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Cardiovascular Disease Overview

About This Condition

Cardiovascular disease encompasses a wide range of conditions, and includes conditions that affect the heart and the blood vessels.

Cardiovascular disease is the number one cause of death in the United States. Many risk factors are associated with cardiovascular disease and most can be managed with lifestyle and medical interventions, but some cannot. The aging process and genetic factors (hereditary or family predisposition) are risk factors that cannot be changed. Until age 50, men are at greater risk of developing heart disease than women, though menopause increases a woman’s risk, up to as much as three times the risk prior to menopause.

Many people with cardiovascular disease have elevated or high cholesterol levels.1 Low HDL cholesterol (known as the “good” cholesterol) and high LDL cholesterol (known as the “bad” cholesterol) are more specifically linked to cardiovascular disease than total cholesterol.2 A blood test, administered by most healthcare professionals, is used to determine cholesterol levels.

Atherosclerosis (hardening of the arteries, often affecting those that supply the heart with blood) is the most common cause of heart attacks. Atherosclerosis and high cholesterol usually occur together,3 though cholesterol levels can change quickly and atherosclerosis generally takes decades to develop.

The link between high triglyceride levels and heart disease is not as well established as the link between high cholesterol and heart disease. According to some studies, having high triglyceride levels is an independent risk factor for heart disease in some people.4

High homocysteine levels are not consistently associated with cardiovascular disease risk,5 but according to some studies, homocysteine levels have been identified as an independent risk factor for heart disease.6 Homocysteine can be measured by a blood test that must be ordered by a healthcare professional.

Hypertension (high blood pressure) is a major risk factor for cardiovascular disease, and the risk increases as blood pressure rises.7 Glucose intolerance and diabetes constitute separate risk factors for heart disease. Smoking increases the risk of heart disease caused by hypertension.

Abdominal fat (central adiposity), or a “beer belly,” versus fat that accumulates on the hips, is associated with increased risk of cardiovascular disease and heart attack.8 Overweight individuals are more likely to have additional risk factors related to heart disease, specifically hypertension, high blood sugar levels, high cholesterol, high triglycerides, and diabetes. Per criteria agreed upon by the International Diabetes Federation; NHLBI; AHA; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity, the presence of three or more of the aforementioned symptoms is a diagnosis of metabolic syndrome. Below is the specific criteria for a diagnosis of metabolic syndrome:

  • Central or abdominal obesity (measured by waist circumference):
    • Men - 40 inches or above
    • Women - 35 inches or above
  • Triglycerides greater than or equal to 150 milligrams per deciliter of blood (mg/dL)
  • HDL cholesterol:
    • Men - Less than 40 mg/dL
    • Women - Less than 50 mg/dL
  • Blood pressure greater than or equal to 130/85 millimeters of mercury (mmHg)
  • Fasting glucose greater than or equal to 100 mg/dL

Symptoms

People with cardiovascular disease may not have any symptoms, and for many people, the first symptom of cardiovascular disease is a myocardial infarction (“heart attack”). For others with cardiovascular disease, they may experience difficulty in breathing during exertion or when lying down, fatigue, lightheadedness, dizziness, fainting, depression, memory problems, confusion, frequent waking during sleep, chest pain, an awareness of the heartbeat, sensations of fluttering or pounding in the chest, swelling around the ankles, or a large abdomen.

Other Therapies

Surgical treatments, such as angioplasty, bypass surgery, valve replacement, pacemaker installation, and heart transplantation, may be recommended for severe cases. Individuals with cardiovascular disease are strongly encouraged to stop smoking.

References

1. Kinosian B, Glick H, Garland G. Cholesterol and coronary heart disease: predicting risks by levels and ratios. Ann Intern Med 1994;121:641-7.

2. Kwiterovich PO Jr. The antiatherogenic role of high-density lipoprotein cholesterol. Am J Cardiol 1998;82:Q13-21 [review].

3. High Blood Cholesterol: What You Need to Know. National Institutes of Health: National Heart Lung and Blood Institute. Available from URL: http://www.nhlbi.nih.gov/health/resources/heart/heart-cholesterol-hbc-what-html.

4. Harchaoui KE, Visser ME, Kastelein JJ, Stroes ES, Dallinga-Thie GM. Triglycerides and cardiovascular risk. Curr Cardiol Rev. 2009;5(3):216-22.

