Cardiovascular disease

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

Many of these heart problems can be prevented by making healthy choices, such as 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 prevent certain heart diseases.

Heart diseases are the biggest cause of death around the world. They affect mostly older people, but they can happen at any age. Men are more likely to develop these conditions than women and usually get them earlier in life. Even though many people in developed countries have seen fewer cases over the years, heart disease remains a major health issue globally.

Types

Cardiovascular diseases are conditions that affect the heart or blood vessels. Some diseases affect the blood vessels, called vascular diseases. 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

There are many things that can increase the chance of heart problems. These include getting older, certain health conditions like high blood pressure or diabetes, not being active, eating unhealthy foods, and even things like air pollution. Some of these factors you can change, like eating better or exercising more, while others like age or family history you cannot change.

Getting older is a big factor for heart problems. As people get older, their risk of heart disease goes up a lot. Men often develop heart problems earlier than women. Not moving enough, smoking, and eating foods high in bad fats can also increase the risk. Having conditions like diabetes or high blood pressure makes heart problems more likely too. Poor sleep and living in areas with pollution can also affect heart health.

Pathophysiology

Population-based studies show that a major cause of heart problems starts in childhood. Research has found early signs of heart disease in the aortas and coronary arteries of children aged 7–9 years.

Obesity and diabetes mellitus are linked to heart disease, as are long-term kidney disease and high levels of cholesterol. Heart disease is a serious risk for people with diabetes, who are much more likely to have heart-related health issues compared to those without diabetes.

Screening

Screening tests like ECGs are not needed for people who show 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

Up to 90% of heart and blood vessel problems may be prevented by avoiding known 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 the main reason people die around the world, except in Africa. In 2008, about 30% of all deaths globally were because of these diseases. Most of these deaths happen in countries that don’t have a lot of money, where more than 80% of all cardiovascular deaths occur.

Experts think that by 2030, over 23 million people will pass away from cardiovascular diseases every year. A big part of this problem is in the South Asian subcontinent, where 60% of these diseases happen even though the area only has 20% of the world’s people. This might be because of both genetic and environmental reasons. Groups like the Indian Heart Association work with the World Heart Federation to help people learn more about this important health issue.

Research

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

People have known about heart problems for a very long time, even before history was written down. Scientists have studied these problems for many years, starting in the 1700s. Today, many scientists are still working hard to learn more about heart health, how to stop these problems, and how to help people who are sick.

Some of the newest research looks at how small health issues can lead to bigger heart problems, new ways to treat heart disease, and how genes might affect heart health. Every week, hundreds of new studies are shared to help doctors and scientists understand more.