“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
570
Cardiovascular diseases and their pathology
Termiz university of economics and service
Eshpolatova Shirina Bakhtyorovna
Abstract:
This article provides all the latest information about cardiovascular
diseases. The article provides information on measures for the treatment of
cardiovascular diseases and effective methods of prevention. Due to the fact that
cardiovascular diseases are common among young people and elderly people, the
statistics of this disease were also studied in the article.
Key words:
cardiovascular diseases, heart failure, myocardium, blood
pressure.
Cardiovascular disease
(
CVD
) is any disease involving the heart or blood
vessels. CVDs constitute a class of diseases that includes: coronary artery
diseases (e.g. angina, heart
disease, rheumatic heart disease, cardiomyopathy, arrhythmia, congenital heart
disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery
disease, thromboembolic disease, and venous thrombosis.
The underlying mechanisms vary depending on the disease. It is estimated that
dietary risk factors are associated with 53% of CVD deaths. Coronary artery disease,
stroke, and peripheral artery disease involve atherosclerosis. This may be caused
by high blood pressure, smoking, diabetes mellitus, lack of exercise, obesity, high
blood cholesterol, poor diet, excessive alcohol consumption and poor sleep, among
other things. High blood pressure is estimated to account for approximately 13% of
CVD deaths, while tobacco accounts for 9%, diabetes 6%, lack of exercise 6%, and
obesity 5%. Rheumatic heart disease may follow untreated strep throat.
It is estimated that up to 90% of CVD may be preventable. Prevention of CVD
involves improving risk factors through: healthy eating, exercise, avoidance of
tobacco smoke and limiting alcohol intake. Treating risk factors, such as high blood
pressure, blood lipids and diabetes is also beneficial. Treating people who have strep
throat with antibiotics can decrease the risk of rheumatic heart disease. The use
of aspirin in people who are otherwise healthy is of unclear benefit.
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
571
Cardiovascular diseases are the leading cause of death worldwide except
Africa. Together CVD resulted in 17.9 million deaths (32.1%) in 2015, up from 12.3
million (25.8%) in 1990. Deaths, at a given age, from CVD are more common and
have been increasing in much of the developing world, while rates have declined in
most of the developed world since the 1970s. Coronary artery disease and stroke
account for 80% of CVD deaths in males and 75% of CVD deaths in females. Most
cardiovascular disease affects older adults. In the United States 11% of people
between 20 and 40 have CVD, while 37% between 40 and 60, 71% of people
between 60 and 80, and 85% of people over 80 have CVD. The average age of death
from coronary artery disease in the developed world is around 80, while it is around
68 in the developing world. CVD is typically diagnosed seven to ten years earlier in
men than in women.
Types
year for
inflammatory heart diseases per 100,000 inhabitants in 2004
No data
Less than 70
70–140
140–210
210–280
280–350
350–420
420–490
490–560
560–630
630–700
700–770
More than 770
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
572
There are many cardiovascular diseases involving the blood vessels. They are
known as vascular diseases.
Coronary artery disease (coronary heart disease or ischemic heart
disease)
Peripheral arterial disease – a disease of blood vessels that supply
blood to the arms and legs
Cerebrovascular disease – a disease of blood vessels that supply
blood to the brain (includes stroke)
There are also many cardiovascular diseases that involve the heart.
Cardiomyopathy – diseases of cardiac muscle
Hypertensive heart disease – diseases of the heart secondary to
high blood pressure or hypertension
Heart failure – a clinical syndrome caused by the inability of the
heart to supply sufficient blood to the tissues to meet their metabolic
requirements
Pulmonary heart disease – a failure at the right side of the heart
with respiratory system involvement
Cardiac dysrhythmias – abnormalities of heart rhythm
Inflammatory heart diseases
Endocarditis – inflammation of the inner layer of
the heart, the endocardium. The structures most commonly
involved are the heart valves.
