Thursday, August 11, 2016

Heart Disease - An Overview

In 2012, an estimated 56 million people died worldwide.

Noncommunicable Diseases (NCDs) were responsible for 68% of all deaths globally in 2012, up from 60% in 2000. The 4 main NCDs are cardiovascular diseases, cancers, diabetes and chronic lung diseases. Communicable, maternal, neonatal and nutrition conditions collectively were responsible for 23% of global deaths, and injuries caused 9% of all deaths.   

Cardiovascular diseases killed 17.5 million people in 2012, that is 3 in every 10 deaths. Of these, 7.4 million people died of ischaemic heart disease and 6.7 million from stroke. 

Causes of death, Chart, WHO
Source: WHO
Causes of death, Chart, WHO
Source: WHO
American dies from stroke, Infographic, Million Hearts
Source: Million Hearts
Heart attack, Infographic, Million Hearts
Source: Million Hearts



Definition


Heart disease describes a range of conditions that affect your heart. Diseases under the heart disease umbrella include blood vessel diseases, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you're born with (congenital heart defects), among others.

The term "heart disease" is often used interchangeably with the term "cardiovascular disease." Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease.

The most common type of heart disease in the United States is coronary artery disease, which affects the blood flow to the heart. Decreased blood flow can cause a heart attack.  



Heart Disease Facts


  • Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men.
  • About 160,000 people who died from cardiovascular disease in 2014 were younger than age 65.
  • About 610,000 Americans die from heart disease each year—that’s 1 in every 4 deaths.
  • Coronary heart disease (CHD) is the most common type of heart disease, killing over 370,000 people annually.
  • Stroke is the fifth leading cause of death for U.S. adults, but the risk of having a stroke varies. Compared to whites, African Americans are nearly twice as likely to have a first stroke. Hispanic Americans' risk falls between the two. African Americans and Hispanics are more likely to die following a stroke than are whites.
  • In the United States, someone has a heart attack every 42 seconds. Each minute, someone in the United States dies from a heart disease-related event.
  • Heart disease is the leading cause of death for all adults in the United States. Some minority groups are more likely to be affected than others: African Americans have the highest rate of high blood pressure of all population groups, and they tend to develop it earlier in life than others.
  • Heart disease is the leading cause of death for people of most racial/ethnic groups in the United States, including African Americans, Hispanics, and whites. For Asian Americans or Pacific Islanders and American Indians or Alaska Natives, heart disease is second only to cancer.
  • Heart disease costs the United States about  $207 billion each year. This total includes the cost of health care services, medications, and lost productivity.
  • Every year about 735,000 Americans have a heart attack. Of these, 525,000 are a first heart attack and 210,000 happen in people who have already had a heart attack.
  • Individuals with low incomes are much more likely to suffer from high blood pressure, high cholesterol, heart attack, and stroke than their high-income peers.
  • The country's highest death rates due to stroke are in the southeastern United States.



Heart Disease Death Vary by Race and Ethnicity


Heart disease is the leading cause of death for people of most ethnicities in the United States, including African Americans, Hispanics, and whites. For American Indians or Alaska Natives and Asians or Pacific Islanders, heart disease is second only to cancer. Below are the percentages of all deaths caused by heart disease in 2008, listed by ethnicity.


Race of Ethnic Group


       % of Deaths
American Indians or Alaska Natives     18.4
Asians or Pacific Islanders     22.2
Non-Hispanic Blacks     23.8
Non-Hispanic Whites     23.8
All     23.5



Heart Disease Death Vary by Geography


During 2008-2010, death rates due to heart disease were highest in the South and lowest in the West. 
You could see the map below is showing the prevalence of heart disease across the United States. 


Heart Disease Death Rates, Infographic, CDC
Source: Interactive Atlas of Heart Disease and StrokeCDC


Heart Disease Maps and Data Sources



Risk Factors


Several health conditions, your lifestyle, and your age and family history can increase your risk for heart disease. These are called risk factors.

Many risks for heart disease and stroke—including high blood pressure and high cholesterol—may not have any symptoms. 

Some of the risk factors for heart disease cannot be controlled, such as your age or family history. But you can take steps to lower your risk by changing the factors you can control.

Many of these risks—specifically high blood pressure, high cholesterol, smoking, and obesity—are preventable and controllable. Controlling these risks could reduce your risk for heart attack or stroke by more than 80%.

