Tip/Thought of the Day

Cardiovascular Disease Prevention, Symptoms, and Treatment

Cardiovascular diseases (CVDs) are the leading causes of death globally. According to the Centers for Disease Control and Prevention, one person dies every 36 seconds in the United States from cardiovascular disease. Many factors can contribute to increased risk of developing a cardiovascular disease, but some of the most common behavioral risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The World Health Organization (WHO) shares that the effects of these risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. And yet, many people do not know they have early stages of cardiovascular diseases or are increasing their risk of developing CVDs. Many symptoms can go undetected, or mimic symptoms of other, less serious concerns. Screening, preventative measures, awareness of family history, and maintaining a healthy lifestyle that includes exercise, a healthy weight, and nutritious diet, are all essential factors in decreasing risk of CVDs.


What are CVDs and what causes them?

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels.

It can also be associated with damage to arteries in organs such as the brain, heart, kidneys and eyes.

  • coronary heart disease (angina, heart attacks, heart failure) – a disease of the blood vessels supplying the heart muscle
  • cerebrovascular disease – a disease of the blood vessels supplying the brain
  • peripheral arterial disease – a disease of blood vessels supplying the arms and legs
  • rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever,caused by streptococcal bacteria
  • congenital heart disease – birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth
  • deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs

Some risk factors include:

  • high blood pressure
  • smoking
  • high cholesterol
  • diabetes
  • inactivity
  • being overweight or obese
  • family history
  • age – most common in people over 50 and the risk increases as you get older
  • gender – men are more likely to develop CVD at an earlier age than women
  • diet – an unhealthy diet can lead to high cholesterol and high blood pressure
  • alcohol– excessive alcohol consumption can also increase your cholesterol and blood pressure levels, and contribute to weight gain

While some risk factors cannot be changed, behavioral risk factors can be modified to decrease the chance that you develop cardiovascular diseases.

Every year, 9.4 million people die from complications related to high blood pressure, according to the World Health Organization. But many people with hypertension aren’t even aware they have it. Regular screening and early intervention were deemed so crucial to managing CVDs that parameters for measuring blood pressure were modified in 2017 and are now lower than previous levels. Instead of a reading below 140/90 being acceptable, it is now recommended to have a reading consistently below 130/80.

The American Heart Association states that the change in parameters is to promote early detection and to mitigate complications due to hypertension. The new guidelines resulted in nearly half of the U.S. adult population (46 %) being categorized as having high blood pressure, or hypertension.


Symptoms

Symptoms vary depending on the specific condition, and can also vary between genders. Some conditions may not have symptoms at all during the early stages (like type 2 diabetes and cardiomyopathy, for example), again highlighting the need for regular screening. Some often overlooked symptoms can cue us into the fact that there may be inadequate blood flow. Some signs like jaw and neck pain, nausea and bloating, and fatigue when doing everyday activities, can sometimes be signs of an impending acute issue (like stroke or heart attack).

  • pain or pressure in the chest, which may indicate angina
  • pain or discomfort in the arms, left shoulder, elbows, jaw, or back
  • shortness of breath
  • nausea and fatigue
  • lightheadedness or dizziness
  • cold sweats

Other symptoms aren’t necessarily directly linked to CVDs, but researchers at Johns Hopkins Medicine share that they are concerns that should be addressed to relieve symptoms and to rule out other health concerns:

Sleep apnea. This temporary collapse of an airway puts a halt to breathing during sleep and has been linked to high blood pressure and an increased risk of heart attack.

Trouble achieving or maintaining an erection. Though men often don’t connect bedroom problems to the heart, erectile dysfunction can be a very early sign of the arterial damage of heart disease.

Cramping, aching or numbness in the calves when you walk. This kind of leg pain, which is felt when you exercise and stops when you stop, can be a sign of peripheral vascular disease (PVD), a circulation disorder.


Diagnosis

Regular screening and awareness of your risk factors is crucial as not all symptoms may directly highlight underlying CVDs.

Here’s a look at some of the tests used to diagnose and manage CVDs. Please speak to your provider for specifics and what is appropriate for your individual health.

  • Blood work measures substances in blood that indicate cardiovascular health, such as cholesterol and specific proteins.
  • Electrocardiogram (EKG) records the electrical activity in your heart.
  • Ambulatory monitoring uses wearable devices that track your heart rhythm and rates.
  • Echocardiogram uses sound waves to create an image of your heartbeat and blood flow.
  • Cardiac CT uses X-rays to create images of your heart and blood vessels.
  • Cardiac MRI uses magnets and radio waves to create images of your heart.
  • Stress tests use different ways to stress the heart in a controlled way (exercise or medications) to determine how your heart responds through EKGs and/or images.
  • Cardiac catheterization uses a catheter (thin, hollow tube) to measure pressure and blood flow in your heart.

Treatment

Some lifestyle changes, like managing your weight, limiting alcohol intake, not smoking, getting regular exercise, and following a heart-healthy diet can help reduce the risk of developing CVDs. These are also general guidelines for overall wellness, and should be adhered to regardless of CVD risk levels. If lifestyle changes aren’t enough to limit your risk levels, providers may use medication to manage the CVD. Sometimes, a medical procedure or surgery is required depending on the extent of damage to the heart and blood vessels.

An aspirin a day keeps the doctor away? Over the years, people had been taught that a daily aspirin was a sound routine to help protect against CVDs, but as we shared in this post, that is no longer the recommendation. Research now shows that the risk outweighs any benefit it may have. But, a doctor may suggest aspirin if a person has a high risk of experiencing a cardiovascular event, such as a heart attack or stroke, and a low risk of bleeding. Doctors may also recommend it to those who have already had a heart attack or stroke. Please speak to your provider before starting any new medication (or supplement) regimen.


Next week, we’ll discuss high blood pressure, or hypertension, and whether new gadgets like phones, smart watches, and bracelet monitors are accurate in testing blood pressure levels.



Sources:

https://www.ahajournals.org/doi/full/10.1161/01.atv.0000116216.56511.39

https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20049357

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/wrist-blood-pressure-monitors/faq-20057802

https://pubmed.ncbi.nlm.nih.gov/31423912/

https://medical.andonline.com/blog/are-wrist-blood-pressure-monitors-accurate

Will wearables ever accurately measure blood pressure?

-https://www.cdc.gov/heartdisease/facts.htm

-https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

-https://www.hopkinsmedicine.org/health/wellness-and-prevention/surprising-body-cues-that-could-be-a-heart-concern

-https://www.nhs.uk/conditions/cardiovascular-disease/

-https://newsroom.heart.org/news/high-blood-pressure-redefined-for-first-time-in-14-years-130-is-the-new-high

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