Cardiovascular disease is the number one cause of death globally: more people die from cardiovascular disease each year than any other cause of death.
In 2016, an estimated 17.9 million people died of cardiovascular disease, accounting for 31% of the global deaths. Among them, 85% died of heart disease and stroke.
More than three quarters of cardiovascular deaths occur in low- and middle-income countries.
Of the 17 million deaths under the age of seventy caused by non communicable diseases, 82% occurred in low- and middle-income countries, and 37% were caused by cardiovascular disease.
Most cardiovascular diseases can be prevented through strategies for the entire population to address risk factors such as tobacco use, unhealthy diet and obesity, lack of physical activity and harmful use of alcohol.
Patients with cardiovascular disease or high-risk persons (due to the presence of one or more risk factors, such as high blood pressure, diabetes, hyperlipidemia, or pre-existing diseases) need early detection and management with the help of counseling and appropriate drugs .
(i) Coronary heart disease - Disease of blood vessels supplying myocardium
(ii) Cerebrovascular diseases - Diseases of the blood vessels of the brain
(iii) Peripheral arterial disease - Disease of the blood vessels supplying arms and legs
(iv) Rheumatic heart disease - Damage to myocardium and heart valves caused by rheumatic fever caused by streptococcus
(v) Congenital heart disease - structural abnormalities of the heart at birth
(vi) Deep vein thrombosis and pulmonary embolism - Blood clots appear in the veins of the legs, which can fall off and move to the heart and lungs.
Heart attacks and strokes are usually an emergency, mainly because the blockage prevents blood from flowing into the heart or brain. The most common cause of this is the accumulation of fat layers on the inner walls of blood vessels in the heart or brain. Stroke may also be caused by cerebrovascular or thrombosis bleeding.
The cause of heart attack and stroke is usually the simultaneous existence of multiple risk factors, such as tobacco use, unhealthy diet and obesity, lack of physical activity and harmful use of alcohol, hypertension, diabetes and hyperlipidemia.
It has been shown that stopping the use of tobacco, reducing the salt content of the diet, eating fruits and vegetables, exercising regularly and avoiding harmful use of alcohol can reduce the risk of cardiovascular disease. In addition, medications for diabetes, hypertension, and hyperlipidemia may be needed to reduce the risk of cardiovascular disease and prevent heart attacks and strokes. Some health policies can create an enabling environment where people can afford and have healthy choices. These policies are essential to encourage people to adopt and maintain healthy behaviors.
There are also some potential determinants of cardiovascular disease, or "causes of cause". They exemplify the main forces driving social, economic and cultural change-globalization, urbanization and population aging. Other determinants of cardiovascular disease include poverty, stress, and genetic factors .
Symptoms of heart disease and stroke
The underlying vascular disease is usually asymptomatic. A heart attack or stroke may be the initial warning of a potential disease. Symptoms of a heart attack include:
1. Pain or discomfort in the middle of the chest;
2. Pain or discomfort in the arm, left shoulder, elbow, jaw, or back.
3. In addition, the patient may experience difficulty breathing or shortness of breath; nausea or vomiting; dizziness or fainting; sweating; and paleness. Women are more prone to shortness of breath, nausea, vomiting, and back or jaw pain.
The most common symptom of stroke is sudden weakness in the face, arms, or legs, usually on the side of the body. Other symptoms include, sudden appearance:
1. Numbness in the face, arms or legs, especially on one side of the body;
2. Confusion, difficulty speaking or understanding;
3. Difficulty seeing with one eye or two eyes;
4. Difficulty walking, dizziness, loss of balance or coordination;
5. Severe headache without cause;
6. Fainting or losing consciousness.
People with these symptoms should seek medical attention immediately.
Rheumatic fever mainly affects children in developing countries, especially those with widespread poverty. Globally, almost 2% of deaths caused by cardiovascular disease are associated with rheumatic heart disease.
Symptoms of rheumatic fever include: fever, joint pain and swelling, nausea, stomach cramps, and vomiting.
Compared with high-income countries, people in low- and middle-income countries do not enjoy the benefits of comprehensive primary health care planning for early detection and treatment of those exposed to risk factors.