High blood pressure, high LDL cholesterol, and smoking are key heart disease risk factors for heart disease.  
About half of all Americans (47%) have at least one of the three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease.
Risk factors for developing heart disease include:

  • Age. Aging increases your risk of damaged and narrowed arteries and weakened or thickened heart muscle.
  • Sex. Men are generally at greater risk of heart disease. However, women's risk increases after menopause.
  • Family history. A family history of heart disease increases your risk of coronary artery disease, especially if a parent developed it at an early age (before age 55 for a male relative, such as your brother or father, and 65 for a female relative, such as your mother or sister).
  • Smoking. Nicotine constricts your blood vessels, and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. Heart attacks are more common in smokers than in nonsmokers.
  • Poor diet. A diet that's high in fat, salt, sugar and cholesterol can contribute to the development of heart disease.
  • High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the vessels through which blood flows.
  • High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis.
  • Diabetes. Diabetes increases your risk of heart disease. Both conditions share similar risk factors, such as obesity and high blood pressure.
  • Obesity. Excess weight typically worsens other risk factors.
  • Physical inactivity. Lack of exercise also is associated with many forms of heart disease and some of its other risk factors, as well.
  • Stress. Unrelieved stress may damage your arteries and worsen other risk factors for heart disease.
  • Poor hygiene. Not regularly washing your hands and not establishing other habits that can help prevent viral or bacterial infections can put you at risk of heart infections, especially if you already have an underlying heart condition. Poor dental health also may contribute to heart disease.
  • Excessive alcohol use


Learn more about heart disease risk factors:




Heart disease and stroke, Infographic, Million Hearts
Source: Million Hearts


Cardiovascular disease, Infographic, Million Hearts
Source: Million Hearts 




Why do we need to know the reasons people die?


Measuring how many people die each year and why they died is one of the most important means – along with gauging how diseases and injuries are affecting people – for assessing the effectiveness of a country’s health system.

Cause-of-death statistics help health authorities determine their focus for public health actions. A country where deaths from heart disease and diabetes rapidly rise over a period of a few years, for example, has a strong interest in starting a vigorous program to encourage lifestyles to help prevent these illnesses.

High-income countries have systems in place for collecting information on causes of death in the population. Many low- and middle-income countries do not have such systems, and the numbers of deaths from specific causes have to be estimated from incomplete data. Improvements in producing high quality cause-of-death data are crucial for improving health and reducing preventable deaths in these countries. 



Symptoms


Heart disease symptoms depend on what type of heart disease you have. 


Symptoms of heart disease in your blood vessels (atherosclerotic disease)


Cardiovascular disease is caused by narrowed, blocked or stiffened blood vessels that prevent your heart, brain or other parts of your body from receiving enough blood. Cardiovascular disease symptoms may be different for men and women. For instance, men are more likely to have chest pain; women are more likely to have symptoms such as shortness of breath, nausea and extreme fatigue.


Symptoms can include:


  • Chest pain (angina)
  • Shortness of breath
  • Pain, numbness, weakness or coldness in your legs or arms if the blood vessels in those parts of your body are narrowed
  • Pain in the neck, jaw, throat, upper abdomen or back

You might not be diagnosed with cardiovascular disease until you have a heart attack, angina, stroke or heart failure. It's important to watch for cardiovascular symptoms and discuss concerns with your doctor. Cardiovascular disease can sometimes be found early with regular exams. 


Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias)


A heart arrhythmia is an abnormal heartbeat. Your heart may beat too quickly, too slowly or irregularly. Heart arrhythmia symptoms can include:

  • Fluttering in your chest
  • Racing heartbeat (tachycardia)
  • Slow heartbeat (bradycardia)
  • Chest pain or discomfort
  • Shortness of breath
  • Lightheadedness
  • Dizziness
  • Fainting (syncope) or near fainting


Heart disease symptoms caused by heart defects


Serious congenital heart defects — defects you're born with — usually become evident soon after birth. Heart defect symptoms in children could include:

  • Pale gray or blue skin color (cyanosis)
  • Swelling in the legs, abdomen or areas around the eyes
  • In an infant, shortness of breath during feedings, leading to poor weight gain

Less serious congenital heart defects are often not diagnosed until later in childhood or during adulthood. Signs and symptoms of congenital heart defects that usually aren't immediately life-threatening include:

  • Easily getting short of breath during exercise or activity
  • Easily tiring during exercise or activity
  • Swelling in the hands, ankles or feet

Heart disease symptoms caused by weak heart muscle (dilated cardiomyopathy)


Cardiomyopathy is the thickening and stiffening of heart muscle. In early stages of cardiomyopathy, you may have no symptoms. As the condition worsens, symptoms may include:

  • Breathlessness with exertion or at rest
  • Swelling of the legs, ankles and feet
  • Fatigue
  • Irregular heartbeats that feel rapid, pounding or fluttering
  • Dizziness, lightheadedness and fainting

Heart disease symptoms caused by heart infections


There are three types of heart infections:

