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Cardiovascular disease

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Estimated that each year in the US approximately 620,000 Americans have a new acute coronary event including myocardial infarction or a coronary heart disease death, and approximately 295,000 have a recurrent event.

Cardiovascular disease is the leading cause of morbidity and death in the US and is the cause of more than 1 of every four deaths.

Coronary heart disease is the single leading cause of death and accounts for 43% of deaths attributable to CVD in the US.

In 2019 and estimated 558,000 deaths were caused by coronary heart disease and 109,000 deaths were caused by ischemic stroke.

Cardiovascular diseases are the leading causes of mortality, with an age adjusted mortality of 285. 5/hundred/100,00 in 2015

CVD is prevalent globally is responsible for 33% of all deaths worldwide.

IN 2019 Cardiovascular Disease was estimated at 18.6 million deaths globally and 957, 000 deaths in the United States.
CVD is the number one cause of death in the United States, with a death rate that exceeds all cancers combined.
The WHO estimate today about 75% of premature cardiovascular disease is preventable and dietary patterns belong to a group of lifestyle modifications have demonstrated a benefit for the prevention of cardiovascular disease.
Global data suggests that 57.2% and 52.6% of cases of incident cardiovascular disease among women and men, respectively, and 22.2%, and 19.1% of deaths from any cause among women and men, respectively, may be attributable to five modifiable risk factors: body mass index, systolic blood pressure, low density, lipoprotein, cholesterol level, tobacco, smoking, and diabetes (The Global Cardiovascular Risk Consortium).

According to American Heart Association data, about 65% of men and 47% of women present with a heart attack or sudden cardiac arrest as their first symptom of cardiovascular disease.

Pollution is a material released into the environment by human activity and important, but commonly overlooked, risk factor for cardiovascular disease.

It is estimated the pollution was responsible for 9 million deaths worldwide in 2019, 62% of which were due to cardiovascular disease, including ischemic heart disease and stroke.

Disease risk can be reduced by his measures 28% with the adoption of the health promoting dietary pattern.

A relative increase in economic prosperity is associated with a small relative decrease in cardiovascular mortality among middle-aged adults.

Traditionally, considered a male predominant disease, however females are equally affected, particularly in later stages of life.

CVD is the leading cause of mortality in women, surpassing cancer.

More than 2000 Americans die of cardiovascular disease daily.

Approximately 92 million Americans are living with some form of cardiovascular disease or aftereffects of stroke.

Is responsible for the largest proportion of global premature noncommunicable chronic disease mortality.

Cardiovascular disease is the leading cause of death globally and accounts for approximately 17.9 million deaths every year.

Steep decline in death rates from heart disease and stroke have occurred in recent decades in the range of 60-70% in the United States.

The major cause of death for women, and the risk increases markedly in the postmenopausal period.

Cardiovascular disease is the most common cause of death among adults and accounts for one in three deaths each year.

Cardiovascular diseases including acute myocardial infarction, ischemic stroke, pulmonary thromboembolism, are the leading causes of death and disability worldwide, often manifesting in the prime of life.

Atherosclerotic cardiovascular disease is largely preventable and its prevention as shown the approximate 70% decrease in cardiac mortality over the last 50 years.

Accounts for 39% of all deaths in the U.S.

Cardiovascular disease including coronary heart disease and stroke causes approximately one in three deaths in the u.s.,and more than 1/3 of arteriosclerotic coronary vascular disease deaths occur among individuals younger than 75 years.

In 2015 cardiovascular disease accounted for 398,035 female deaths, exceeding the number of lives lost to malignant disease, chronic lung diseases, and diabetes combined.

Accounts for 800,000 death per year in the U.S.

There are seven evidence-based measurable health behaviors to improve cardiovascular health and include:smoking, diet, physical activity, blood pressure, glucose, cholesterol, and BMI.

Women have an increased prevalence of fatalities due to plaque erosion compared with men.

Cardiovascular risk closely relates to cerebrovascular injury and cognitive decline in older adults .

Both sexes have similar risk factors for coronary heart disease but some factors including: tobacco use, type two diabetes, depression, and emotional stress are more potent in women.

The lifetime is one out of every two men will develop a cardiovascular event during his remaining lifetime and for women, it’s about one out of every three.

Women with acute myocardial infarction more often present with atypical symptoms, resulting in more difficult diagnosis and treatment, and subsequent worse outcomes, with increased rates of readmission, reinfarction, and death.

Individuals who experience worse socioeconomic conditions in childhood, independent of their circumstances during adult life, generally have a greater risk for developing and dying to cardiovascular disease.

Immediate cause of death for cardiovascular diseases is often an occlusive blood clot, or thrombus and is its timely removal can restore blood flow in the vessel and salvage organ function and save lives.

