The Disease

CVD is a group of disorders of the heart and blood vessels which include:

• Coronary heart disease (affecting blood vessels supplying the heart muscle),
• Cerebrovascular disease (affecting blood vessels supplying the brain),
• Peripheral arterial disease (affecting 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), and
• Deep vein thrombosis and pulmonary embolism (blood clots in the leg veins, which can dislodge and move to the heart and lungs).

The Burden

Cardiovascular disease (CVD) is the number one cause of death globally. In 2008, an estimated 17.3 million men and women died from CVD, representing 30% of all global deaths, 4/5 of which were in LMICs.

An estimated 7.3 million of CVD deaths were due to coronary heart disease and 6.2 million were due to stroke. If current trends are allowed to continue, annual CVD deaths are projected to rise to 23.3 million by 2030 (mainly from heart attacks and strokes).

Management

Early detection of high CVD risk in primary care settings avails inexpensive treatment to prevent many heart attacks and strokes.  Heart attack and stroke survivors are at high risk of recurrences and subsequent death, although these risks can be lowered with a combination of drugs – statins to lower cholesterol, drugs to lower blood pressure, and aspirin.

Surgical operations are sometimes required to treat CVD, with varying complexity from coronary artery bypass to heart transplantation, and artificial heart operations. Medical devices are required to treat some CVD, including pacemakers, prosthetic valves, and patches for closing holes in the heart.

In some cases, determinants of CVD include poverty, stress and hereditary factors. However the leading risk factor for CVD is high blood pressure, also known as raised blood pressure or hypertension, with one in three adults being affected. It is often referred to as the “silent killer” as many people are not aware they have it, yet it causes 9.4 million deaths each year including 51% of deaths due to strokes and 45% of deaths due to coronary heart disease.

Prevention

Most CVD can be prevented by addressing risk factors such as avoiding tobacco use and second-hand smoke, ensuring healthy diet and body weight, maintaining regular moderate to vigorous physical activity, lowering blood pressure, preventing and controlling diabetes and keeping blood-lipid levels low.

CVD expenditures vary from country to country, but most countries spend 8-22% of their health budget on CVD. These costs could be considerably reduced with policies that create environments which make healthy choices affordable, available and sustainable.

Examples of population-wide, cost-effective interventions include:

• Implementing comprehensive tobacco control policies
• Taxing foods that are high in fat, sugar and salt
• Building walking and cycle ways to increase physical activity
• Providing healthy school meals to children

World Heart Day is held each year on September 29th