Inflammatory cardiomegaly
Myocarditis – inflammation of the myocardium, the
muscular part of the heart, caused most often by viral infection
and less often by bacterial infections, certain medications,
toxins, and autoimmune disorders. It is characterized in part by
infiltration of the heart by lymphocyte and monocyte types
of white blood cells.
Eosinophilic myocarditis – inflammation of the
myocardium
caused
by
pathologically
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
573
activated eosinophilic white blood cells. This disorder differs
from myocarditis in its causes and treatments.
Congenital heart disease – heart structure malformations existing
at birth
Rheumatic heart disease – heart muscles and valves damage due
to rheumatic
fever caused
Risk factors
There are many risk factors for heart diseases: age, sex, tobacco use, physical
inactivity, non-alcoholic fatty liver disease, excessive alcohol consumption,
unhealthy diet, obesity, genetic predisposition and family history of cardiovascular
disease, raised blood pressure (hypertension), raised blood sugar (diabetes mellitus),
raised blood cholesterol (hyperlipidemia), undiagnosed celiac disease, psychosocial
factors, poverty and low educational status, air pollution, and poor sleep. While the
individual contribution of each risk factor varies between different communities or
ethnic groups the overall contribution of these risk factors is very consistent. Some
of these risk factors, such as age, sex or family history/genetic predisposition, are
immutable; however, many important cardiovascular risk factors are modifiable by
lifestyle change, social change, drug treatment (for example prevention of
hypertension, hyperlipidemia, and diabetes). People with obesity are at increased
risk of atherosclerosis of the coronary arteries.
Genetics
Cardiovascular disease in a person's parents increases their risk by ~3
fold,
and genetics is an important risk factor for cardiovascular diseases. Genetic
cardiovascular disease can occur either as a consequence of single variant
(Mendelian) or polygenic influences.
There are more than 40 inherited
cardiovascular disease that can be traced to a single disease-causing DNA variant,
although these conditions are rare.
Most common cardiovascular diseases are
non-Mendelian and are thought to be due to hundreds or thousands of genetic
variants (known as single nucleotide polymorphisms), each associated with a small
effect.
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
574
Age
Calcified heart of an older woman with
cardiomegaly
Age is the most important risk factor in developing cardiovascular or heart
diseases, with approximately a tripling of risk with each decade of life. Coronary
fatty streaks can begin to form in adolescence. It is estimated that 82 percent of
people who die of coronary heart disease are 65 and older. Simultaneously, the risk
of stroke doubles every decade after age 55.
Multiple explanations are proposed to explain why age increases the risk of
cardiovascular/heart diseases. One of them relates to serum cholesterol level. In most
populations, the serum total cholesterol level increases as age increases. In men, this
increase levels off around age 45 to 50 years. In women, the increase continues
sharply until age 60 to 65 years.
Aging is also associated with changes in the mechanical and structural
properties of the vascular wall, which leads to the loss of arterial elasticity and
reduced arterial compliance and may subsequently lead to coronary artery disease.
Sex
See also: Cardiovascular disease in women
Men are at greater risk of heart disease than pre-menopausal women. Once
past menopause, it has been argued that a woman's risk is similar to a man's although
more recent data from the WHO and UN disputes this. If a female has diabetes, she
is more likely to develop heart disease than a male with diabetes. Women who have
high blood pressure and had complications in their pregnancy have three times the
risk of developing cardiovascular disease compared to women with normal blood
pressure who had no complications in pregnancy.
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
575
Coronary heart diseases are 2 to 5 times more common among middle-aged
men than women. In a study done by the World Health Organization, sex contributes
to approximately 40% of the variation in sex ratios of coronary heart disease
mortality. Another study reports similar results finding that sex differences explains
nearly half the risk associated with cardiovascular diseases One of the proposed
explanations for sex differences in cardiovascular diseases is hormonal difference.