In low- and middle-income countries, people suffering from cardiovascular diseases and other non-communicable diseases are not easy to obtain effective and fair medical services that meet their needs. Therefore, in low- and middle-income countries, many people die of cardiovascular disease and other non-communicable diseases at a young age, and often die when their lives are at their highest.
The poorest people in low- and middle-income countries are the most affected. At the family level, there is continuous and sufficient evidence to prove that cardiovascular diseases and other non-communicable diseases can lead to poverty due to catastrophic health expenditures and high out-of-pocket expenses.
At the macroeconomic level, cardiovascular disease places a heavy burden on the economies of low- and middle-income countries.
Population-wide interventions that can be used to reduce cardiovascular disease include:
1. Comprehensive tobacco control policy;
2. Taxation to reduce the intake of foods high in fat, sugar and salt;
3. Paved walking and cycling paths to increase physical activity;
4. Strategies to reduce harmful use of alcohol;
5. Provide healthy school meals to children.
To prevent the first heart attack and stroke at the individual level, it is necessary to target individual health care interventions to people with a median and high risk of cardiovascular disease, or single risk factors (such as diabetes, hypertension, and hypercholesterolemia) Personnel who exceed the recommended threshold for treatment. The former (total risk integrated approach) is more cost-effective than the latter and has the potential to significantly reduce cardiovascular events. This method is feasible in primary care work in resource-poor settings, including implementation by non-physician health workers.
To carry out secondary prevention of cardiovascular diseases for people who already have diabetes and other diseases, it is necessary to adopt the following treatment methods:
1. aspirin
2. β-blocker
3. Angiotensin converting enzyme inhibitor
4. Statin
Most of the benefits of these interventions are unique, but when used in combination with smoking cessation, it can prevent nearly 75% of recurrent vascular events. Currently, there is a great lack of implementation of these interventions, especially at the primary health care level.
In addition, sometimes expensive surgical procedures are needed to treat cardiovascular disease. This includes:
1. Coronary artery bypass
2. Balloon angioplasty (with a small spherical device to unblock the artery through an artery)
3. Valve repair and replacement
4. Heart transplant
5. Artificial Heart Surgery
(2) It is not recommended to start drinking alcohol or frequent drinking for the prevention of heart disease. It is recommended that adult men drink less than 25 g/d of alcohol (equivalent to 750 ml of beer, or 250 ml of wine, or 50 g of high-level liquor, or 75 g of 38-degree liquor); adult women drink less than 15 g/d (equivalent to Beer 450 ml, or wine 150 ml, or 38 degrees liquor 50 g); pregnant women , children and teenagers are prohibited from drinking alcohol. Alcohol (g) = alcohol consumption (ml) × alcohol content (%) × 0.8 (alcohol specific gravity);
(3) Reduce the intake of sodium salt, daily salt should be controlled within 5g; increase potassium salt intake, daily potassium salt ≥4.7g.
(2) Conduct resistance training (such as weight training) at least twice a week, repeating 10 to 15 times for each exercise;
(2) To strengthen smoking cessation education and behavior guidance for all smokers, it is recommended to use smoking cessation drugs to assist smoking cessation and reduce withdrawal symptoms;
(3) Avoid passive smoking.
2. It is estimated that 17.3 million people died of cardiovascular disease in 2008, accounting for 30% of the global deaths (1). Of these dead, an estimated 7.3 million died from coronary heart disease and 6.2 million died from stroke.
3. Low- and middle-income countries are particularly affected: more than 80% of cardiovascular deaths occur in low- and middle-income countries, and the situation is almost the same for men and women.
4. By 2030, the number of people dying of cardiovascular disease (mainly heart disease and stroke) will increase to 23.3 million (1,3). It is expected that cardiovascular disease will continue to be the single leading cause of death.
5. Most cardiovascular diseases can be prevented by addressing risk factors such as tobacco use, unhealthy diet and obesity, lack of physical activity, high blood pressure, diabetes and elevated blood lipids.
6. There are 9.4 million deaths each year, or 16.5% of all deaths may be caused by hypertension. This includes 51% of deaths due to stroke and 45% of deaths due to coronary heart disease.
