Cardiology Topic Homepage

On the other hand, the death rate has increased in Central and Eastern Europe for example the death rate in men under 65 years increased by 57% and 19% in Albania and Ukraine respectively between 1994 and 2004. The trend is the same for women under 65 years in these countries with a 46% and 19% increase respectively within the period.²

Diseases of the cardiovascular system include hypertension,acute coronary syndrome or ACS, heart failure , stroke, cardiac arrhythmias, cardiac conduction defect, pericarditis, congenital heart disease, cardiac valvulopathy and venous thromboembolism.³

Although hypertension is a CVD, it's also a risk factor for other CVD. The risk of developing subsequent CVD is higher with more severe hypertension.⁴

Cardiac arrhythmias and cardiac conduction disorders are mainly represented by atrial fibrillation and bradycardia.⁵

Patients with atrial fibrillation are five times more likely to suffer a stroke, while those with either atrial fibrillation or myocardial infarction have an increased risk of heart failure.⁵

Acute Coronary Syndrome (ACS) and stroke are usually the end result of atherosclerosis -which is the most common cause of deaths in industrialised countries. Atherosclerosis is the formation of a plaque in the blood vessels. Its main components are LDL-cholesterol and its mechanism of formation is accurately described in both the Cholesterol and Heart Failure Knowledge Centres.

The main CVD modifiable risk factors are tobacco, excessive alcohol consumption, diet (salt and fat), physical inactivity, obesity, stress and diabetes. Usually, people combine several of these risk factors creating a synergic effect.³ By altering these lifestyle choices, 80% of cardiovascular diseases could be prevented.¹

Some other risk factors are non modifiable such as, increased age, male gender and positive family history.³

There are two types of prevention: primary (to prevent atherosclerosis) and secondary (to prevent disease exacerbation).

Diagnostic techniques include blood pressure measurement, ECG, chest X-Ray, Echocardiography, cardiac catheterization, MRI and blood tests (K+, Cholesterol, Haemoglobin, natriuretic peptides).³

The treatment of CVD, can be divided in two categories. For ACS pharmacological management (e.g. statins) and non pharmacological management are available. For hypertension, the approach is similar, treated with both lifestyle and pharmacological intervention. The main goals of many CVD treatments are to lower LDL-C and blood pressure and prevent thrombus formation (anticoagulant agents).

References

1. WHO, Fact Sheet N317 september 2011, available at: http://www.who.int/mediacentre/factsheets/fs317/en/index.html, accessed the 20th of September 2012
2. The European Heart Network, European cardiovascular Statistics 2008 Edition available at: http://www.herzstiftung.ch/uploads/media/European_cardiovascular_disease_statistics_2008.pdf, accessed the 20th of September 2012
3. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003, 113-239
4. NICE clinical Guideline, Hypertension Clinical Management of Primary Hypertension in Adults, August 2011, available at: http://www.nice.org.uk/nicemedia/live/13561/56008/56008.pdf, accessed the 20th of September 2012
5. European Society of Cardiology, Guidelines for the Management of Atrial Fibrillation, 2010, available at: http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-afib-FT.pdf, accessed the 20th of September 2012