Cardiovascular diseases: Reducing risk and improving management is possible!

What are cardiovascular diseases? 

About 7 million people are affected with cardiovascular diseases, or CVD, in the UK. It is a significant cause of disability and death: CVD is responsible for 1 in 4 premature deaths. The disease affects men and women of all ages due to the increase in risky behaviour, such as alcohol consumption, physical inactivity and stress, among others.

CVDs are the first cause of death in women and in people over 65.

CVDs are also one of the main causes of morbidity and occupy the first place in healthcare expenditures in developed countries. The economic burden associated with the management of these conditions is considerable.

Cardiovascular diseases is a group of disorders affecting the heart and blood vessels which includes:

• Coronary or ischemic heart disease,
  
• Cerebrovascular diseases,
  
• Peripheral arterial disease,
  
• Rheumatic heart disease,
  
• Congenital heart disease,
  
• Deep vein thrombosis and pulmonary embolism.

The most common CVDs are atherosclerosis, transient ischemic attack (TIA), stroke, myocardial infarction, heart failure and hypertension-related conditions.

What are the risk factors for cardiovascular diseases?  

These diseases all have a number of individual risk factors in common, most of which, apart from inheritance, gender and age, result from risky but modifiable behaviours:

• Smoking,
  
• Physical inactivity,
  
• Excessive alcohol consumption,
  
• Poor diet,
  
• Exposure to stress.
• These factors may be the cause of high blood pressure, hyperglycaemia, hyperlipidaemia, high cholesterol, excessive weight and obesity.
  

CVD has long been viewed as a uniquely masculine condition. This idea is now obsolete, women's lifestyle now resembles that of men. In addition, a woman's risk of developing CVD is higher due to hormonal changes at certain life stages, since oestrogen deficiency makes a woman vulnerable.

Prevention of CVD is important and is mainly provided by general practitioners. They play an essential role, giving lifestyle recommendations for patients who are at risk of developing cardiovascular disease. The management of CVDs is also a priority because of the significant morbidity they generate as well as because of premature mortality they can cause.

How to prevent cardiovascular diseases?  

There exist various online tools allowing to calculate the patient's risk of CVD.

Prevention is called primary when the person does not yet have CVD. When a heart condition has already been diagnosed or if the patient suffers from a disease with a high risk of comorbidity, it is called secondary prevention. The recommendations are similar.

Here are a few of them:  

Stopping smoking 

Tobacco provokes narrowing of the arteries, formation of clots and the development of heart problems, by stopping it, you can prevent thrombosis and heart attacks.

A healthy and balanced diet 

A healthy diet prevents the excess of cholesterol which is harmful, as cholesterol can build up as fatty deposits in the arteries, causing atherosclerosis. You should also watch your salt intake (5g / d), as too much salt can cause high blood pressure, which makes the heart work harder and weakens it, the increase in blood pressure also damages the walls of the arteries.

Watching your weight 

The risk of high blood pressure increases in people who are overweight or obese. Also, obesity-related diabetes damages artery walls if it is poorly controlled. Abdominal obesity increases the risk of cardiovascular disease.  

Saying no to sedentary lifestyle 

Half an hour of walking a day is enough to lower the risk of CVDs: physical activity strengthens the heart.

Stress management 

Stress increases blood pressure and blood sugar levels. Chronic stress is bad for the heart, it makes the heart beat faster, increases blood pressure and changes blood clotting. It also encourages harmful behaviours such as smoking, alcohol, diet rich in fat and sugar, etc. It is recommended to practice relaxation methods, meditation and yoga.

Good-quality sleep

Good-quality sleep decreases the risk of developing CVD, insufficient sleep is associated with weight loss, high blood pressure, diabetes and increased triglycerides. 

Regular doctor's appointments 

It is recommended to have regular check-ups and monitor the levels of sugar, salt, cholesterol, etc, in your blood and the level of albumin in your urine.

Other recommendations include maintaining good oral hygiene in order to avoid the passage of bacteria into the blood in the event of bleeding, and therefore the formation of clots.

Also, regular sexual activity is beneficial to our health. It activates arterial and venous circulation, stimulates the heart and releases relaxing hormones.

Also, eating 2 squares of chocolate per day presumably reduces the risk of heart attacks and stroke due to the presence of flavonoids and anti-oxidants which limit the formation of bad cholesterol and high blood pressure, and helps fight the stress, thanks to magnesium it contains.

What is the care plan for a patient at risk for CVD? 

The therapeutic aim of the treatment is to offer a strategy based on a medical decision that the doctor and the patient have taken together.

Once the risks have been assessed through a clinical examination, a risk calculator and socio-economic markers, a care plan is established. It includes:

• Non-drug therapeutic management of risk factors with recommendations on lifestyle, physical activity and diet,
  
• Drug treatment for high blood pressure, diabetes, smoking,
  
• Patient education, through motivational interview, support and adaptation of care plan depending on whether it is primary or secondary prevention, and whether the patient is elderly, with comorbidities, etc.,
  
• Monitoring the implementation of recommendations, assessing compliance with the measures taken, monitoring adverse reactions to drugs and reassessing, if necessary, the overall care plan.
  
  

Treatment of cardiovascular diseases represents a huge burden on global economics, due to expensive treatments and surgeries. This is why World Health Organization (WHO) has identified some effective and economical interventions that must be implemented, for example: tobacco control strategies and interventions against alcohol abuse, increased taxes on foods rich in fat, sugar and salt, the development of pedestrian and cycle paths to encourage physical activity, etc.

Educating the general population on life-saving actions and installing fully or semi-automatic defibrillators in crowded places, in particular at stadiums, has already saved many lives.