In 2016, an estimated 17.9 million people died of cardiovascular disease, accounting for 31% of the global deaths. Among them, 85% died of heart disease and stroke.
More than three quarters of cardiovascular deaths occur in low- and middle-income countries.
Of the 17 million deaths under the age of seventy caused by non communicable diseases, 82% occurred in low- and middle-income countries, and 37% were caused by cardiovascular disease.
Most cardiovascular diseases can be prevented through strategies for the entire population to address risk factors such as tobacco use, unhealthy diet and obesity, lack of physical activity and harmful use of alcohol.
Patients with cardiovascular disease or high-risk persons (due to the presence of one or more risk factors, such as high blood pressure, diabetes, hyperlipidemia, or pre-existing diseases) need early detection and management with the help of counseling and appropriate drugs .
What is cardiovascular disease?
Cardiovascular diseases are a group of heart and vascular disorders, including:(i) Coronary heart disease - Disease of blood vessels supplying myocardium
(ii) Cerebrovascular diseases - Diseases of the blood vessels of the brain
(iii) Peripheral arterial disease - Disease of the blood vessels supplying arms and legs
(iv) Rheumatic heart disease - Damage to myocardium and heart valves caused by rheumatic fever caused by streptococcus
(v) Congenital heart disease - structural abnormalities of the heart at birth
(vi) Deep vein thrombosis and pulmonary embolism - Blood clots appear in the veins of the legs, which can fall off and move to the heart and lungs.
Heart attacks and strokes are usually an emergency, mainly because the blockage prevents blood from flowing into the heart or brain. The most common cause of this is the accumulation of fat layers on the inner walls of blood vessels in the heart or brain. Stroke may also be caused by cerebrovascular or thrombosis bleeding.
The cause of heart attack and stroke is usually the simultaneous existence of multiple risk factors, such as tobacco use, unhealthy diet and obesity, lack of physical activity and harmful use of alcohol, hypertension, diabetes and hyperlipidemia.
Causes of cardiovascular disease
1. Abnormal cell metabolism:
The abnormal metabolism of blood vessel wall cells is the main cause of cardiovascular disease, because new cells cannot be formed normally, which leads to inflammation of blood vessels, which leads to poor contraction, which leads to blockage or rupture.2. Dietary effects:
Long-term consumption of large amounts of lipids and alcoholic foods can lead to excessive lipoproteins in the blood, which can easily accumulate and form thrombosis, leading to cardiovascular and cerebrovascular diseases.3. Lack of exercise:
The lack of exercise for a long time results in the body's inability to metabolize lipids and alcohols normally. Some lipids in the blood oxidize to block blood vessels, form blood clots, and block blood vessels, causing cardiovascular and cerebrovascular diseases.4. Obesity:
Obese patients have endocrine disorders, increased levels of cholesterol and triglycerides in the blood, and decreased high-density lipoprotein, which can easily lead to arteriosclerosis. Secondly, obese patients are also prone to diseases such as diabetes, coronary heart disease and hypertension, which are all risk factors for cardiovascular and cerebrovascular diseases.5. Emotions:
After clinical research, it has been found that some people who are often irritable, solitary, and suspicious are more likely to induce cerebrovascular disease than ordinary people.Characteristics of cardiovascular disease
1. High incidence rate:
Cardiovascular diseases are extremely prone to morbidity due to improper diet and inadequate exercise and self-disease and behavioral habits.2. High mortality rate:
Cardiovascular diseases are prone to serious complications, and even cause death or loss of labor capacity after treatment.3. High recurrence rate:
Cardiovascular diseases need to take drugs for several years after treatment and discharge, but many patients cannot take medicines on time, which leads to an increase in the relapse rate of the disease.4. Many complications:
Cardiovascular diseases, not only have vascular factors but also nerve factors, so it is easy to cause other serious complications.Risk factors for cardiovascular disease
The most important behavioral risk factors for heart disease and stroke are unhealthy diet, lack of physical activity, use of tobacco and harmful use of alcohol. The impact of behavioral risk factors may be manifested in individuals as increased blood pressure, blood sugar and blood lipids , as well as being overweight and obese. These "indirect risk factors" can be measured in primary care institutions, which indicate an increased risk of heart attack, stroke, heart failure and other complications.It has been shown that stopping the use of tobacco, reducing the salt content of the diet, eating fruits and vegetables, exercising regularly and avoiding harmful use of alcohol can reduce the risk of cardiovascular disease. In addition, medications for diabetes, hypertension, and hyperlipidemia may be needed to reduce the risk of cardiovascular disease and prevent heart attacks and strokes. Some health policies can create an enabling environment where people can afford and have healthy choices. These policies are essential to encourage people to adopt and maintain healthy behaviors.