5. Ntaios G, Savopoulos C, Grekas D, Hatzitolios A. The controversial role of B-vitamins in cardiovascular risk: An update. Arch Cardiovasc Dis. 2009;102(12):847-54.

6. Seman LJ, McNamara JR, Schaefer EJ. Lipoprotein(a), homocysteine, and remnantlike particles: emerging risk factors. Curr Opin Cardiol 1999;14:186-91.

7. Kannel WB. Office assessment of coronary candidates and risk factor insights from the Framingham study. J Hypertens Suppl 1991;9:S13-9.

8. Megnien JL, Denarie N, Cocaul M, et al. Predictive value of waist-to-hip ratio on cardiovascular risk events. Int J Obes Relat Metab Disord 1999;23:90-7.

9. Lehtonen HM, Suomela JP, Tahvonen R, et al. Different berries and berry fractions have various but slightly positive effects on the associated variables of metabolic diseases on overweight and obese women. Eur J ClinNutr 2011;65:394-401.

10. Natural Medicines Comprehensive Database citation: Zhang MS, et al. Treatment of ischemic heart diseases with flavonoids of Hippophaerhamnoides. Chinese J Cardiol 1987;15:97-9.Pubmed citation: Zhang MS. A control trial of flavonoids of Hippophaerhamnoides L. in treating ischemic heart disease. ZhonghuaXinXue Guan Bing ZaZhi 1987;15:97-9 [in Chinese].

11. Larmo P, Alin J, Salminen E, et al. Effects of sea buckthorn berries on infections and inflammation: a double-blind, randomized, placebo-controlled trial. Eur J ClinNutr 2008;62:1123-30.

12. Suomela JP, Ahotupa M, Yang B, et al. Absorption of flavonols derived from sea buckthorn (Hippophaërhamnoides L.) and their effect on emerging risk factors for cardiovascular disease in humans. J Agric Food Chem 2006;54:7364-9.

13. Eccleston C, Baoru Y, Tahvonen R et al. Effects of an antioxidant-rich juice (sea buckthorn) on risk factors for coronary heart disease in humans. JNutrBiochem 2002;13:346-354.

14. Girgih A, Udenigwe C, Aluko R. Reverse-phase HPLC separation of hemp seed (Cannabis sativa L.) protein hydrolysate produced peptide fractions with enhanced antioxidant capacity. Plant Foods Hum Nutr 2013;68:39-46. doi: 10.1007/s11130-013-0340-6.

15. Lee M, Park S, Han J, et al. The effects of hempseed meal intake and linoleic acid on Drosophila models of neurodegenerative diseases and hypercholesterolemia. Mol Cells 2011;31:337-42. doi: 10.1007/s10059-011-0042-6. Epub 2011 Feb 10.

16. Rigamonti E, Parolini C, Marchesi M, et al. Hypolipidemic effect of dietary pea proteins: Impact on genes regulating hepatic lipid metabolism. Mol Nutr Food Res 2010;54 Suppl 1:S24-30. doi: 10.1002/mnfr.200900251.

17. Whelton PK, Appel LJ, Sacco RL, Anderson, CAM, Antman EM, Campbell N, Dunbar SB, et al. Sodium, Blood Pressure, and Cardiovascular Disease. Circulation. 2012;126:2880-89.

18. Whelton PK, Appel LJ, Sacco RL, Anderson, CAM, Antman EM, Campbell N, Dunbar SB, et al. Sodium, Blood Pressure, and Cardiovascular Disease. Circulation. 2012;126:2880-89.

19. Get the Facts: Sodium and the Dietary Guidelines. The Centers for Disease Control and Prevention. Available from URL: http://www.cdc.gov/salt/pdfs/sodium_dietary_guidelines.pdf.

20. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129:S102-S138.

21. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Miller NH, Hubbard VS, Lee I-M, et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129 S76-S99.

22. Freund KM, Belanger AJ, D'Agostino RB, Kannel WB. The health risks of smoking. The Framingham Study: 34 years of follow-up. Ann Epidemiol 1993;3:417-24.

23. Law MR, Morris JK, Wald NJ. Environmental tobacco smoke exposure and ischaemic heart disease: an evaluation of the evidence. BMJ 1997;315:973-80.

24. Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 1999;69:373-80.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

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