Cardiovascular Disease

Trends

Aust ContinuesIn this downward trend

Facts• One of the leading causes of sickness and

death• 36% of all deaths • Males are more likely to die than females• Death rate has declined in both male and

female (improved medical care, reduced risk)

Nature of Cardiovascular Disease

The major cardiovascular conditions are:• coronary heart disease • stroke • peripheral vascular disease.One of the major contributing factors to

cardiovascular disease is atherosclerosis

AtherosclerosisAtherosclerosis is the build-up of fatty and/or fibrous material on the interiorwalls of arteries. This build-up hinders the flow of blood to the body’stissues and also acts to increase blood pressure. Often, the build-up occurs inpatches known as atheroma or plaque, and is characterised by the presence of cholesterol. The development of atheroma tends to decrease the elasticity of the arteries and limits the flow of blood.

Coronary heart diseaseCoronary heart disease is the most common type of cardiovascular disease and accounts for just over 20 per cent of all deaths. It occurs when the blood supply to the heart is decreased by a narrowing (usually caused by atherosclerosis) in one or more of the coronary arteries.If the blockage severely decreases blood flow to the heart it can lead to a condition called angina. Angina is chest pain that occurs as a result of cramping of the heart muscle due to constricted arteries. In some cases the decrease in the blood supply can result in a more serious sudden heart attack, which can be fatal.

Cerebrovascular diseaseCerebrovascular disease is a disease of the arteries of the brain. An interruption (usually caused by atherosclerosis) of the blood supply to the brain results in what is commonly known as a ‘stroke’. A stroke can also occur as a result of a blood vessel bursting in the brain. The effects that a stroke has on the person will depend on which part of the brain has had its blood supply restricted.

Peripheral vascular diseasePeripheral vascular disease is a type of cardiovascular disease that affects the blood vessels in the limbs. Hardening of the arteries that interferes with blood supply to the muscles and skin is known as arteriosclerosis. This disease has close links to smoking, and to diabetes and certain other diseases. In extreme cases, this can result in gangrene and possibly limb amputation.

Risk Factors

Factors that make the occurrence of a disease more likely are called

risk factors.

Non Modifiable Risk FactorsAge—The risk of cardiovascular disease increases as people age; this is often the result of the slow progression of atherosclerosis.

Heredity—People with a family history of cardiovascular disease are more prone to developing the disease themselves.

Gender—Males are more at risk of coronary heart disease than are females.

Modifiable risk factors• High blood pressure—Blood pressure is one of the most common causes of heart disease; high blood pressure is linked to a high-salt diet and being overweight. If left untreated, it significantly increases the risk of both cerebrovascular disease and coronary heart disease.• High blood fats—High levels of cholesterol and triglycerides (types of lipids or ‘fats’) in the blood significantly increase the chances of cardiovascular disease. Dangerously high levels of these substances can often be decreased by low-fat diets.

Modifiable risk factors (cont)

• Overweight and obesity—People who are overweight are at an increased risk of heart disease because of the extra burden placed on the heart and lungs, and because obesity is linked to high blood pressure and an increased level of blood fats.

• Lack of physical activity—People who do not engage in regular physical activity can have a less efficient heart, higher levels of blood fats and a propensity to gain weight. These factors combine to increase the risk of coronary heart disease.

Modifiable risk factors (cont)• Smoking—Smokers are up to five times more likely to develop a cardiovascular disease than are non-smokers. The chemicals contained in cigarette smoke (such as nicotine, tar and carbon monoxide) can increase heart rate, constrict the vessels (reducing blood flow) and reduce the oxygen-carrying capacity of the blood.

Besides these major risk factors, other possible influencesinclude poor nutrition, alcohol, the contraceptive ‘pill’(especially coupled with smoking) and diabetes.

Protective factors are the

opposite of risk factorsin that they help lowera person’s chances ofdeveloping a disease.

Protective Factors• Maintain healthy levels of blood pressure and blood cholesterol—Regular checks will assist early identification and management.• Quit smoking—the single most important action a person can take .• Enjoy healthy eating—enjoy a variety of foods mainly fruits & veg, lean meats, fish, reduced-fat dairy and polyunsaturated or monounsaturated oils• Visit the doctor regularly—early signs of risk (blood pressure, cholesterol, family history and lifestyle)• Be physically active—Regular, moderate-intensity physical activity (30min\day)• Achieve and maintain a healthy weight

Sociocultural Determinants• People with a family history of CVD are more at risk.

• Asians are less prone to getting CVD due to a generally low-fat diet.

• Aboriginal and Torres Strait Islander peoples are more at risk as they are associated with having a lower socioeconomic status and lower education levels.

• Media exposure of the effects of smoking on health have led to a reduction in smoking rates and therefore a declining trend for CVD rates.

Socioeconomic determinants

• People with low education levels are more at risk as poor education is linked to poor health choices and less knowledge about how to access and use health services.

• People with a low socioeconomic status or who are unemployed have higher death rates because income can limit health choices, such as purchasing fresh fruit and vegetables and using exercise facilities.

Environmental determinant

People living in rural and remote areas are more at risk, as they tend to have less access to health information, health services and technology.

Groups at risk of developing CVD• tobacco smokers• people with a family history of the disease• people with high blood pressure levels(hypertension)• people who consume a high-fat diet (which leads to raised blood cholesterol and triglyceride levels)• people aged over 65 years• males• blue-collar workers (labourers and tradespeople who may have higher levels of smoking, alcohol consumption and high-fat diets).Cardiovascular