Among women, estrogen is the predominant sex hormone. Estrogen may have
protective effects on glucose metabolism and hemostatic system, and may have
direct effect in improving endothelial cell function. The production of estrogen
decreases after menopause, and this may change the female lipid metabolism toward
a more atherogenic form by decreasing the HDL cholesterol level while increasing
LDL and total cholesterol levels.
Among men and women, there are differences in div weight, height, div fat
distribution, heart rate, stroke volume, and arterial compliance. In the very elderly,
age-related large artery pulsatility and stiffness are more pronounced among women
than men. This may be caused by the women's smaller div size and arterial
dimensions which are independent of menopause.
Tobacco
Cigarettes are the major form of smoked tobacco. Risks to health from tobacco
use result not only from direct consumption of tobacco, but also from exposure to
second-hand smoke. Approximately 10% of cardiovascular disease is attributed to
smoking; however, people who quit smoking by age 30 have almost as low a risk of
death as never smokers.
Physical inactivity
Further information: Sedentary lifestyle
Insufficient physical activity (defined as less than 5 x 30 minutes of moderate
activity per week, or less than 3 x 20 minutes of vigorous activity per week) is
currently the fourth leading risk factor for mortality worldwide. In 2008, 31.3% of
adults aged 15 or older (28.2% men and 34.4% women) were insufficiently
physically active. The risk of ischemic heart disease and diabetes mellitus is reduced
by almost a third in adults who participate in 150 minutes of moderate physical
activity each week (or equivalent). In addition, physical activity assists weight loss
and improves blood glucose control, blood pressure, lipid profile and insulin
sensitivity. These effects may, at least in part, explain its cardiovascular benefits.
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
576
Diet
Further information: Saturated fat § Cardiovascular disease, Salt and
cardiovascular disease, and Lipid hypothesis
High dietary intakes of saturated fat, trans-fats and salt, and low intake of fruits,
vegetables and fish are linked to cardiovascular risk, although whether all these
associations indicate causes is disputed. The World Health Organization attributes
approximately 1.7 million deaths worldwide to low fruit and vegetable consumption.
Frequent consumption of high-energy foods, such as processed foods that are high
in fats and sugars, promotes obesity and may increase cardiovascular risk. The
amount of dietary salt consumed may also be an important determinant of blood
pressure levels and overall cardiovascular risk. There is moderate quality evidence
that reducing saturated fat intake for at least two years reduces the risk of
cardiovascular disease. High trans-fat intake has adverse effects on blood lipids and
circulating inflammatory markers, and elimination of trans-fat from diets has been
widely advocated. In 2018 the World Health Organization estimated that trans fats
were the cause of more than half a million deaths per year. There is evidence that
higher consumption of sugar is associated with higher blood pressure and
unfavorable blood lipids, and sugar intake also increases the risk of diabetes
mellitus. High consumption of processed meats is associated with an increased
risk of cardiovascular disease, possibly in part due to increased dietary salt intake.
Alcohol
Further information: Alcohol and cardiovascular disease
The relationship between alcohol consumption and cardiovascular disease is
complex, and may depend on the amount of alcohol consumed. There is a direct
relationship between high levels of drinking alcohol and cardiovascular
disease. Drinking at low levels without episodes of heavy drinking may be
associated with a reduced risk of cardiovascular disease, but there is evidence that
associations between moderate alcohol consumption and protection from stroke are
non-causal. At the population level, the health risks of drinking alcohol exceed any
potential benefits.
Celiac disease
Untreated celiac disease can cause the development of many types of
cardiovascular diseases, most of which improve or resolve with a gluten-free
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
577
diet and intestinal healing. However, delays in recognition and diagnosis of celiac
disease can cause irreversible heart damage.