The incidence of mortality related to coronary heart disease, acute myocardial infarction, heart failure, arrhythmias, and sudden cardiac death are increased during winter.

CVD associated increased incidence of cancer.

Cardiovascular diseases and cancer share a number of common risk factors such as tobacco smoking, lack of cardiorespiratory fitness, obesity, and diabetes.

Accounts for more than 7 million hospital discharges annually in the US

More than 2 million people per year in the US have a heart attack or stroke.

Accounted for 37% of adult deaths in the U.S. in 2004.

During the past 2 decades cardiovascular mortality decreased in both men and women,

but the rate is not decreased in parallel in women, especially those in midlife.

WHO estimates annual mortality due to cardiovascular diseases will approached 25 million by 2030.

Projected health care costs of cardiovascular disease in 2010 a 0.5 trillion dollars.

Approximately 80.7 million people in the U.S. have cardiovascular disease with one or more types of disease and at least 65 million have hypertension.

Sudden death is the initial manifestation in approximately 20% of patients.

Accounts for an estimated 17.3 million deaths annually.

Prevalence of coronary artery disease in the US between 2007 and 2011 among those 65 years or older was 19.1%

Prognosis of patients that experience a vascular event is poor.

Patients with a history of atherosclerotic cardiovascular disease such as a myocardial infarction, stroke, peripheral arterial disease, are at significantly elevated risk for a new or recurrent cardiovascular events and associated illness and death.

Cardiovascular diseases disproportionately affect women include: coronary microvascular dysfunction, spontaneous coronary artery dissection, apical ballooning syndrome,

inflammatory conditions associated with autoimmune disorders, peripheral arterial

disease, heart failure with preserved ejection fraction, and postural orthostatic tachycardia syndrome.

More than 16 million US adults are living with coronary heart disease including previous myocardial infarction and angina, another 7 million have had a stroke, and approximately eight million have peripheral arterial disease.

Procedures that can recognize sub clinical arteriosclerosis include ultrasound of the carotid artery and computerized chest CT scan: the former can detect plaque and determine carotid intima-media thickness and later can assess calcification of the coronary artery scores.

Carotid wall intima-media thickness is a surrogate measure of atherosclerosis, associated with cardiovascular risk factors and cardiovascular outcomes.

The intima-media thickness refers to the distance from the lumen-intima interface to the media-adventitia interface of the artery wall, as measured by ultrasound images of the carotid artery.

Carotid artery increased intima-media thickness represents a form of atherosclerosis that is manifested as diffuse arterial wall thickening.

Proximal carotid artery increased intima-media thickness is a surrogate for focal atherosclerotic plaque.

The mean intima-thickness of the common carotid artery is more reproducible than the intima-media thickness of the internal carotid artery and is a better measure for cardiovascular risk assessment.

Carotid artery-intima-media thickness, as measured by US, is an independent predictor of new cardiovascular events in individuals without a history of cardiovacular disease.

Carotid intima media thickness has small value in 10 year risk prediction of CV disease (Meta-analysis, Den Ruitjter HM et al),

Plaque in the internal carotid artery , either measured as part of the continuous intima-media thickness or assumed to be present if the thickness exceeds a set point of 1.5 mm improves cardiovascular risk prediction.

13% of total cardiovascular deaths associated with BMI≥ 30.

Older age, male gender, diabetes, hypertension, dyslipidemia, and smoking are the major risk factors.

Most important risk factors are largely modifiable, such as elevated cholesterol, smoking, obesity, diabetes, high-fat diet, and poor exercise habits.

It is estimated that 44% of the decrease in coronary deaths between 1980-2000 are related to improvements in treating the above risk factors.

It is estimated for the 1m/s increase in aortic pulse wave velocity corresponds to age, sex, and risk factor adjusted risk increase of 15% in cardiovascular diseases and all cause mortality.

A 0.1 mm Increase in carotid intima-media thickness is associated with 18% and 15% increased risk for stroke and myocardial infarction, respectively.

The three major risk factors are hypertension, hyperlipidemia and smoking: 49.7% of adults 20 years or older have at least 1 of the 3 risk factors.

Lees than 10% of healthy adults aged 25-74 years have no CV risk factors: therefore risk of CV disease can potentially be improved in most people.

Conventional risk factors explain less than 50% of the variability in the measures of coronary vascular disease as assessed by coronary angiography or electron beam computed tomography.

In men 50% of deaths due to coronary artery disease occur in men without a preceding history of such disease.

Children with cardiovascular risk factors become adults with increased cardiovascular risk.

Muscatine Study and Cardiovascular Risk in Young Finns study risk cardiovascular risk factors in childhood and carotid intima-media thickness in young adulthood.

