10.1161/CIRCULATIONAHA.107.717033. PMID 18316498.
  10. ^ O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. (August 2016). "Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study". Lancet. 388 (10046): 761–75. doi:10.1016/S0140-6736(16)30506-2. PMID 27431356. S2CID 39752176.
  11. ^ Spinks A, Glasziou PP, Del Mar CB (2021-12-09). "Antibiotics for treatment of sore throat in children and adults". The Cochrane Database of Systematic Reviews. 2021 (12): CD000023. doi:10.1002/14651858.CD000023.pub5. ISSN 1469-493X. PMC 8655103. PMID 34881426.
  12. ^ Sutcliffe P, Connock M, Gurung T, Freeman K, Johnson S, Ngianga-Bakwin K, et al. (2013). "Aspirin in primary prevention of cardiovascular disease and cancer: a systematic review of the balance of evidence from reviews of randomized trials". PLOS ONE. 8 (12): e81970. Bibcode:2013PLoSO...881970S. doi:10.1371/journal.pone.0081970. PMC 3855368. PMID 24339983.
  13. ^ Sutcliffe P, Connock M, Gurung T, Freeman K, Johnson S, Kandala NB, et al. (September 2013). "Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews". Health Technology Assessment. 17 (43): 1–253. doi:10.3310/hta17430. PMC 4781046. PMID 24074752.
  14. ^ a b Institute of Medicine of the National Academies (2010). "Epidemiology of Cardiovascular Disease". In Fuster V, Kelly BB (eds.). Promoting cardiovascular health in the developing world : a critical challenge to achieve global health. Washington, DC: National Academies Press. ISBN 978-0-309-14774-3. Archived from the original on 2017-09-08.
  15. ^ Moran AE, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M, Murray CJ, et al. (April 2014). "Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study". Circulation. 129 (14): 1483–92. doi:10.1161/circulationaha.113.004042. PMC 4181359. PMID 24573352.