Sleep
A lack of good sleep, in amount or quality, is documented as increasing
cardiovascular risk in both adults and teens. Recommendations suggest that infants
typically need 12 or more hours of sleep per day, adolescents at least eight or nine
hours, and adults seven or eight. About one-third of adult Americans get less than
the recommended seven hours of sleep per night, and in a study of teenagers, just
2.2 percent of those studied got enough sleep, many of whom did not get good
quality sleep. Studies have shown that short sleepers getting less than seven hours
sleep per night have a 10 percent to 30 percent higher risk of cardiovascular disease.
Sleep disorders such as sleep-disordered breathing and insomnia, are also
associated with a higher cardiometabolic risk. An estimated 50 to 70 million
Americans have insomnia, sleep apnea or other chronic sleep disorders.
In addition, sleep research displays differences in race and class. Short sleep
and poor sleep tend to be more frequently reported in ethnic minorities than in
whites. African-Americans report experiencing short durations of sleep five times
more often than whites, possibly as a result of social and environmental factors.
Black children and children living in disadvantaged neighborhoods have much
higher rates of sleep apnea.
Socioeconomic disadvantage
Cardiovascular disease has a greater impact on low- and middle-income
countries compared to those with higher income. Although data on the social
patterns of cardiovascular disease in low- and middle-income countries is
limited, reports from high-income countries consistently demonstrate that low
educational status or income are associated with a greater risk of cardiovascular
disease. Policies that have resulted in increased socio-economic inequalities have
been associated with greater subsequent socio-economic differences in
cardiovascular disease implying a cause and effect relationship. Psychosocial
factors, environmental exposures, health behaviours, and health-care access and
quality contribute to socio-economic differentials in cardiovascular disease. The
Commission on Social Determinants of Health recommended that more equal
distributions of power, wealth, education, housing, environmental factors, nutrition,
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
578
and health care were needed to address inequalities in cardiovascular disease and
non-communicable diseases.
Air pollution
Particulate matter has been studied for its short- and long-term exposure effects
on cardiovascular disease. Currently, airborne particles under 2.5 micrometers in
diameter (PM
2.5
) are the major focus, in which gradients are used to determine CVD
risk. Overall, long-term PM exposure increased rate of atherosclerosis and
inflammation. In regards to short-term exposure (2 hours), every 25 μg/m
3
of
PM
2.5
resulted in a 48% increase of CVD mortality risk. In addition, after only 5
days of exposure, a rise in systolic (2.8 mmHg) and diastolic (2.7 mmHg) blood
pressure occurred for every 10.5 μg/m
3
of PM
2.5
. Other research has implicated
PM
2.5
in irregular heart rhythm, reduced heart rate variability (decreased vagal tone),
and most notably heart failure PM
2.5
is also linked to carotid artery thickening and
increased risk of acute myocardial infarction
Cardiovascular risk assessment
Existing cardiovascular disease or a previous cardiovascular event, such as a
heart attack or stroke, is the strongest predictor of a future cardiovascular event. Age,
sex, smoking, blood pressure, blood lipids and diabetes are important predictors of
future cardiovascular disease in people who are not known to have cardiovascular
disease. These measures, and sometimes others, may be combined into composite
risk scores to estimate an individual's future risk of cardiovascular disease.
Numerous risk scores exist although their respective merits are debated. Other
diagnostic tests and biomarkers remain under evaluation but currently these lack
clear-cut evidence to support their routine use. They include family history, coronary
artery calcification score, high sensitivity C-reactive protein (hs-CRP), ankle–
brachial pressure index, lipoprotein subclasses and particle concentration,
lipoprotein(a), apolipoproteins A-I and B, fibrinogen, white blood cell
count, homocysteine, N-terminal pro B-type natriuretic peptide (NT-proBNP), and
markers of kidney function. High blood phosphorus is also linked to an increased
risk.
Depression and traumatic stress
There is evidence that mental health problems, in particular depression and
traumatic stress, is linked to cardiovascular diseases. Whereas mental health
problems are known to be associated with risk factors for cardiovascular diseases
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
579
such as smoking, poor diet, and a sedentary lifestyle, these factors alone do not
explain the increased risk of cardiovascular diseases seen in depression, stress, and
anxiety. Moreover, posttraumatic stress disorder is independently associated with
increased risk for incident coronary heart disease, even after adjusting for depression
and other covariates.
