- 50 million people suffer from high blood pressure

- 12 million people suffer from coronary heart disease

- Heart attack happens to 7 million people

- Another 4.4 million experience stroke

- 6.2 million has angina pectoris (chest pain because of blood vessels blockage)

- 1.8 million suffer from rheumatic heart disease (a kind of inflammatory disease)

- Meanwhile 1 million people have congenital cardiovascular defects

- 35 percent of people who have high blood pressure do not realize about it

- Surprisingly, every 29 seconds, a person suffers from a kind of coronary occurrence

- 50 percent of heart attack victims wait for two hours before requesting help.

- The result, a quarter of million people die annually before they reach hospital due to heart attack

- And the last, heart disease is a number one killer.

Causes of Heart Disease: Understanding is Prevention

Understanding the causes of heart disease is the best way to prevent it from happening. Currently,
research has found various causes of heart disease. Damage to the heart muscle or valves due to
birth defect, irritation and damage related to various viral, bacteria, fungi, and parasite are some of the
causes of heart disease.

Other contributors or causes of heart disease are illnesses such as syphilis and rheumatic fever as
well as genetic or autoimmune disorders. Autoimmune disorders happen when the body produces an
inappropriate immune response against its own tissue.

Besides the factors above, there are still other causes of heart disease as follow:

- Atherosclerosis (a chronic inflammatory in the arterial blood vessels) - Dermatomyositis

(inflammation of the skin and the muscles due to connective-tissue disease) - Type 1 and 2 diabetes -
Friedrich's ataxia (a hereditary disease causes progressive damage to the nervous system) -
Hemochromatosis (iron overload disorder) - High cholesterol - Hypertension - Kawasaki disease (a
cardiovascular disease happened mostly in young children) - Menopause - Paget's disease of bone
(enlarged and deformed bones due to a chronic disorder) - Lack of exercise - Smoking habit -
Underweight or overweight

There are two factors that are deemed to instigate a heart attack. First is a pathological build up of
abnormal plaque in the arteries which hardens steadily because of calcification. This abnormal plaque
is different with the fatty streaks and thickening happened in the arteries of both industrialized and
primitive peoples in the world. In reality, this natural thickening is necessary or else the arteries would
weaken as the body aged and create aneurysms and rupture of the arteries.

The second factor is the blockage of blood flow to the heart or the brain due to blood clot (thrombus).
Inflammation has a potential to create blockages as well. Recent findings in coronary artery disease
mentioned the inflammatory process which follows the cycle of irritation, injury, healing, and re-injury
of the blood vessels, is responsible for the disease.
As I mentioned previously, it is critical to understand the causes of heart disease if you want to
prevent it. Basically, heart disease is inevitable. However, several activities are recommended to
protect yourself, such as healthy eating habit and adequate exercise or physical activity. When you
keep yourself in a good shape, you will reduce dramatically the causes of heart disease as well as
preventing other illnesses to come.

Types of Heart Disease

Diseases of the heart and circulatory system are called cardiovascular disease or CVD.
CVD comes in two main forms:

1. Heart disease (CHD), and

2. Stroke.

Things We Can Change 
The major factors individuals can change include: smoking, high blood cholesterol levels,
high blood pressure, obesity, physical inactivity and being overweight.

Smoking
Smokers have twice as high a risk of heart attack as nonsmokers, and have two to four
times the risk of sudden cardiac death. Smokers are also more likely to die quickly and
suddenly than nonsmokers.

High blood pressure

African-Americans have the highest death rates from the disease. This may be due to
their higher rates of high blood pressure; about 1 in 3 black adults have high blood
pressure, compared to about 1 in 4 white adults. High blood pressure is also generally
more severe among elderly African-Americans than elderly whites, leading to more cases
of strokes, heart disease and kidney failure.

Cholesterol and cholesterol levels

Cholesterol is a waxy substance found in all parts of your body. It helps make cell
membranes, some hormones, and vitamin D. Cholesterol comes from two sources: your
body and the foods you eat.

 Blood cholesterol is made in your liver. Your liver makes all the cholesterol your
body needs.
 Dietary cholesterol comes from animal foods like meats, whole milk dairy foods,
egg yolks, poultry and fish.
 Eating too much dietary cholesterol can make your blood cholesterol go up. Foods
from plants, like vegetables, fruits, grains, and cereals, do not have any dietary
cholesterol.