Men frequently have preexisting erectile dysfunction.

Is largely a preventable disease.

Not prevented in high-risk individuals with 400 IU of vitamin E daily.

Angiotensin-converting enzyme inhibitors are effective in preventing cardiovascular disease in high-risk individuals.

Approximately 64 million people in the U.S. have cardiovascular disease.

The number 1 cause of death of men and women in the U.S.

Responsible for 1 of 2.6 deaths.

631,636 deaths from heart disease in 2006 in the US, with coronary artery disease accounts for 68% of these deaths.

Since 2000 there has been a 22% reduction in heart disease related deaths among men from 320 per 100,000 to 249 per 100,000.

Since 2000 there has been a 25% reduction in heart disease related deaths among women from 211 per 100,000 to 162 per 100,000.

African-Americans compared with whites have more prevalent and severe hypertension, and more cardiovascular disease including myocardial infarction and stroke.

Cardiovascular disease, including stroke is the largest contributed to the mortality difference between the black and white populations in the US, accounting for 34% of the difference in years of life lost.

Hypertension is the single largest contributor accounting for 15% of the disparity in white versus black mortality.

The 2014 coronary heart disease death rates per 100,00 were 137.5 for whites, 150.6 for African American males, 72.1 for white females, and 89.4 for African American females.

Within 5 years after a first myocardial infarction, at 45-64 years of age, death occurs in 11% of white males, 16% of African American males, 17% of white females and 28% of African American females (Benjamin EJ).

Coronary artery disease affects more than 1 million people a year in the US (CDC).

In 2002 cause or was a contributing cause of death in 58% of Americans.

Since 1900 the number one killer in the U.S. each year, except in 1918 when the influenza pandemic took more lives.

Affects 50% of men and 48% of women by age 55 years.

Women with favorable levels of risk factors at younger ages, reflect lower long-term coronary heart disease compared to others.

Men consistently at higher risk of cardiovascular disease compared to women until age 65 years.

Prognosis worse for women compared to men.

In females the prevalence of cardiovascular disease more than doubles between ages 35-44 years and ages 45-54 years increasing from 13.6% to 28.8%.

In veterans undergoing exercise testing, higher resting heart rates were significantly associated with increased risk for mortality.The threshold where this effect begins to occur is at roughly 70 beats per minute.

Nearly 80% of women aged 75 years or older are affected by cardiovascular disease.

Chronic renal disease associated with substantially increased risk of cardiovascular disease morbidity and mortality.

Risk is greater with diabetes than with chronic renal disease, and the risk of a first major cardiovascular event is approximately 30% higher in individuals with chronic renal insufficiency than in those with normal or near-normal renal function, whetheThe major cause of death for women, and the risk increases markedly in the postmenopausal period.

Accounts for 39% of all deaths in the U.S.

Accounts for 800,000 death per year in the U.S

Accounts for more than 7 million hospital discharges annually in the US

More than 2 million people per year in the US have a heart attack or stroke.

Accounted for 37% of adult deaths in the U.S. in 2004.

Projected health care costs of cardiovascular disease in 2010 a 0.5 trillion dollars.

Approximately 80.7 million people in the U.S. have cardiovascular disease with one or more types of disease and at least 65 million have hypertension.

Sudden death is the initial manifestation in approximately 20% of patients.

Prognosis of patients that experience a vascular event is poor.

Patients with a history of atherosclerotic cardiovascular disease such as a myocardial infarction, stroke, peripheral arterial disease, are at significantly elevated risk for a new or recurrent cardiovascular events and associated illness and death.

More than 16 million US adults are living with coronary heart disease including previous myocardial infarction and angina, another 7 million have had a stroke, and approximately eight million have peripheral arterial disease.

Procedures that can recognize sub clinical arteriosclerosis include ultrasound of the carotid artery and computerized chest CT scan: the former can detect plaque and determine carotid intima-media thickness and later can assess calcification of the coronary artery scores.

Carotid wall intima-media thickness is a surrogate measure of atherosclerosis, associated with cardiovascular risk factors and cardiovascular outcomes.

The intima-media thickness refers to the distance from the lumen-intima interface to the media-adventitia interface of the artery wall, as measured by ultrasound images of the carotid artery.

Carotid artery increased intima-media thickness represents a form of atherosclerosis that is manifested as diffuse arterial wall thickening.

Proximal carotid artery increased intima-media thickness is a surrogate for focal atherosclerotic plaque.

The mean intima-thickness of the common carotid artery is more reproducible than the intima-media thickness of the internal carotid artery and is a better measure for cardiovascular risk assessment.

