Cardiovascular Diseases: Causes and Prevention

Through cohort study designs and other evidence-based management studies, identify the major causes of CVD, and analyze the key steps, including current medications, used to address the disease. The understanding of the pathophysiology of many cardiovascular diseases is evolving rapidly, especially atherosclerosis, hypertension, myocardial, ischemia, and congestive heart failure. The role of genetics and its interaction with environment in the etiology and the progression of all forms of cardiovascular diseases is just one example of new information that is leading to improvements in prevention and treatment.

Cardiovascular diseases include illnesses that involve the blood vessels like the veins, arteries and capillaries or even the heart, or both. The cardiovascular system, also called the circulatory system, is the system that moves blood throughout the human body. It is composed of the heart, arteries, veins, and capillaries.

It transports oxygenated blood from the lungs and heart throughout the whole body through the arteries. Blood goes through the capillaries and vessels situated between the veins and arteries.

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When the blood has been depleted of oxygen, it makes its way back to the heart and lungs through the veins. The circulatory system may also include the circulation of lymph, which is essentially recycled blood plasma after it has been filtered from the blood cells and returned to the lymphatic system. The cardiovascular system does not include the lymphatic system. In this article, the circulatory system does not include the circulation of lymph. Angina is most frequently the result of underlying coronary artery disease. The coronary arteries supply the heart with oxygen rich blood.

When cholesterol aggregates on the artery wall and hard plaques form, the artery narrows. It is increasingly difficult for oxygen rich blood to reach the heart muscle as these arteries become too narrow. In addition, damage to the arteries from other factors (such as smoking and high levels of fat or sugar in the blood) can cause plaque to build up where the arteries are damaged. These plaques narrow the arteries or may break off and form blood clots that block the arteries.

The actual angina attacks are the result of this reduced oxygen supply to the heart. Physical exertion is a common trigger for stable angina, as the heart demands more oxygen than it receives in order to work harder. In addition, severe emotional stress, a heavy meal, exposure to extreme temperatures, and smoking may trigger angina attacks. Unstable angina is often caused by blood clots that partially or totally block an artery. Larger blockages may lead to heart attacks. As blood clots form, dissolve, and form again, angina can occur with each blockage. Variant angina occurs when an artery experiences a spasm that causes it to tighten and narrow, disrupting blood supply to the heart. This can be triggered by exposure to cold, stress, medicines, smoking, or cocaine use. Angina treatments aim to reduce pain, prevent symptoms, and prevent or lower the risk of heart attack. Medicines, lifestyle changes, and medical procedures may all be employed depending on the type of angina and the severity of symptoms. Lifestyle changes recommended to treat angina include:

1.Stopping smoking
2.Controlling weight
3.Regularly checking cholesterol levels
4.Resting and slowing down
5.Avoiding large meals
6.Learning how to handle or avoid stress
7.Eating fruits, vegetables, whole grains, low-fat or no-fat diary products, and lean meat and fish Medicines called nitrates (like nitroglycerin) are most often prescribed for angina.

Nitrates prevent or reduce the intensity of angina attacks by relaxing and widening blood vessels. Other medicines such as beta blockers, calcium channel blockers, ACE inhibitors, oral anti-platelet medicines, anticoagulants, and high blood pressure medications may also be prescribed to treat angina. These medicines are designed to lower blood pressure and cholesterol levels, slow the heart rate, relax blood vessels, reduce strain on the heart, and prevent blood clots from forming. In some cases, surgical medical procedures are necessary to treat angina. A heart specialist may recommend an angioplasty - a procedure where a small balloon is used to widen the narrowed arteries in the heart. Coronary artery bypass grafting is another common procedure; this is surgery where the narrowed arteries in the heart are bypassed using a healthy artery or vein from another part of the body. Develop at least five (5) leading questions that may be posed to your local health department in regard to mitigating the proliferation of the disease.

Provide a sound rationale for raising these questions.

1. Can second or third hand smoking cause cardiovacular diseases? Cigarette smoking remains the leading preventable cause of cardiovascular disease in women, with more than 50 percent of heart attacks among middle-aged women attributable to tobacco. Risk of cardiovascular disease begins to decline within months of smoking cessation and reaches the level of persons who have never smoked within 3 to 5 years.

2. What do cholesterol has to do with cardiovascular diseases? High blood cholesterol is a condition that greatly increases your chances of developing coronary heart disease. Extra cholesterol in the blood settles on the inner walls of the arteries, narrowing them and allowing less blood to pass through them to the heart. Aim for total cholesterol below 200 mg/dL; LDL cholesterol below 130 mg/dL and HDL above 35 mg/dL.

3. How do weight gain or maintaining a healthy weight control cardiovascular disease? Obesity and sedentary lifestyles are epidemics in the United States that contribute to increased risk of cardiovascular disease. The prevalence of obesity has increased among both men and women in the United States in the past decade; currently about one third of adult women (or 34 million) are classified as obese. Also, 60% of both men and women get no regular physical activity. Obesity, especially abdominal adiposity, is an important risk factor for cardiovascular disease in women.