There are also some potential determinants of cardiovascular disease, or "causes of cause". They exemplify the main forces driving social, economic and cultural change-globalization, urbanization and population aging. Other determinants of cardiovascular disease include poverty, stress, and genetic factors .
Common symptoms of cardiovascular disease:
Symptoms of heart disease and stroke
The underlying vascular disease is usually asymptomatic. A heart attack or stroke may be the initial warning of a potential disease. Symptoms of a heart attack include:
1. Pain or discomfort in the middle of the chest;
2. Pain or discomfort in the arm, left shoulder, elbow, jaw, or back.
3. In addition, the patient may experience difficulty breathing or shortness of breath; nausea or vomiting; dizziness or fainting; sweating; and paleness. Women are more prone to shortness of breath, nausea, vomiting, and back or jaw pain.
The most common symptom of stroke is sudden weakness in the face, arms, or legs, usually on the side of the body. Other symptoms include, sudden appearance:
1. Numbness in the face, arms or legs, especially on one side of the body;
2. Confusion, difficulty speaking or understanding;
3. Difficulty seeing with one eye or two eyes;
4. Difficulty walking, dizziness, loss of balance or coordination;
5. Severe headache without cause;
6. Fainting or losing consciousness.
People with these symptoms should seek medical attention immediately.
What is Rheumatic heart disease?
Rheumatic heart disease is caused by inflammation and scars caused by rheumatic fever that damage the heart valves and myocardium. Rheumatic fever is caused by an abnormal reaction of the body to streptococcal infection. The initial symptoms in children are usually sore throat or tonsillitis.Rheumatic fever mainly affects children in developing countries, especially those with widespread poverty. Globally, almost 2% of deaths caused by cardiovascular disease are associated with rheumatic heart disease.
Symptoms of Rheumatic heart disease
Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heartbeat, chest pain, and fainting.Symptoms of rheumatic fever include: fever, joint pain and swelling, nausea, stomach cramps, and vomiting.
Why is cardiovascular disease a development problem in low- and middle-income countries?
At least three quarters of deaths caused by cardiovascular disease occur in low- and middle-income countries.Compared with high-income countries, people in low- and middle-income countries do not enjoy the benefits of comprehensive primary health care planning for early detection and treatment of those exposed to risk factors.
In low- and middle-income countries, people suffering from cardiovascular diseases and other non-communicable diseases are not easy to obtain effective and fair medical services that meet their needs. Therefore, in low- and middle-income countries, many people die of cardiovascular disease and other non-communicable diseases at a young age, and often die when their lives are at their highest.
The poorest people in low- and middle-income countries are the most affected. At the family level, there is continuous and sufficient evidence to prove that cardiovascular diseases and other non-communicable diseases can lead to poverty due to catastrophic health expenditures and high out-of-pocket expenses.
At the macroeconomic level, cardiovascular disease places a heavy burden on the economies of low- and middle-income countries.
How to reduce the burden of cardiovascular disease?
WHO has identified "best cost-effective measures" or very cost-effective interventions for the prevention and control of cardiovascular diseases, even in resource-poor settings. This includes two interventions: the entire population and individuals. It is recommended to use the two together to reduce the burden of cardiovascular disease, the heaviest disease.Population-wide interventions that can be used to reduce cardiovascular disease include:
1. Comprehensive tobacco control policy;
2. Taxation to reduce the intake of foods high in fat, sugar and salt;
3. Paved walking and cycling paths to increase physical activity;
4. Strategies to reduce harmful use of alcohol;
5. Provide healthy school meals to children.
To prevent the first heart attack and stroke at the individual level, it is necessary to target individual health care interventions to people with a median and high risk of cardiovascular disease, or single risk factors (such as diabetes, hypertension, and hypercholesterolemia) Personnel who exceed the recommended threshold for treatment. The former (total risk integrated approach) is more cost-effective than the latter and has the potential to significantly reduce cardiovascular events. This method is feasible in primary care work in resource-poor settings, including implementation by non-physician health workers.