Carotid artery-intima-media thickness, as measured by US, is an independent predictor of new cardiovascular events in individuals without a history of cardiovacular disease.

Carotid intima media thickness has small value in 10 year risk prediction of CV disease (Meta-analysis, Den Ruitjter HM et al),

Plaque in the internal carotid artery , either measured as part of the continuous intima-media thickness or assumed to be present if the thickness exceeds a set point of 1.5 mm improves cardiovascular risk prediction.

13% of total cardiovascular deaths associated with BMI≥ 30.

Older age, male gender, diabetes, hypertension, dyslipidemia, and smoking are the major risk factors.

Most important risk factors are largely , such as elevated cholesterol, smoking, obesity, diabetes, high-fat diet, and poor exercise habits.

The three ajor risk factors are hypertension, hyperlipidemia and smoking: 49.7% of adults 20 years or older have at least 1 of the 3 risk factors.

Lees than 10% of healthy adults aged 25-74 years have no CV risk factors: therefore risk of CV disease can potentially be improved in most people.

Conventional risk factors explain less than 50% of the variability in the measures of coronary vascular disease as assessed by coronary angiography or electron beam computed tomography.

In men 50% of deaths due to coronary artery disease occur in men without a preceding history of such disease.

Muscatine Study and Cardiovascular Risk in Young Finns study risk cardiovascular risk factors in childhood and carotid intima-media thickness in young adulthood.

A prospective study showed that the cardiovascular risk factors of body mass index, systolic blood pressure, total cholesterol level, triglyceride level, and youth smoking, particularly in combination beginning in early childhood, were associated with adult cardiovascular events and death from cardiovascular causes before the age of 60 years (Jacobs DR, Jr).

Men frequently have preexisting erectile dysfunction.

Is largely a preventable disease.

Not prevented in high-risk individuals with 400 IU of vitamin E daily.

Angiotensin-converting enzyme inhibitors are effective in preventing cardiovascular disease in high-risk individuals.

Approximately 64 million people in the U.S. have cardiovascular disease.

The number 1 cause of death of men and women in the U.S.

Responsible for 1 of 2.6 deaths.

631,636 deaths from heart disease in 2006 in the US, with coronary artery disease accounts for 68% of these deaths.

Since 2000 there has been a 22% reduction in heart disease related deaths among men from 320 per 100,000 to 249 per 100,000.

Since 2000 there has been a 25% reduction in heart disease related deaths among women from 211 per 100,000 to 162 per 100,000.

Coronary artery disease affects more than 1 million people a year in the US (CDC).

In 2002 cause or was a contributing cause of death in 58% of Americans.

Since 1900 the number one killer in the U.S. each year, except in 1918 when the influenza pandemic took more lives.

Affects 50% of men and 48% of women by age 55 years.

Women with favorable levels of risk factors at younger ages, reflect lower long-term coronary heart disease compared to others.

Men consistently at higher risk of cardiovascular disease compared to women until age 65 years.

Prognosis worse for women compared to men.

In females the prevalence of cardiovascular disease more than doubles between ages 35-44 years and ages 45-54 years increasing from 13.6% to 28.8%.

In veterans undergoing exercise testing, higher resting heart rates were significantly associated with increased risk for mortality.The threshold where this effect begins to occur is at roughly 70 beats per minute.

Nearly 80% of women aged 75 years or older are affected by cardiovascular disease.

Chronic renal disease associated with substantially increased risk of cardiovascular disease morbidity and mortality.

Risk is greater with diabetes than with chronic renal disease, and the risk of a first major cardiovascular event is approximately 30% higher in individuals with chronic renal insufficiency than in those with normal or near-normal renal function, whether or not patients have diabetes.

Left atrial volume correlates with the chronicity of increased left ventricular filling pressure and is associated with the risk of cardiovascular disease, including morbidity and mortality of coronary artery disease, atrial fibrillation, stroke systemic thromboembolsim and congestive heart failure.

Increased age associated with increased vascular stiffness which results in increased left ventricular afterload.

Increase in vascular load causally related to age associated increased in left ventricular wall thickness, impaired exercise reserve and increased risk of cardiovascular morbidity and mortality.

Disease in parents is a risk factor for subclinical atherosclerosis and cardiovascular disease.

Markers include CRP, lipoprotein associated phospholipase A2, homocysteine, E-selectin, plasminogen interleukin 6 and vitamin B6.

Patients with recent diagnosis of cancer have increased risk of having suicide and death from cardiovascular disease (Fang F).

USPSTF recommends a statin be prescribed for the primary prevention of CVD  for adults age 40 to 75 years who have had one or more CVD risk factors: dyslipidemia, diabetes, hypertension, or smoking and an estimated 10 year CVD risk of 10% or greater.

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