  • Pericarditis, which affects the tissue surrounding the heart (pericardium)
  • Myocarditis, which affects the muscular middle layer of the walls of the heart (myocardium)
  • Endocarditis, which affects the inner membrane that separates the chambers and valves of the heart (endocardium)

Varying slightly with each type of infection, heart infection symptoms can include:

  • Fever
  • Shortness of breath
  • Weakness or fatigue
  • Swelling in your legs or abdomen
  • Changes in your heart rhythm
  • Dry or persistent cough
  • Skin rashes or unusual spots

Heart disease symptoms caused by valvular heart disease


The heart has four valves — the aortic, mitral, pulmonary and tricuspid valves — that open and close to direct blood flow through your heart. Valves may be damaged by a variety of conditions leading to narrowing (stenosis), leaking (regurgitation or insufficiency) or improper closing (prolapse).
Depending on which valve isn't working properly, valvular heart disease symptoms generally include:

  • Fatigue
  • Shortness of breath
  • Irregular heartbeat
  • Swollen feet or ankles
  • Chest pain
  • Fainting (syncope)

When to see a doctor


Seek emergency medical care if you have these heart disease symptoms:

  • Chest pain
  • Shortness of breath
  • Fainting

Heart disease is easier to treat when detected early, so talk to your doctor about your concerns about your heart health. If you're concerned about developing heart disease, talk to your doctor about steps you can take to reduce your heart disease risk. This is especially important if you have a family history of heart disease.
If you think you may have heart disease, based on new signs or symptoms you're having, make an appointment to see your doctor.



Complications


Complications of heart disease include:

  • Heart failure. One of the most common complications of heart disease, heart failure occurs when your heart can't pump enough blood to meet your body's needs. Heart failure can result from many forms of heart disease, including heart defects, cardiovascular disease, valvular heart disease, heart infections or cardiomyopathy.
  • Heart attack. A blood clot blocking the blood flow through a blood vessel that feeds the heart causes a heart attack, possibly damaging or destroying a part of the heart muscle. Atherosclerosis can cause a heart attack.
  • Stroke. The risk factors that lead to cardiovascular disease also can lead to an ischemic stroke, which happens when the arteries to your brain are narrowed or blocked so that too little blood reaches your brain. A stroke is a medical emergency — brain tissue begins to die within just a few minutes of a stroke.
  • Aneurysm. A serious complication that can occur anywhere in your body, an aneurysm is a bulge in the wall of your artery. If an aneurysm bursts, you may face life-threatening internal bleeding.
  • Peripheral artery disease. Atherosclerosis also can lead to peripheral artery disease. When you develop peripheral artery disease, your extremities — usually your legs — don't receive enough blood flow. This causes symptoms, most notably leg pain when walking (claudication).
  • Sudden cardiac arrest. Sudden cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness, often caused by an arrhythmia. Sudden cardiac arrest is a medical emergency. If not treated immediately, it is fatal, resulting in sudden cardiac death.



Prevention



Healthy Living Habits, Infographic, Million Hearts
Source: Million Hearts

Heart disease and stroke are an epidemic in the United States today. Many of the people who are at high risk for heart attack or stroke don’t know it. The good news is that many of the major risks for these conditions can be prevented and controlled through healthy lifestyle changes.

Certain types of heart disease, such as heart defects, can't be prevented. However, you can help prevent many other types of heart disease by making the same lifestyle changes that can improve your heart disease, such as:

  • Quit smoking
  • Control other health conditions, such as high blood pressure, high cholesterol and diabetes
  • Exercise at least 30 minutes a day on most days of the week
  • Eat a diet that's low in salt and saturated fat
  • Maintain a healthy weight
  • Reduce and manage stress
  • Practice good hygiene

Key Barriers


Many people with risks for heart disease and stroke—such as high blood pressure and high cholesterol—do not know that they have these conditions or how to effectively control them to prevent a heart attack or stroke. Other barriers include the following:

  • Access to convenient, consistent, and affordable monitoring of blood pressure and cholesterol.
  • Inadequate time with health care professionals to ask important questions and receive personalized advice.
  • Medication expense, side effects, and habits about daily use.
  • Lack of continuity of clinical care across varied providers and systems.
  • Need for community-based strategies for healthier lifestyle choices, such as reduced sodium in meals and smoke-free air policies.



ABCS, Infographic, Million Hearts
Source: Million Hearts




Healthy Living Habits


By living a healthy lifestyle, you can help keep your blood pressure, cholesterol, and sugar normal and lower your risk for heart disease and heart attack. A healthy lifestyle includes the following:

  • Eating a healthy diet.
  • Maintaining a healthy weight.
  • Getting enough physical activity.
  • Not smoking or using other forms of tobacco.
  • Limiting alcohol use.

