Preventing Cardiovascular Diseases

 


Cardiovascular diseases (CVD) include conditions such as :

1. Disease of the heart blood vessels manifested by heart attack, chest pain, heart failure or even sudden death.
2. Disease of the brain blood vessels manifested by stroke (e.g. Paralysis)
3. Poor circulation in the legs manifested by intermittent leg pain.

While CVD is the number one killer worldwide, more than 80% of all CVD deaths worldwide are expected to occur in the developing world by 2020. Major goals of prevention are to identify individuals at high risk of future CVD events and to intervene in order to reduce their risk. In Addis Cardiac Hospital, proper examination and follow up of individuals are provided, in order to prevent further complications.



What are Cardiovascular
Risk Factors?


Risk factors are factors whose presence confers individuals on increased risk of developing future CVD.


Interventions include both life style measures (including increased exercise and controlled diet) and drug therapy, directed towards lowering the risk factors.




Risk Factors of Cardiovascular diseases

1. Smoking
Smoking increases morbidity and mortality of Cardiovascular diseases, proportional to the number of cigarettes smoked. It is never too late to stop smoking in order to reduce the risk of CVD. Thus, all patients should be counseled on a regular basis to quit smoking.

2. Hypertension
Hypertension is a chronic disease where the pressure of the blood on the inner walls of the arteries is raised above normal. Blood pressure (BP) is defined by two measurement: systolic and diastolic. Blood pressure value at or above 140/90mmHg on two occasions after initial screening is termed hypertension. Because hypertension does not usually cause any noticeable symptoms, it is commonly found incidentally during medical check up. Untreated hypertension can lead to a variety of Cardiovascular diseases. Treatment modalities are life style change (salt restriction, exercise, etc) and drugs. Drugs to lower hypertension are recommended when BP is consistently at or above 140/90mmHg and at lower BP in selected high risk patients. There are several types of drugs and the selection varies from patient to patient depending on added risks and/or existing complications. It is advisable to take drugs regularly and to never stop without consultation of a physcian.

3. Diabetes
Diabetes mellitus is a chronic medical condition characterized by a high blood sugar level that requires regular monitoring and treatment. The morbidity is a consequence of both large vessel disease and small vessel diseases (affecting eyes, kidneys and nerves). The major types of diabetes are: Type 1 and Type 2. Because disease onset is insidious in Type 2 diabetes, diagnosis is often delayed. As a result, complication may be present at the time of diagnosis. The risk of large vessel disease of heart (coronary heart disease) in diabetics is estimated to be at least twice that of persons without diabetes. This risk can be substantially reduced in diabetes by aggressive management of the other major risk factors. Optimal blood sugar control should be viewed as adjunct and not an alternative to these measures.

4. Dyslipidemia
This refers to abnormal increment in levels of lipids (fats) in the blood. There are many different types of lipid particles in the blood and the standard test includes measurement of total cholesterol, low density and high density (LDL and HDL) cholesterol and triglycerides. Although dyslipidemia may not cause symptoms, it significantly increases the risk of coronary heart disease. Most decisions about treatment are made based on the level of LDL (sometimes called bad cholesterol) or HDL (good cholesterol) rather than the level of total cholesterol and on the presence or absence of other risk factors. The treatment modalities are dietary changes and exercise as well as medications.

5. Obesity
Obesity is associated with significant increase in mortality and risk of many disorders, including diabetes, hypertension, dyslipidemia, CVD and many others. The distribution of body fat is an important determinant as patients with abdominal (central) obesity are at greatest risk. Screening for overweight and obesity includes measurement of body mass index (BMI) {calculated from weight and height measurements} as well as waist circumference which is more than 94cm in males and 82cm in females carries a high risk. Therapeutic dietary change and increased physical activity are effective weight loss interventions.

6. Diet and physical inactivity
Diet and physical inactivity are important major risk factors which can be modifiable. Assessment of the individual’s habits and recommendation towards healthy diet which is rich in vegetables and fiber, low in saturated fat and reduced intake of certain food like meat and egg as well as increased exercise are among the affordable preventive strategies that lower risk of CVD significantly.

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