Heart and Circulatory Health

The term cardiovascular refers to the heart (cardio) and the blood vessels (vascular). The cardiovascular system includes arteries, veins, arterioles, venules, and capillaries.

Cardiovascular Disease

Cardiovascular diseases include coronary heart disease (heart attacks), cerebrovascular disease, raised blood pressure (hypertension), peripheral artery disease, rheumatic heart disease, congenital heart disease and heart failure. The major causes of cardiovascular disease are tobacco use, physical inactivity, and an unhealthy diet.

Globally, cardiovascular diseases are the number one cause of death and is projected to remain so. An estimated 17.5 million people died from cardiovascular disease in 2005, representing 30 % of all global deaths. Of these deaths, 7.6 million were due to heart attacks and 5.7 million due to stroke. About 80% of these deaths occurred in low and middle income countries. If current trends are allowed to continue, by 2015 an estimated 20 million people will die from cardiovascular disease (mainly from heart attacks and strokes).

What Causes Heart Attacks and Strokes?

Heart attacks and strokes are mainly caused by a blockage that prevents blood from flowing to the heart or the brain. The most common cause is a build-up of fatty deposits in the inner walls of the blood vessels that supply the heart or brain. The blood vessels become narrower and less flexible, also known as atherosclerosis (or hardening of the arteries). The blood vessels are then more likely to become blocked by blood clots. When this happens, the blocked vessels cannot supply blood to the heart and brain, resulting in damage.

Factors of Cardiovascular Disease include:

• The most prevalent causes of heart disease and stroke are unhealthy diet, physical inactivity and tobacco use. These are called 'modifiable risk factors.'
• The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity; these are called 'intermediate risk factors'.
• The major modifiable risk factors are responsible for about 80% of coronary heart disease and cerebrovascular disease.
• There are also a number of underlying determinants of chronic diseases. These are a reflection of the major forces driving social, economic and cultural change globalization, urbanization, and population ageing. Other determinants of CVDs are poverty and stress.

Common Symptoms of Cardiovascular Diseases

• Often, there are no symptoms of an underlying disease of the blood vessels. A heart attack or stroke may be the first warning of the disease.
• Symptoms of a heart attack include: pain or discomfort in the center of the chest; pain or discomfort in the arms, the left shoulder, elbows, jaw, or back. In addition, the person may experience difficulty in breathing or shortness of breath, feeling sick or vomiting, feeling light-headed or faint, breaking into a cold sweat, and becoming pale.
• Women are more likely to have shortness of breath, nausea, vomiting, and back or jaw pain.
• The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one side of the body. Other symptoms include sudden onset of: numbness of the face, arm, or leg, especially on one side of the body, confusion, difficulty speaking or understanding speech, difficulty seeing with one or both eyes; difficulty walking, dizziness, loss of balance or coordination, severe headache with no known cause, and fainting or unconsciousness.
• People experiencing these symptoms should seek medical care immediately.

Blood Vessel Constriction

There are three main reasons for fatty build-up and blood vessel constriction. These are all controllable factors.

• Smoking and other tobacco use
• Unhealthy diet; and
• Physical inactivity.

An early form of fatty deposits, known as "fatty streaks," can even be found in some children younger than 10 years. These deposits get slowly worse as the person gets older.

Tips for a Healthy Heart

• Eat a variety of whole foods with high nutritional value.
• Cessation of tobacco use reduces the chance of a heart attack or stroke.
• Engaging in physical activity for at least 30 minutes every day of the week will help to prevent heart attacks and strokes.
• Eating at least five servings of fruit and vegetables a day, and limiting your salt intake to less than one teaspoon a day, also helps to prevent heart attacks and strokes.
• Have your blood pressure checked regularly. High blood pressure has no symptoms, but can cause a sudden stroke or heart attack.
• Diabetes increases the risk of heart attacks and stroke. If you have diabetes, control your blood pressure and blood sugar to minimize your risk.
• Being overweight increases the risk of heart attacks and strokes. To maintain an ideal body weight, engage in physical activity and eat a healthy diet.

Cardiovascular Diseases

• Coronary heart disease - disease of the blood vessels supplying the heart muscle
• Cerebrovascular disease - disease of the blood vessels supplying the brain
• Peripheral arterial disease - 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 - malformations of heart structure existing at birth.
• Deep vein thrombosis and pulmonary embolism blood clots in the leg veins, which can dislodge and move to the heart and lungs.

Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by bleeding from a blood vessel in the brain or from blood clots.

Facts About Cardiovascular Diseases

• CVDs are the number one cause of death globally: more people die annually from CVDs than from any other cause
• Over 80% of CVD deaths take place in low and middle income countries and occur almost equally in men and women
• Cardiovascular disease is projected to remain the single leading causes of death in the near future

Rheumatic Heart Disease

• Rheumatic heart disease is damage to the heart valves and heart muscle from the inflammation and scarring caused by rheumatic fever. Rheumatic fever is caused by streptococcal bacteria, which usually begins as a sore throat or tonsillitis in children.
• Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heart beats, chest pain and fainting
• Symptoms of rheumatic fever include: fever, pain and swelling of the joints, nausea, stomach cramps and vomiting.
• Early treatment of streptococcal sore throat can stop the development of rheumatic fever. Regular long-term penicillin treatment can prevent repeat attacks of rheumatic fever and can stop disease progression in people whose heart valves are already damaged by the disease.

Economic Costs of Heart Disease?

• CVDs affect many people in middle age, very often severely limiting the income and savings of affected individuals and their families. Lost earnings and out of pocket health care payments undermine the socioeconomic development of communities and nations.
• CVDs place a heavy burden on the economies of countries. For example, it is estimated that over the next 10 years (2006-2015), China will lose $558 billion in foregone national income due to the combination of heart disease, stroke and diabetes.
• Lower socioeconomic groups in high income countries generally have a greater prevalence of risks factors, diseases and mortality. A similar pattern is emerging as the CVD epidemic evolves in low and middle income countries.

Common Cardiovascular Disease Treatments

• Effective and inexpensive medication is available to treat nearly all CVDs
• After a heart attack or stroke, the risk of a recurrence or death can be substantially lowered with a combination of drugs statins to lower cholesterol, drugs to lower blood pressure, and aspirin
• Effective medical devices have been developed to treat CVDs, such as pacemakers, prosthetic valves, and patches for closing holes in the heart
• Operations used to treat CVDs include coronary artery bypass, balloon angioplasty (where a small balloon-like device is threaded through an artery to open the blockage), valve repair and replacement, heart transplantation, and artificial heart operations
• There is a need for increased government investment through national programs aimed at prevention and control of CVDs and other chronic diseases.

WHO Strategy for Cardiovascular Disease Prevention and Control

The work of the World Health Organization (WHO) on cardiovascular diseases is integrated into the overall WHO chronic disease prevention and control framework of the Department of Chronic Disease and Health Promotion. The strategic objectives of the Department are to raise awareness about the global epidemic of chronic diseases, create healthy environments, especially for poor and disadvantaged populations, slow and reverse trends in common chronic disease risk factors such as unhealthy diet and physical inactivity, and prevent premature deaths and avoidable disability due to major chronic diseases.

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