Heart disease and strokes are leading causes of death globally, representing significant public health challenges. These conditions fall under the broader category of cardiovascular diseases (CVDs), which are disorders of the heart and blood vessels. Understanding the reasons, risk factors, prevention, and treatment of these diseases is crucial in lowering their impact.
Cardiovascular diseases, including heart disease and stroke, account for nearly 18 million deaths annually, according to the World Health Organization (WHO). This figure represents about 31% of all global deaths, with the majority occurring in low- and middle-income countries. Heart disease, specifically coronary artery disease, is the most common type of CVD and is responsible for the majority of CVD-related deaths. Strokes, which occur when the blood supply to part of the brain is interrupted or reduced, follow closely.
Risk Factors
Several risk factors contribute to the development of heart disease and strokes.
Non-modifiable risk factors:
1. Age: The risk increases with age.
2. Sex: Men are generally at higher risk at a younger age, though the risk for women increases post-menopause.
3. Family History: A family history of CVD increases risk.
Modifiable risk factors:
1. High Blood Pressure (Hypertension): A leading risk factor for both heart disease and stroke.
2. High Cholesterol: Elevated levels of LDL cholesterol can lead to atherosclerosis increasing
risk of death.
3. Smoking: Significantly increases the risk of heart disease, respiratory problems as well as deadly diseases like lung and larynx cancer
4. Diabetes: Raises the risk of developing CVD.
5. Obesity: Linked to other risk factors like hypertension, high cholesterol, and diabetes.
6. Physical Inactivity: Another major cause for dealing with disease like CVD.
7. Unhealthy Diet: Diets high in saturated fats, trans fats, carbohydrates and sodium contribute to heart disease and stroke.
8. Excessive Alcohol Intake: This also leads to high blood pressure, heart failure, and cardiac arrest.
Pathophysiology
Heart disease often involves the narrowing or blockage of coronary arteries due to atherosclerosis, a condition characterized by the build-up of fatty deposits (plaques) inside the artery walls. This can lead to myocardial infarction (heart attack) if a plaque ruptures and forms a clot that obstructs blood flow. Strokes are classified into ischemic (caused by blood clots) and hemorrhagic (caused by bleeding) types. Ischemic strokes, the most common type, result from blockages in the arteries supplying blood to the brain.
Prevention
Preventing heart disease and strokes involves addressing modifiable risk factors through lifestyle changes and medical interventions. Key strategies include:
1. Healthy Diet: Emphasize fruits, vegetables, whole grains, lean proteins, and healthy fats. Reduce intake of salt, sugar, and unhealthy fats.
2. Regular Exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity per week.
3. Smoking Cessation: Quitting smoking significantly reduces the risk of CVD.
4. Managing Blood Pressure and Cholesterol: Regular monitoring and medication adherence if necessary.
5. Weight Management: Maintaining a healthy weight through diet and exercise.
6. Limit Alcohol Consumption: Follow guidelines for moderate alcohol intake.
The treatment of heart disease and strokes depends on the specific condition and severity:
1 .Medications: Antihypertensives, statins, antiplatelet agents (like aspirin), and anticoagulants are commonly prescribed.
2. Surgical Procedures: For heart disease, procedures like angioplasty, stent placement, and coronary artery bypass grafting (CABG) may be necessary. In the case of strokes, particularly ischemic strokes, thrombolytic therapy to dissolve clots or mechanical thrombectomy to remove clots may be employed.
3. Lifestyle Modifications: Continuous lifestyle changes are essential to manage and reduce the risk of future cardiovascular events.
Heart disease and strokes remain major causes of death globally, but they are largely preventable and curable through effective management of risk factors and healthy lifestyle choices. Continued public health awareness is essential to educate and empower individuals to take proactive steps in reducing their cardiovascular risk. Additionally, advancement in medical treatments and technologies provide hope for better management and outcomes for those affected by these diseases.
https://www.thelancet.com/journals/lansea/article/PIIS2772-3682(23)00016-1/fulltext