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Cardiovascular and cerebrovascular diseases 

Cardiovascular and cerebrovascular diseases
Chapter:
Cardiovascular and cerebrovascular diseases
Author(s):

Russell V. Luepker

and Kamakshi Lakshminarayan

DOI:
10.1093/med/9780199218707.003.0059
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date: 12 December 2017

Cardiovascular diseases, conditions of the heart and blood vessels, are leading causes of morbidity and mortality throughout the world. Largely diseases of lifestyle and affluence, they account for a majority of deaths in some industrialized countries. They are a coming epidemic in the developing world as communities and individuals attain richer and less healthy lifestyles. The leading cardiovascular diseases are coronary heart disease, hypertension, stroke, and heart failure. They are frequently interconnected with the underlying pathology atherosclerosis, a condition damaging medium and large arteries. There are also other important diseases which, while less common, present considerable health burden including rheumatic heart disease, peripheral artery disease, cardiomyopathy, and congenital heart disease.

Unlike many lifestyle related conditions, the causes or risk factors for the leading cardiovascular diseases are well known. They are diet resulting in hyperlipidemia, elevated blood pressure leading to hypertension, diabetes mellitus, physical inactivity, and cigarette smoking. There are also other identified characteristics but this group of risk factors underlies the epidemic. As well studied conditions, much is known about the pathophysiology of risk factors and cardiovascular disease. In addition, knowledge from clinical trials dictates treatment of risk for primary and secondary prevention. Few chronic diseases had such an extensive scientific basis for the prevention and treatment. Prevention starts at the community level where unhealthy diets, smoking and physical inactivity can be confronted and reduced. Clinical presentations of individual risk factors such as hypertension, hyperlipidemia and diabetes mellitus can be treated with lifestyle modification and/or medication. The implementation of prevention programmes at the community and clinic level results in population-wide changes and disease reduction. The potential for continuing improvement in the industrialized world and blunting the epidemic in the developing world is substantial.

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