The 2 types of cholesterol - (1) LDL (bad), (2) HDL (good)

Like oil and water, cholesterol and blood do not mix. So, for cholesterol to travel through
your blood, it is coated with a layer of protein to make a "lipoprotein." The two
lipoproteins are low density lipoprotein (LDL) and high density lipoprotein (HDL).
  LDL-cholesterol carries most of the cholesterol in the blood. When too much LDL-
cholesterol is in the blood, it can lead to cholesterol buildup in the arteries. That
is why LDL-cholesterol is called the "bad" cholesterol.
 HDL-cholesterol helps remove cholesterol from the blood and helps prevent the
fatty  buildup. This is why HDL-cholesterol is called the "good" cholesterol.

High cholesterol increases the risk of coronary heart disease. It makes the heart pump
more and faster, causing it to weaken. The risk is compounded with other factors, such
as smoking and high blood pressure. On the average, each of these doubles your chance
of developing heart disease. Therefore, a person who has all three risk factors is eight
times more likely to develop heart disease than someone who has none. Diabetes,
obesity and physical inactivity are other factors that can lead to coronary heart disease.

Things That Affect Blood Cholesterol

Your blood cholesterol level is influenced by many factors, including:

What you eat

High intake of saturated fat, dietary cholesterol, and excess calories leading to
overweight leads to increased blood cholesterol levels.

Warning!
It is now universally recognized that a diet which is high in fat, particularly saturated fat,
and low in complex carbohydrates, fruit and vegetables increases the risk of chronic
diseases - particularly heart disease, stroke and cancer.

Overweight
Being overweight can make your LDL-cholesterol level go up and your HDL-cholesterol
level go down.

Exercise
Increased physical activity lowers LDL-cholesterol and raises HDL-cholesterol levels.

Heredity
Your genes partly influence how your body makes and handles cholesterol.

Age and Sex

Blood cholesterol levels in both men and women begin to go up around age 20. Women
before menopause have levels that are lower than men of the same age. After
menopause, a woman's LDL-cholesterol level goes up - and so her risk for heart disease
increases.

Exercise
Individuals who don't exercise and/or are obese also put themselves at greater risk.
Excess weight strains the heart; influences blood pressure, blood cholesterol and tri-
glyceride levels; and increases the risk of diabetes.

Diabetes
Diabetes also increases the risk of heart disease. Heart disease kills more than 80% of
people with diabetes.

Stress
Stress may also contribute to the development of heart disease, because people may
overeat, exercise less or smoke more when they're under stress.
WHO:

Cardiovascular diseases (CVDs)

KEY FACTS

 CVDs are the number one cause of death globally: more people die annually from CVDs than
from any other cause.
 An estimated 17.1 million people died from CVDs in 2004, representing 29%of all global deaths.
Of these deaths, an estimated 7.2 million were due to coronary heart disease and 5.7 million
were due to stroke.
 Low- and middle-income countries are disproportionally affected: 82% of CVD deaths take place
in low- and middle-income countries and occur almost equally in men and women.
 By 2030, almost 23.6 million people will die from CVDs, mainly from heart disease and stroke.
These are projected to remain the single leading causes of death. The largest percentage
increase will occur in the Eastern Mediterranean Region. The largest increase in number of
deaths will occur in the South-East Asia Region.

Related links:

WHO action plan for the

strategy for prevention and
control of noncommunicable 

Health topic: cardiovascular

diseases 

What are cardiovascular diseases?

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and include:

 coronary heart disease – disease of the blood vessels supplying the heart muscle
 cerebrovascular disease - disease of the blood vessels supplying the brain
 peripheral arterial disease – disease of blood vessels supplying the arms and legs
 rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever,
caused by streptococcal bacteria
 congenital heart disease - malformations of heart structure existing at birth
 deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can
dislodge and move to the heart and lungs.

Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents
blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits
on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by
bleeding from a blood vessel in the brain or from blood clots.
What are the risk factors for cardiovascular disease?

The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical
inactivity and tobacco use. Behavioural risk factors are responsible for about 80% of coronary heart
disease and cerebrovascular disease.

The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure,
raised blood glucose, raised blood lipids, and overweight and obesity; these are called 'intermediate risk
factors'.

There are also a number of underlying determinants of CVDs, or, if you like, "the causes of the causes".
These are a reflection of the major forces driving social, economic and cultural change – globalization,
urbanization, and population ageing. Other determinants of CVDs are poverty and stress.

What are common symptoms of cardiovascular diseases?

Symptoms of heart attacks and strokes

Often, there are no symptoms of the underlying disease of the blood vessels. A heart attack or stroke
may be the first warning of underlying disease. Symptoms of a heart attack include:

 pain or discomfort in the centre of the chest;

 pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.