4. Can exercise reduce cardiovascular disease? Recent evidence suggests that even moderate-intensity activity, including brisk walking, is associated with substantial reduction of cardiovascular disease risk. These findings support the 1995 federal exercise guidelines endorsing 30 minutes of moderately intense physical activity most days of the week, a program that should be feasible and safe for most of the population. Regular exercise and maintenance of healthy weight should also help reduce insulin resistance and the risk of non–insulin-dependent diabetes mellitus, which appears to be an even stronger risk factor for cardiovascular disease in women than in men. Diabetes is associated with a threefold to sevenfold elevation in cardiovascular disease risk among women, compared with a twofold to threefold elevation among men. Approximately half of all deaths in patients with non–insulin dependent diabetes mellitus are due to heart disease.

5.Can eating less saturated fat, more produce and more fiber reduce cardiovascular disease? 
Diets low in saturated fat and high in fruits, vegetables, whole grains, and fiber are associated with a reduced risk of cardiovascular disease. Also, a recent study reported in the Annals of Internal Medicine journal confirmed that eating fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, seems to have a protective effect against coronary heart disease. You may even think about moving toward more flexitarian or vegetarian eating habits: A vegetarian diet reduces the risk of coronary artery disease, and may even reverse existing coronary artery disease when combined with other lifestyle changes. A Mediterranean diet that uses olive oil can reduce the risk of coronary artery disease. Based on the five (5) questions you developed in Question two (2), provide a rudimentary protocol to disseminate this information to your local community leaders. Based on the above listed question in question two, the population that is directly affected by lack of basic health care information is poor families in rural areas across the United States.

However, many others are indirectly affected by this including Governments who on varying levels are trying to determine how to keep their people alive and healthy longer and institutional partners who are spending significant resources to treat conditions that could be prevented or taken care of at earlier stages of a problem or condition. SMS to mobile phones which can be done through mobile networks at the prompting or through a contract with an institution, NGO, private company or the Ministry of Health. This does not have to be expensive and is something in some countries that is partly supported by the Ministry of Health or can be provided in limit cases free of charge by the network provider. Through mobile cinemas which are used throughout much of Africa in rural areas to disseminate information on health care or other pertinent issues. Many times these mobile cinema vans already exist and are under the control of the Ministry of Transportation or Ministry of Health. It is possible, depending on the circumstances to access these vans and pay only for fuel consumption.

Posters displayed in prominent areas that can provide a very clear and visual message, can sometimes transcend language barriers and get across simple messages most effectively. The cost of this would be the printing of the posters, the human resources to disseminate the posters (you can sometimes go through the Ministry of Health and utilize the community health workers and regional and district hospitals and other partners) and in some instances a small charge to hang the posters at certain locations. Radio spots that provide simple information in the most basic terminology to ensure the messages are construed properly. The cost of this depends on the availability of community messaging which is provided by some stations in some countries free of charge or station to station depending on country and size of the listener group. Recommend six (6) steps that may be given to your current or previous place of employment to prevent the proliferation of CVD. Provide support for your recommendations.

Heart disease and stroke, the principal components of cardiovascular disease (CVD), are the first and third leading causes of death in the United States. In 2002, employers representing 88 companies in the United States paid an average of $18,618 per employee for health and productivity-related costs. A sizable portion of these costs are related to CVD. Employers can yield a $3 to $6 return on investment for each dollar invested over a 2 to 5 year period and improve employee cardiovascular health by investing in comprehensive worksite health-promotion programs, and by choosing health plans that provide adequate coverage and support for essential preventive services. The most effective interventions in worksites are those that provide sustained individual follow-up risk factor education and counseling and other interventions within the context of a comprehensive health-promotion program: (1) screening, health risk assessments, and referrals; (2) environmental supports for behavior change (e.g., access to healthy food choices); (3) financial and other incentives; (4) corporate policies that support healthy lifestyles (e.g., tobacco-free policies). (5) standardized treatment and prevention protocols consistent with national guidelines. (6) multidisciplinary clinical care teams to deliver quality patient care.

References
1.Austin, C. J., & Boxerman, S. B. (2008). Information systems for healthcare management (7th ed.). Chicago: Health Administration Press. 2. Harvey, B.H.,”Technology, Diversity and Work Culture-Key Trends in the Next Millenium,”HR Magazine, 45,(7) ,p.59. 3. Bowen, D.E., and Lawler, E.III.”The Empowerment of Service Worker;”Sloan Management Review, pp.31-39. 4. Williams, S. J., & Torrens, P.R. (2010). Introduction to Health Services. Mason Ohio. Cengage Learning. 5.Marquis, M.S., & Rogowski, J.A. (2004). Journal of the American Medical Association, 52(5)408-415.