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Cardiovascular disease

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**Risk Factors for Cardiovascular Disease:**
– Age, sex, tobacco use, physical inactivity, excessive alcohol consumption
– Unhealthy diet, obesity, genetic predisposition, family history of cardiovascular disease
– Raised blood pressure, blood sugar, blood cholesterol
– Undiagnosed celiac disease, psychosocial factors, poverty, low educational status
– Air pollution, poor sleep

**Genetics and Cardiovascular Disease:**
– Parental history increases risk by ~3 fold
– Over 40 inherited cardiovascular diseases linked to single disease-causing DNA variant
– Common cardiovascular diseases influenced by many genetic variants
– Small effects of genetic variants like single nucleotide polymorphisms

**Prevention and Lifestyle Changes:**
– Healthy eating, exercise, avoiding tobacco smoke, limited alcohol intake
– Lifestyle changes can prevent up to 90% of cardiovascular diseases
– Treating risk factors like high blood pressure, blood lipids, diabetes is beneficial
– Antibiotics for strep throat can reduce rheumatic heart disease risk

**Specific Types and Conditions of Cardiovascular Diseases:**
– Coronary artery disease, peripheral arterial disease, cerebrovascular disease
– Heart-related diseases like cardiomyopathy, hypertensive heart disease, heart failure
– Renal artery stenosis, aortic aneurysm, pulmonary heart disease, cardiac dysrhythmias

**Environmental and Behavioral Factors in Cardiovascular Disease Risk:**
– Tobacco use, physical inactivity, unhealthy diet, excessive alcohol consumption
– Air pollution, poor sleep, occupational exposure
– Depression, traumatic stress, somatic mutations
– Radiation therapy, lifestyle factors, dietary supplements

Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.

Cardiovascular disease
Micrograph of a heart with fibrosis (yellow) and amyloidosis (brown). Movat's stain.
SymptomsChest pain, shortness of breath, fatigue, loss of consciousness
ComplicationsHeart failure, heart attack, stroke, aneurysm, peripheral artery disease, sudden cardiac arrest.
Usual onsetOlder adults
TypesCoronary artery diseases, stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, Arrhythmia
Risk factorsDiabetes, high blood lipids, excess weight, Smoking, excessive drug use, and excessive alcohol intake
PreventionHealthy eating, exercise, avoiding tobacco smoke, limited alcohol intake, Overall lifestyle changes
TreatmentTreating high blood pressure, high blood lipids, diabetes
MedicationAspirin, beta blockers, blood thinners
Deaths17.9 million / 32% (2015)

The underlying mechanisms vary depending on the disease. It is estimated that dietary risk factors are associated with 53% of CVD deaths. Coronary artery disease, stroke, and peripheral artery disease involve atherosclerosis. This may be caused by high blood pressure, smoking, diabetes mellitus, lack of exercise, obesity, high blood cholesterol, poor diet, excessive alcohol consumption, and poor sleep, among other things. High blood pressure is estimated to account for approximately 13% of CVD deaths, while tobacco accounts for 9%, diabetes 6%, lack of exercise 6%, and obesity 5%. Rheumatic heart disease may follow untreated strep throat.

It is estimated that up to 90% of CVD may be preventable. Prevention of CVD involves improving risk factors through: healthy eating, exercise, avoidance of tobacco smoke and limiting alcohol intake. Treating risk factors, such as high blood pressure, blood lipids and diabetes is also beneficial. Treating people who have strep throat with antibiotics can decrease the risk of rheumatic heart disease. The use of aspirin in people who are otherwise healthy is of unclear benefit.

Cardiovascular diseases are the leading cause of death worldwide except Africa. Together CVD resulted in 17.9 million deaths (32.1%) in 2015, up from 12.3 million (25.8%) in 1990. Deaths, at a given age, from CVD are more common and have been increasing in much of the developing world, while rates have declined in most of the developed world since the 1970s. Coronary artery disease and stroke account for 80% of CVD deaths in males and 75% of CVD deaths in females. Most cardiovascular disease affects older adults. In the United States 11% of people between 20 and 40 have CVD, while 37% between 40 and 60, 71% of people between 60 and 80, and 85% of people over 80 have CVD. The average age of death from coronary artery disease in the developed world is around 80, while it is around 68 in the developing world. CVD is typically diagnosed seven to ten years earlier in men than in women.

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