Healthy Diet


Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables and fewer processed foods.
Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet also can lower your blood pressure. Limiting sugar in your diet can lower you blood sugar level to prevent or help control diabetes.
For more information on healthy diet and nutrition, see CDC’s Nutrition, Physical Activity, and Obesity Program website.


Healthy Weight


Being overweight or obese increases your risk for heart disease. To determine if your weight is in a healthy range, doctors often calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC’s Assessing Your Weight website. Doctors sometimes also use waist and hip measurements to calculate excess body fat. They may use special equipment to calculate excess body fat and hydration status.


Physical Activity


Physical activity can help you maintain a healthy weight and lower your blood pressure, cholesterol, and sugar levels. For adults, the Surgeon General recommends 2 hours and 30 minutes of moderate-intensity exercise, like brisk walking or bicycling, every week. Children and adolescents should get 1 hour of physical activity every day.
For more information, see CDC's Nutrition, Physical Activity, and Obesity Web site.


No Smoking


Cigarette smoking greatly increases your risk for heart disease. If you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.
For more information about tobacco use and quitting, see CDC's Smoking & Tobacco Use Web site.


Limited Alcohol


Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than 2 drinks per day, and women only 1. 

For more information, visit CDC's Alcohol and Public Health Web site.



Other Medical Conditions


If you have high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for heart disease.


Check Cholesterol


Your health care provider should test your blood levels of cholesterol at least once every 5 years. If you have already been diagnosed with high cholesterol or have a family history of the condition, you may have your cholesterol checked more frequently. Talk with your health care team about this simple blood test. If you have high cholesterol, medications and lifestyle changes can help reduce your risk for heart disease.


Control Blood Pressure


High blood pressure usually has no symptoms, so be sure to have it checked on a regular basis. Your health care team should measure your blood pressure at least once every 2 years if you have never had high blood pressure or other risk factors for heart disease. If you have been diagnosed with high blood pressure, also called hypertension, your health care team will measure your blood pressure more frequently to ensure you have the condition under control. Talk to your health care team about how often you should check your blood pressure. You can check it at a doctor’s office, at a pharmacy, or at home.
If you have high blood pressure, your health care team might recommend some changes in your lifestyle or advise you to lower the sodium in your diet; your doctor may also prescribe medication when necessary to help lower your blood pressure. There are many strategies to help monitor and improve blood pressure control and medication adherence[PDF-1M] to improve health outcomes for patients with hypertension.


Manage Diabetes


If your health care provider thinks you have symptoms of diabetes, he or she may recommend that you get tested. If you have diabetes, monitor your blood sugar levels[PDF-250K] carefully. Talk with your health care team about treatment options. Your doctor may recommend certain lifestyle changes to help keep your blood sugar under good control—those actions will help reduce your risk for heart disease.


Take Your Medicine


If you take medication to treat high cholesterol, high blood pressure, or diabetes, follow your doctor’s instructions carefully. Always ask questions if you don’t understand something. Never stop taking your medication without talking to your doctor, nurse, or pharmacist.


Talk with Your Health Care Team


You and your health care team can work together to prevent or treat the medical conditions that lead to heart disease. Discuss your treatment plan regularly, and bring a list of questions to your appointments.
If you’ve already had a heart attack, your health care team will work with you to prevent another heart attack. Your treatment plan may include medications or surgery and lifestyle changes to reduce your risk. Be sure to take your medications as directed and follow your doctor’s instructions. 



For Further More


You could read here for further information about heart disease

You can download heart disease fact sheet here.

If you would like to know more about Heart Disease Statistical Reports for Health Professionals, you could read here for more information. 


Let's have a heart disease quiz to test your knowledge about heart disease.



Sources:
CDC-Heart Disease Fact Sheet
CDC-Heart Disease Facts 
CDC-About Heart Disease 
CDC-Heart Disease Risk Factors
CDC-Heart Disease Quiz  
CDC-Heart Disease Maps and Data Sources
CDC-Preventing Heart Disease: Healthy Living Habits
CDC-Preventing Heart Disease: Other Medical Conditions
WHO-The top 10 causes of death-major causes of death
WHO-The top 10 causes of death-Why do we need to know the reasons people die? 
Mayo Clinic-Heart Disease-Definition
Mayo Clinic-Heart Disease-Symptoms 
Mayo Clinic-Heart Disease-Risk Factors
Mayo Clinic-Heart Disease-Complications 
Mayo Clinic-Heart Disease-Prevention 
Million Hearts-Risks for Heart Disease & Stroke
Million Hearts-Prevention 

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