Occupational exposure
Main article: Occupational cardiovascular disease
Little is known about the relationship between work and cardiovascular
disease, but links have been established between certain toxins, extreme heat and
cold, exposure to tobacco smoke, and mental health concerns such as stress and
depression.
Non-chemical risk factors
A 2015 SBU-report looking at non-chemical factors found an association for
those:
with mentally stressful work with a lack of control over their
working situation — with an effort-reward imbalance
who experience low social support at work; who experience
injustice or experience insufficient opportunities for personal
development; or those who experience job insecurity
those who work night schedules; or have long working weeks
those who are exposed to noise
Specifically the risk of stroke was also increased by exposure to ionizing
radiation. Hypertension develops more often in those who experience job strain and
who have shift-work. Differences between women and men in risk are small,
however men risk having and dying of heart attacks or stroke twice as often as
women during working life.
Chemical risk factors
A 2017 SBU report found evidence that workplace exposure to silica
dust, engine exhaust or welding fumes is associated with heart disease. Associations
also
exist
for
exposure
to arsenic, benzopyrenes, lead, dynamite, carbon
disulphide, carbon monoxide, metalworking fluids and occupational exposure
to tobacco smoke. Working with the electrolytic production of aluminium or the
production of paper when the sulphate pulping process is used is associated with
heart disease. An association was also found between heart disease and exposure to
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
580
compounds which are no longer permitted in certain work environments, such
as phenoxy acids containing TCDD(dioxin) or asbestos.
Workplace exposure to silica dust or asbestos is also associated with pulmonary
heart disease. There is evidence that workplace exposure to lead, carbon disulphide,
phenoxyacids containing TCDD, as well as working in an environment where
aluminum is being electrolytically produced, is associated with stroke.
Somatic mutations
As
of
2017,
evidence
suggests
that
certain leukemia-
associated mutations in blood cells may also lead to increased risk of cardiovascular
disease. Several large-scale research projects looking at human genetic data have
found a robust link between the presence of these mutations, a condition known
as clonal hematopoiesis, and cardiovascular disease-related incidents and mortality.
Radiation therapy
Radiation treatments (RT) for cancer can increase the risk of heart disease and
death, as observed in breast cancer therapy. Therapeutic radiation increases the risk
of a subsequent heart attack or stroke by 1.5 to 4 times; the increase depends on the
dose strength, volume, and location. Use of concomitant chemotherapy, e.g.
anthracyclines, is an aggravating risk factor. The occurrence rate of RT induced
cardiovascular disease is estimated between 10% and 30%.
Side-effects from radiation therapy for cardiovascular diseases have been
termed radiation-induced
heart
disease or radiation-induced
cardiovascular
disease. Symptoms are dose-dependent and include cardiomyopathy, myocardial
fibrosis, valvular
arrhythmia and peripheral artery disease. Radiation-induced fibrosis, vascular cell
damage and oxidative stress can lead to these and other late side-effect symptoms.
Pathophysiology
Density-Dependent Colour Scanning Electron
Micrograph SEM (DDC-SEM) of cardiovascular calcification, showing in orange
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
581
calcium phosphate spherical particles (denser material) and, in green, the
extracellular matrix (less dense material)
Population-based studies show that atherosclerosis, the major precursor of
cardiovascular disease, begins in childhood. The Pathobiological Determinants of
Atherosclerosis in Youth (PDAY) study demonstrated that intimal lesions appear in
all the aortas and more than half of the right coronary arteries of youths aged 7–9
years.
Obesity and diabetes mellitus are linked to cardiovascular disease, as are a
history
of
chronic kidney
disease and hypercholesterolaemia.
fact,
cardiovascular disease is the most life-threatening of the diabetic complications and
diabetics are two- to four-fold more likely to die of cardiovascular-related causes
than nondiabetics.