To carry out secondary prevention of cardiovascular diseases for people who already have diabetes and other diseases, it is necessary to adopt the following treatment methods:
1. aspirin
2. β-blocker
3. Angiotensin converting enzyme inhibitor
4. Statin
Most of the benefits of these interventions are unique, but when used in combination with smoking cessation, it can prevent nearly 75% of recurrent vascular events. Currently, there is a great lack of implementation of these interventions, especially at the primary health care level.
In addition, sometimes expensive surgical procedures are needed to treat cardiovascular disease. This includes:
1. Coronary artery bypass
2. Balloon angioplasty (with a small spherical device to unblock the artery through an artery)
3. Valve repair and replacement
4. Heart transplant
5. Artificial Heart Surgery
Primary Prevention of Cardiovascular diseases
1. Meal
(1) Daily intake of 300-500g of vegetables, 200-400g of fruits, 250-400g of cereals, cholesterol <300mg/d, edible oil <25g, and daily water consumption of at least 1200 ml;(2) It is not recommended to start drinking alcohol or frequent drinking for the prevention of heart disease. It is recommended that adult men drink less than 25 g/d of alcohol (equivalent to 750 ml of beer, or 250 ml of wine, or 50 g of high-level liquor, or 75 g of 38-degree liquor); adult women drink less than 15 g/d (equivalent to Beer 450 ml, or wine 150 ml, or 38 degrees liquor 50 g); pregnant women , children and teenagers are prohibited from drinking alcohol. Alcohol (g) = alcohol consumption (ml) × alcohol content (%) × 0.8 (alcohol specific gravity);
(3) Reduce the intake of sodium salt, daily salt should be controlled within 5g; increase potassium salt intake, daily potassium salt ≥4.7g.
2. Regular exercise
(1) Persist in moderate-intensity aerobic exercise for at least 30 minutes every day;(2) Conduct resistance training (such as weight training) at least twice a week, repeating 10 to 15 times for each exercise;
3. Weight control
Overweight and obese people lose 5% to 10% of their body weight within 6 to 12 months, BMI is maintained at 18.5 to 23.9 kg/m2, and waist circumference is controlled to be ≤90 cm for men and ≤85 cm for women.4. Smoking
(1) Ask about smoking in each clinic and record it in the medical record, persuade each smoker to quit smoking, assess the degree of willingness to quit smoking, draw up a plan to quit smoking, give guidance on smoking cessation methods, psychological support and (or) smoking cessation drug treatment, regular follow-up;(2) To strengthen smoking cessation education and behavior guidance for all smokers, it is recommended to use smoking cessation drugs to assist smoking cessation and reduce withdrawal symptoms;
(3) Avoid passive smoking.
Facts about Cardiovascular diseases
1. Cardiovascular disease is the number one cause of death worldwide: more people die from cardiovascular disease each year than any other cause of death (1).2. It is estimated that 17.3 million people died of cardiovascular disease in 2008, accounting for 30% of the global deaths (1). Of these dead, an estimated 7.3 million died from coronary heart disease and 6.2 million died from stroke.
3. Low- and middle-income countries are particularly affected: more than 80% of cardiovascular deaths occur in low- and middle-income countries, and the situation is almost the same for men and women.
4. By 2030, the number of people dying of cardiovascular disease (mainly heart disease and stroke) will increase to 23.3 million (1,3). It is expected that cardiovascular disease will continue to be the single leading cause of death.
5. Most cardiovascular diseases can be prevented by addressing risk factors such as tobacco use, unhealthy diet and obesity, lack of physical activity, high blood pressure, diabetes and elevated blood lipids.
6. There are 9.4 million deaths each year, or 16.5% of all deaths may be caused by hypertension. This includes 51% of deaths due to stroke and 45% of deaths due to coronary heart disease.
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