Cardiovascular diseases

CVD(stroke)-emboli's in the brain Coronary heart disease-because of thrombus denying of oxygen Myocardial infarction-heart attack Angina pectoris-Severe pain in heart because of thrombus in heart Aneurysm-bulging of an artery Ischaemia-localised anaemia Thrombus-blood clot in blood vessels Embolus-moving blood clot Atheroma-deposition of atherosclerotic plate Arteriosclewsis-losing of elasticity of the wall

Factors affecting CVD Factors

Canbe controlled 1. 2. 3. 4. 5. 6. 7. Hypertension Smoking Cholesterol Obesity Diet Alcohol Diabetes

Cant control 1. Age 2. Gender 3. Genetics

Age Over 83% of the people who die due to coronary heart disease are at the age of 65 or older. At older ages women who have heart attacks are more likely than men are to die from them within a few weeks.

Gender Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause ,when women death rate from heart disease increases, its not as greater as men's.

Genetic factors The occurrence of heart attacks at a relatively early age frequently runs in families, suggesting that there are genes that may confer vulnerability to CHD.Children of parents of heart diseases are distinctly more likely to develop the condition too. This aspect will become clearer to knowledge of the human genome is developed to identify the roles of individual genes and their effects on metabolism. Additionally some races are more prone to CHD and strokes. Another genetic factor beyond the dispute is gender, for the possession of a Y chromosome predisposes to greater risk of CHD than that carried by females.

Hypertension Hypertension is known as a silent killer because of the damage it does to the heart by increasing its workload, causing the heart to enlarge and weaken with time. It also causes damage to blood vessels, accelerating onset of atherosclerosis . The brain and the kidneys are also damaged, although without causing noticeable discomfort. Hypertension increases the risk of strokes, too, and it makes a brain haemorrhage more likely.However hypertension is a condition that once detected and regularly monitored, maybe successfully treated with drugs .

Smoking Cigarette smoking has been established as a risk factor not only for lung cancer,emphysema,and bronchitis but also for coronary, cerebral, and peripheral vascular disease. This association has been seen in many countries, among widely diverse ethnic groups, in both sexes, and across various adult age groups. In addition, the risk increases with heavier cigarette use and the longer one has smoked. Equally important has been the observation that this increased risk falls rapidly over time when people quit smoking. For coronary heart disease, approximately 40 percent of the increased risk is removed within five years of quitting, although it takes several more years of non smoking to achieve the level associated with someone who never smoked. The constituents in smoke affect the circulatory system in the following ways: The haemoglobin in red blood cells carries carbon monoxide from the smoke instead of oxygen. This reduces the supply of oxygen to cells Nicotine in smoke stimulates the production of hormone adrenaline. This hormone causes an increase in heart rate and also causes arteries and arterioles to constrict. The numerous chemicals that are found in smoke can cause damage to the lining of the arteries, triggering atherosclerosis. Smoking has also been linked with reduction in HDL cholesterol level.

Cholesterol Cholesterol is a type of fat and is essential for the body in small amounts. It is produced in the liver and some is also obtained from the diet. It is a constituent of cells.Eg:brain cells. Cholesterol is carried around the body in the blood by particles called lipoproteins. Ex: Low density lipoprotein(LDL)-it is often called 'bad cholesterol' because high levels of LDL in the blood promote the accumulation of fat in the vessel walls. High density lipoprotein(HDL)-often called 'good cholesterol' because it retrieves cholesterol from body tissues and helps to transfer it to the liver for disposal

Obesity Overweight and obese (due to lack of physical inactivity) people have an increased incidence of cardiovascular disease(CVD) including heart attack, congestive heart failure, sudden cardiac death, angina and abnormal heart rhythm(arrhythmias). Obesity often increases CVD risk because of its negative effect on blood lipid levels, including increasing triglyceride levels and decreasing high density lipo protein levels. People with an excessive amount of body fat have higher levels of triglycerides and LDL cholesterol, and lower HDL cholesterol in the blood, which may cause inflammation, and an increased risk for developing and decrease inflammation throughout the body.

Diet The choice of our food must be particular on the type and quantity of energy food. This food may increase or decrease our risk of cardiovascular diseases. The energy releasing foods are carbohydrates ,lipids and proteins.

Energy content of nutrients

Nutrient Carbohydrates Lipids Proteins Alcohol Energy available per gram/kj 16 37 17 29

We have to be aware that we need both and fats in our diet for good health, if we consume too much we get wrong consequences. We need constant supply of energy to maintain essential body processes. The energy needed for these essential processes is called Basal Metabolic Rate. The average person may require between 8000 and 10000kJ a day.

Alcohol An excessive intake of alcohol leads to raised blood pressure, to damaged heart muscle and to irregular heart beats. It also causes raised LDL levels in the blood and is associated with certain cancers too. This harm may arise when more than one unit of alcohol a day is imbibed by women and more than two units per day by men.

Diabetes Is a disease that carries a significantly raised risk of the patient developing CVD and people with this condition require especially close monitoring of their blood pressure and blood glucose to ensure they are continuously controlled within safe parameters.

Treating CVD
1. Antihypertensive medications These are used to treat high blood pressure. The prescription includes: Drug type ACE inhibitors Used to treat High blood pressure, And weakened heart muscle Effect on the body Inhibit the activity of enzyme converting angiotensin I to angiotensin II. Decrease Na and H2O retention. Prevent vasoconstriction, lowers blood pressure Block the action of angiotensin. Prevent vasoconstriction, lowers blood pressure Relax the muscular walls of the arteries. In coronary arteries,this enables better blood supply to heart muscle. In arteries in the rest of the body,it reduces blood pressure. Causes kidneys to retain less water,reducing excess fluid in the body Blocks beta receptors on the heart that respond to adrenaline and related hormones. Preventing the heart from working harder, when these hormones are released.

Angiotensin receptor blockers

High blood pressure,heart failure,kidney failure in diabetes people.

Calcium channel blockers

High BP, angina pectoris, coronary artery disease

Diuretics

High bp Congestive heart failure High bp Angina, arrhythmia to prevent heart attacks in people with coronary heart disease; to reduce death rate in people who have suffered a heart attack.

Beta blockers

2. Cholesterol lowering drugs Statins Doctors often prescribe statins if diet,weight loss and excercise doesnt work to sufficiently lower a persons cholesterol.Statins work by slowing the bodies ability to produce LDL as well as decreasing blood fats called triglycerides.Stains also increase the bloodlevels of HDL.

3. Anti coagulant drugs Anticoagulant (Warfarin) Post heart attack,post stroke,blood clot. Affects the synthesis of clotting factors.So blood cannot clot easily.

4. Antiplatelet drugs Platelet inhibitory drug(Aspirin) Post heart attack,post stroke,blood clot. Reduces the stickiness of platelets so reduce the clotting of blood

Treatments to re-establish blood flow in damaged arteries coronary arteries that have been seriously damaged maybe by-passed. Coronary angioplasty (balloon angioplasty) is an alternative technique for re-establishing flow in an occluded coronary artery. Here the balloon catheter is inserted to a main artery in the patients arm or leg, and is then guided all the way to the damaged coronary artery using the X-ray observation. After the inflated balloon tip has re-established the flow and been collapsed and withdrawn, it maybe necessary to shore up the damaged artery to subsequently maintain the flow of oxygenated blood. This is done by inserting a stainless steel spring(a stent) into the lumen of the artery.