Screening
Screening ECGs (either at rest or with exercise) are not recommended in those
without symptoms who are at low risk. This includes those who are young without
risk factors. In those at higher risk the evidence for screening with ECGs is
inconclusive. Additionally echocardiography, myocardial
and cardiac stress testing is not recommended in those at low risk who do not have
symptoms. Some biomarkers may add to conventional cardiovascular risk factors in
predicting the risk of future cardiovascular disease; however, the value of some
biomarkers is questionable. Ankle-brachial index (ABI), high-sensitivity C-reactive
protein (hsCRP), and coronary artery calcium, are also of unclear benefit in those
without symptoms as of 2018
The NIH recommends lipid testing in children beginning at the age of 2 if there
is a family history of heart disease or lipid problems. It is hoped that early testing
will improve lifestyle factors in those at risk such as diet and exercise.
Screening and selection for primary prevention interventions has traditionally
been done through absolute risk using a variety of scores (ex. Framingham or
Reynolds risk scores). This stratification has separated people who receive the
lifestyle interventions (generally lower and intermediate risk) from the medication
(higher risk). The number and variety of risk scores available for use has multiplied,
but their efficacy according to a 2016 review was unclear due to lack of external
validation or impact analysis. Risk stratification models often lack sensitivity for
population groups and do not account for the large number of negative events among
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
582
the intermediate and low risk groups. As a result, future preventative screening
appears to shift toward applying prevention according to randomized trial results of
each intervention rather than large-scale risk assessment.
Prevention
Up to 90% of cardiovascular disease may be preventable if established risk
factors are avoided. Currently practised measures to prevent cardiovascular disease
include:
Maintaining a healthy diet, such as the Mediterranean diet,
a vegetarian, vegan or another plant-based diet.
Replacing saturated fat with healthier choices: Clinical trials
show that replacing saturated fat with polyunsaturated vegetable oil
reduced CVD by 30%. Prospective observational studies show that in
many populations lower intake of saturated fat coupled with higher intake
of polyunsaturated and monounsaturated fat is associated with lower rates
of CVD.
Decrease div fat if overweight or obese. The effect of weight
loss is often difficult to distinguish from dietary change, and evidence on
weight reducing diets is limited. In observational studies of people with
severe obesity, weight loss following bariatric surgery is associated with a
46% reduction in cardiovascular risk.
Limit alcohol consumption to the recommended daily
limits. People who moderately consume alcoholic drinks have a 25–30%
lower risk of cardiovascular disease. However, people who are genetically
predisposed to consume less alcohol have lower rates of cardiovascular
disease suggesting that alcohol itself may not be protective. Excessive
alcohol intake increases the risk of cardiovascular disease and
consumption of alcohol is associated with increased risk of a
cardiovascular event in the day following consumption.
Decrease non-HDL cholesterol. Statin treatment reduces
cardiovascular mortality by about 31%.
smoking and
avoidance
of
second-hand
smoke. Stopping smoking reduces risk by about 35%.
At least 150 minutes (2 hours and 30 minutes) of moderate
exercise per week.
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
583
Lower blood pressure, if elevated. A 10 mmHg reduction in
blood pressure reduces risk by about 20%.Lowering blood pressure
appears to be effective even at normal blood pressure ranges.
Decrease psychosocial stress. This measure may be complicated
by imprecise definitions of what constitute psychosocial interventions.
Mental stress–induced myocardial ischemia is associated with an
increased risk of heart problems in those with previous heart disease.
Severe emotional and physical stress leads to a form of heart dysfunction
known as Takotsubo syndrome in some people. Stress, however, plays a
relatively minor role in hypertension. Specific relaxation therapies are of
unclear benefit.
Not enough sleep also raises the risk of high blood pressure.
Adults need about 7–9 hours of sleep. Sleep apnea is also a major risk as
it causes breathing to stop briefly, which can put stress on the div which
can raise the risk of heart disease.
