Cardiovascular Disease

Cardiovascular diseases are diseases affecting the heart and circulatory system. The most widespread form of cardiovascular disease worldwide starts with damage to the blood vessels.

The two main processes by which the blood vessels become damaged are atherosclerosis and hypertension:

1. Atherosclerosis leads to the formation of plaques of atheroma, fatty material that can build up within the arterial walls and narrow the diameter of the large and medium-sized arteriesA vessel carrying blood from the heart to various parts of the body.. This narrowing of the arteries impairs blood flow. Plaques are also prone to rupture or to ulcerate and then act as a site for blood clot formation. The resulting blood clots, which can block the affected vessel completely, are usually responsible for the more severe clinical manifestations of cardiovascular disease such as heart attackAlso called myocardial infarction - results from permanent damage to an area of the heart muscle. This happens when the blood supply to the area of the heart is interrupted because of narrowed or blocked blood vessels. In the majority of cases this is due to coronary artery disease. and strokeA sudden loss of function in part of the brain as a result of the interruption of its blood supply by a blocked or burst artery..
2. Hypertension damages the smaller vessels in the circulatory system. Over time they become scarred, hardened, narrowed and less elastic. Hypertension can also both predispose to and accelerate the development of atherosclerosis.

The Cardiovascular Disease Triad   

The major clinical manifestations of cardiovascular disease can be divided into three groups:

• those affecting the heart and coronary circulation (coronary heart diseaseAny disease of the heart caused by coronary artery disease, although it usually refers to heart attack and angina.);
• those affecting the brain and cerebral circulation (cerebrovascular diseaseDamage to the blood vessels in the brain, which may result in a stroke.); and
• those affecting the lower limbs (peripheral vascular diseasePeripheral vascular disease refers to diseases of blood vessels outside the heart and brain. It often involves a narrowing of the vessels that carry blood to leg muscles.).

The Extent of the Problem

Cardiovascular disease is a major worldwide public health problem. It is the number one cause of death in industrialized countries. The global burden of cardiovascular disease can be seen from the mortality data for coronary heart disease and cerebrovascular disease for individual countries; the data are available at www.eatlas.idf.org/cvd. 

Cardiovascular disease is the number one cause of death in industrialized countries. It is also set to overtake infectious diseases as the most common cause of death in many parts of the developing world.

It is also set to overtake infectious diseases as the most common cause of death in many parts of the less developed world, with levels becoming comparable to those in Western societies - a situation which seemed inconceivable a few decades ago.

The manifestations vary between different ethnic groups. For example, while Caucasian people are particularly prone to disease of the coronary circulation, Chinese, Japanese and African people are more prone to disease of the cerebral circulation. Studies among migrant populations, such as Japanese people living in the USA, suggest that these differences may be due more to differences in external risk factors such as diet than to differences in the genes of the people themselves.

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