In addition the person may experience difficulty in breathing or shortness of breath; feeling sick or
vomiting; feeling light-headed or faint; breaking into a cold sweat; and becoming pale. Women are more
likely to have shortness of breath, nausea, vomiting, and back or jaw pain.

The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one
side of the body. Other symptoms include sudden onset of: numbness of the face, arm, or leg, especially
on one side of the body; confusion, difficulty speaking or understanding speech; difficulty seeing with
one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache with no
known cause; and fainting or unconsciousness.

People experiencing these symptoms should seek medical care immediately.

What is rheumatic heart disease?

Rheumatic heart disease is caused by damage to the heart valves and heart muscle from the
inflammation and scarring caused by rheumatic fever. Rheumatic fever is caused by streptococcal
bacteria, which usually begins as a sore throat or tonsillitis in children.

Rheumatic fever mostly affects children in developing countries, especially where poverty is widespread.
Globally, almost 2% of deaths from cardiovascular diseases is related to rheumatic heart disease, while
42% of deaths from cardiovascular diseases is related to ischaemic heart disease, and 34% to
cerebrovascular disease.

Symptoms of rheumatic heart disease

 Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heart
beats, chest pain and fainting.
 Symptoms of rheumatic fever include: fever, pain and swelling of the joints, nausea, stomach
cramps and vomiting.

Treatment

 Early treatment of streptococcal sore throat can stop the development of rheumatic fever.
Regular long-term penicillin treatment can prevent repeat attacks of rheumatic fever which give
rise to rheumatic heart disease and can stop disease progression in people whose heart valves
are already damaged by the disease.
Why are cardiovascular diseases a development issue in low- and middle-income countries?

 Over 80% of the world's deaths from CVDs occur in low- and middle-income countries.
 People in low- and middle-income countries are more exposed to risk factors leading to CVDs
and other noncommunicable diseases and are less exposed to prevention efforts than people in
high-income countries.
 People in low- and middle-income countries who suffer from CVDs and other noncommunicable
diseases have less access to effective and equitable health care services which respond to their
needs (including early detection services).
 As a result, many people in low- and middle-income countries die younger from CVDs and other
noncommunicable diseases, often in their most productive years.
 The poorest people in low- and middle-income countries are affected most. At household level,
sufficient evidence is emerging to prove that CVDs and other noncommunicable diseases
contribute to poverty. For example, catastrophic health care expenditures for households with a
family member with CVD can be 30 per cent or more of annual household spending.
 At macro-economic level, CVDs place a heavy burden on the economies of low- and middle-
income countries. Heart disease, stroke and diabetes are estimated to reduce GDP between 1
and 5% in low- and middle-income countries experiencing rapid economic growth, as many
people die prematurely. For example, it is estimated that over the next 10 years (2006-2015),
China will lose $558 billion in foregone national income due to the combination of heart disease,
stroke and diabetes.

How can the burden of cardiovascular diseases be reduced?

Heart disease and stroke can be prevented through healthy diet, regular physical activity and avoiding
tobacco smoke. Individuals can reduce their risk of CVDs by engaging in regular physical activity,
avoiding tobacco use and second-hand tobacco smoke, choosing a diet rich in fruit and vegetables and
avoiding foods that are high in fat, sugar and salt, and maintaining a healthy body weight.

Comprehensive and integrated action is the means to prevent and control CVDs.

 Comprehensive action requires combining approaches that seek to reduce the risks throughout
the entire population with strategies that target individuals at high risk or with established
disease.
 Examples of population-wide interventions that can be implemented to reduce CVDs include:
comprehensive tobacco control policies, taxation to reduce the intake of foods that are high in
fat, sugar and salt, building walking and cycle ways to increase physical activity, providing
healthy school meals to children.
 Integrated approaches focus on the main common risk factors for a range of chronic diseases
such as CVD, diabetes and cancer: unhealthy diet, physically inactivity and tobacco use.

There are several treatment options available.

 Effective and inexpensive medication is available to treat nearly all CVDs.

 Survivors of a heart attack or stroke are at high risk of recurrences and at high risk of dying
from them. The risk of a recurrence or death can be substantially lowered with a combination of
drugs – statins to lower cholesterol, drugs to lower blood pressure, and aspirin.
 Operations used to treat CVDs include coronary artery bypass, balloon angioplasty (where a
small balloon-like device is threaded through an artery to open the blockage), valve repair and
replacement, heart transplantation, and artificial heart operations.
 Medical devices are required to treat some CVDs. Such devices include pacemakers, prosthetic
valves, and patches for closing holes in the heart.

There is a need for increased government investment through national programmes aimed at prevention
and control of CVDs and other noncommunicable diseases.