Most guidelines recommend combining preventive strategies. There is some
evidence that interventions aiming to reduce more than one cardiovascular risk
factor may have beneficial effects on blood pressure, div mass index and waist
circumference; however, evidence was limited and the authors were unable to draw
firm conclusions on the effects on cardiovascular events and mortality.
There is additional evidence to suggest that providing people with a
cardiovascular disease risk score may reduce risk factors by a small amount
compared to usual care. However, there was some uncertainty as to whether
providing these scores had any effect on cardiovascular disease events. It is unclear
whether or not dental care in those with periodontitis affects their risk of
cardiovascular disease. According to a 2021 WHO study, working 55+ hours a week
raises the risk of stroke by 35% and the risk of dying from heart conditions by 17%,
when compared to a 35-40 hours week.
Diet
See also: Lipid hypothesis, Saturated fat and cardiovascular disease, and Salt
A diet high in fruits and vegetables decreases the risk of cardiovascular disease
and death.
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
584
A 2021 review found that plant-based diets can provide a risk reduction for
CVD if a healthy plant-based diet is consumed. Unhealthy plant-based diets do not
provide benefits over diets including meat. A similar meta-analysis and systematic
review also looked into dietary patterns and found "that diets lower in animal foods
and unhealthy plant foods, and higher in healthy plant foods are beneficial for CVD
prevention".A 2018 meta-analysis of observational studies concluded that "In most
countries, a vegan diet is associated with a more favourable cardio-metabolic profile
compared to an omnivorous diet."
Evidence suggests that the Mediterranean diet may improve cardiovascular
outcomes. There is also evidence that a Mediterranean diet may be more effective
than a low-fat diet in bringing about long-term changes to cardiovascular risk factors
(e.g., lower cholesterol level and blood pressure).
The DASH diet (high in nuts, fish, fruits and vegetables, and low in sweets, red
meat and fat) has been shown to reduce blood pressure, lower total and low density
lipoprotein cholesteroland improve metabolic syndrome; but the long-term benefits
have been questioned. A high-fiber diet is associated with lower risks of
cardiovascular disease.
Worldwide, dietary guidelines recommend a reduction in saturated fat, and
although the role of dietary fat in cardiovascular disease is complex and
controversial there is a long-standing consensus that replacing saturated fat with
unsaturated fat in the diet is sound medical advice. Total fat intake has not been
found to be associated with cardiovascular risk. A 2020 systematic review found
moderate quality evidence that reducing saturated fat intake for at least 2 years
caused a reduction in cardiovascular events. A 2015 meta-analysis of observational
studies however did not find a convincing association between saturated fat intake
and cardiovascular disease. Variation in what is used as a substitute for saturated fat
may explain some differences in findings The benefit from replacement
with polyunsaturated fats appears greatest, while replacement of saturated fats
with carbohydrates does not appear to have a beneficial effect. A diet high in trans
fatty acids is associated with higher rates of cardiovascular disease, and in 2015 the
Food and Drug Administration (FDA) determined that there was 'no longer a
consensus among qualified experts that partially hydrogenated oils (PHOs), which
are the primary dietary source of industrially produced trans fatty acids (IP-TFA),
are generally recognized as safe (GRAS) for any use in human food'. There is
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
585
conflicting evidence concerning whether dietary supplements of omega-3 fatty
acids (a type of polyunsaturated essential fatty acid) added to diet improve
cardiovascular risk.
The benefits of recommending a low-salt diet in people with high or normal
blood pressure are not clear. In those with heart failure, after one study was left out,
the rest of the trials show a trend to benefit. Another review of dietary salt concluded
that there is strong evidence that high dietary salt intake increases blood pressure
and worsens hypertension, and that it increases the number of cardiovascular disease
events; both as a result of the increased blood pressure and probably through other
mechanisms. Moderate evidence was found that high salt intake increases
cardiovascular mortality; and some evidence was found for an increase in overall
mortality, strokes, and left ventricular hypertrophy.
