Cardiovascular disease

Cardiovascular disease (CVD) is any problem that affects the heart or blood vessels. This includes issues like angina, heart attack, and heart failure, among others. These diseases can happen for many reasons. Common causes are high blood pressure, smoking, not enough exercise, being overweight, and having a poor diet.

Many heart problems can be prevented by making healthy choices. This includes eating well, staying active, and not smoking. Treating conditions like high blood pressure and diabetes mellitus also helps lower the risk. In some cases, taking care of infections like strep throat with antibiotics can help prevent certain heart diseases.

Heart disease is one of the leading causes of death worldwide. It mostly affects older people, but it can happen at any age. Men are more likely to develop these conditions than women and usually get them earlier in life. Even though some places have seen fewer cases over time, heart disease is still a big health concern everywhere.

Types

Cardiovascular diseases are conditions that affect the heart or blood vessels. Some diseases affect the blood vessels. These include:

• Coronary artery disease (also known as coronary heart disease or ischemic heart disease)
• Peripheral arterial disease – a disease of blood vessels that supply blood to the arms and legs
• Cerebrovascular disease – a disease of blood vessels that supply blood to the brain (this includes stroke)
• Renal artery stenosis
• Aortic aneurysm

Other cardiovascular diseases affect the heart itself. These include:

• Cardiomyopathy – diseases of the heart muscle
• Hypertensive heart disease – diseases of the heart caused by high blood pressure or hypertension
• Heart failure – when the heart cannot pump enough blood to meet the body's needs
• Pulmonary heart disease – problems with the right side of the heart linked to breathing issues
• Cardiac dysrhythmias – problems with the heart's rhythm
• Inflammatory heart diseases, such as:
  • Endocarditis – inflammation of the inner layer of the heart, the endocardium, often affecting the heart valves
  • Myocarditis – inflammation of the heart's muscular part, usually caused by viral infections
  • Eosinophilic myocarditis – a special type of heart muscle inflammation caused by certain white blood cells
• Valvular heart disease
• Congenital heart disease – heart shape problems present at birth
• Rheumatic heart disease – damage to the heart muscles and valves from rheumatic fever, an infection caused by a type of bacteria called Streptococcus pyogenes.

Risk factors

Many things can make heart problems more likely. These include getting older, having health issues like high blood pressure or diabetes, not being active, eating unhealthy foods, and even things like air pollution. Some of these you can change, like eating better or exercising more, but others like age or family history you cannot change.

Getting older is a big reason for heart problems. As people get older, their chance of heart disease grows. Men often have heart problems earlier than women. Not moving enough, smoking, and eating foods with bad fats can raise the risk. Having diabetes or high blood pressure also makes heart problems more likely. Poor sleep and living in polluted areas can affect heart health too.

Pathophysiology

Studies show that heart problems can start when children are very young. Scientists have found early signs of heart disease in the blood vessels of kids aged 7 to 9 years.

Being very overweight and having diabetes mellitus can lead to heart disease. Long-term kidney disease and high cholesterol levels are also linked to heart problems. People with diabetes have a higher chance of having heart health issues than those without diabetes.

Screening

Screening tests like ECGs are not needed for people who have no signs of heart problems and are at low risk, such as young people without any known risk factors. For those at higher risk, it is still unclear if these tests help.

Other tests like echocardiography, myocardial perfusion imaging, and cardiac stress testing are also not recommended for people at low risk without symptoms. Some special blood tests might help predict future heart problems, but their usefulness is still uncertain. Tests like the ankle-brachial index, high-sensitivity C-reactive protein, and coronary artery calcium may not be very helpful for people without symptoms.

Doctors suggest checking cholesterol levels in children starting at age 2 if there is a family history of heart disease. Early testing can help encourage better habits like healthy eating and regular exercise.

Traditionally, doctors used different scores to decide who needs prevention steps, separating people into lower, intermediate, and higher risk groups. However, many of these scores have not been well tested, and they often miss many events that happen in lower and intermediate risk groups. In the future, prevention may focus more on specific steps proven to work rather than just using these scores.

Prevention

Many heart and blood vessel problems can be prevented by avoiding certain risk factors. Good ways to prevent these problems include:

• Eating healthy foods like fruits, vegetables, and plant-based meals.
• Getting regular exercise — at least 150 minutes of moderate activity each week.
• Keeping a healthy weight and limiting alcohol.
• Quitting smoking and avoiding second-hand smoke.
• Getting enough sleep — about 7 to 9 hours each night.
• Managing stress and staying mentally healthy.

Doctors also recommend checking blood pressure and cholesterol levels regularly. Some medicines can help lower these numbers and reduce risk. Eating a diet rich in fruits, vegetables, whole grains, and healthy fats — like the Mediterranean or DASH diets — is also good for the heart. Staying active and keeping a healthy lifestyle are the best ways to protect your heart.

Management

Cardiovascular disease can often be treated by changing diet and lifestyle. Getting a flu shot can help prevent heart problems in people who already have heart disease.

Doctors focus on treating heart attacks and strokes because they can be very serious. Some treatments, like taking aspirin, are affordable and help save lives. For heart valve problems, surgery can replace the valve. For irregular heartbeats, a pacemaker can help. After a heart attack, treatments like coronary angioplasty or coronary artery bypass surgery can also be helpful.

Epidemiology

Cardiovascular diseases are a leading cause of death around the world, except in Africa. In 2008, they were responsible for about 30% of all deaths globally. Most of these deaths occur in countries with less money.

Experts predict that by 2030, over 23 million people each year could die from cardiovascular diseases. Many of these cases are in the South Asian subcontinent, where a lot of these diseases happen even though the area has only a small part of the world’s people. This may be due to both genetic and environmental reasons. Groups like the Indian Heart Association work with the World Heart Federation to help people learn more about this health issue.

Research

See also: Heart-on-a-chip and Vessel-on-a-chip

People have known about heart problems for a long time, even before we had writing. Scientists have studied these problems since the 1700s. Today, many scientists are still working to learn more about heart health and how to help people who are sick.

Some new research looks at how small health issues can grow into bigger heart problems. Scientists are also finding new ways to treat heart disease and studying how genes might affect heart health. Every week, hundreds of new studies are shared to help doctors and scientists learn more.