Intermittent fasting
Overall, the current div of scientific evidence is uncertain on
whether intermittent fasting could prevent cardiovascular disease. Intermittent
fasting may help people lose more weight than regular eating patterns, but was not
different from energy restriction diets.
Medication
Blood pressure medication reduces cardiovascular disease in people at
risk, irrespective of age, the baseline level of cardiovascular risk, or baseline blood
pressure. The commonly-used drug regimens have similar efficacy in reducing the
risk of all major cardiovascular events, although there may be differences between
drugs in their ability to prevent specific outcomes. Larger reductions in blood
pressure produce larger reductions in risk, and most people with high blood pressure
require more than one drug to achieve adequate reduction in blood
pressure. Adherence to medications is often poor, and while mobile phone text
messaging has been tried to improve adherence, there is insufficient evidence that it
alters secondary prevention of cardiovascular disease.
Statins are effective in preventing further cardiovascular disease in people with
a history of cardiovascular disease. As the event rate is higher in men than in women,
the decrease in events is more easily seen in men than women. In those at risk, but
without a history of cardiovascular disease (primary prevention), statins decrease the
risk of death and combined fatal and non-fatal cardiovascular disease. The benefit,
however, is small. A United States guideline recommends statins in those who have
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
586
a 12% or greater risk of cardiovascular disease over the next ten years.
Niacin, fibrates and CETP Inhibitors, while they may increase HDL cholesterol do
not affect the risk of cardiovascular disease in those who are already on
statins. Fibrates lower the risk of cardiovascular and coronary events, but there is no
evidence to suggest that they reduce all-cause mortality.
Anti-diabetic medication may reduce cardiovascular risk in people with Type
2 diabetes, although evidence is not conclusive. A meta-analysis in 2009 including
27,049 participants and 2,370 major vascular events showed a 15% relative risk
reduction in cardiovascular disease with more-intensive glucose lowering over an
average follow-up period of 4.4 years, but an increased risk of major hypoglycemia.
Aspirin has been found to be of only modest benefit in those at low risk of heart
disease, as the risk of serious bleeding is almost equal to the protection against
cardiovascular problems. In those at very low risk, including those over the age of
70, it is not recommended. The United States Preventive Services Task
Force recommends against use of aspirin for prevention in women less than 55 and
men less than 45 years old; however, it is recommended for some older people.
The use of vasoactive agents for people with pulmonary hypertension with left
heart disease or hypoxemic lung diseases may cause harm and unnecessary expense.
Antibiotics for secondary prevention of coronary heart disease
Antibiotics may help patients with coronary disease to reduce the risk of heart
attacks and strokes. However, evidence in 2021 suggests that antibiotics for
secondary prevention of coronary heart disease are harmful, with increased mortality
and occurrence of stroke; the use of antibiotics is not supported for preventing
secondary coronary heart disease.
Physical activity
Exercise-based cardiac rehabilitation following a heart attack reduces the risk
of death from cardiovascular disease and leads to less hospitalizations. There have
been few high-quality studies of the benefits of exercise training in people with
increased cardiovascular risk but no history of cardiovascular disease.
A systematic review estimated that inactivity is responsible for 6% of the
burden of disease from coronary heart disease worldwide. The authors estimated that
121,000 deaths from coronary heart disease could have been averted in Europe in
2008 if people had not been physically inactive. Low-quality evidence from a limited
number of studies suggest that yoga has beneficial effects on blood pressure and
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
587
cholesterol.
Tentative evidence suggests that home-based exercise programs may be
more efficient at improving exercise adherence.
Dietary supplements
While a healthy diet is beneficial, the effect of antioxidant supplementation
(vitamin E, vitamin C, etc.) or vitamins has not been shown to protect against
cardiovascular disease and in some cases may possibly result in harm. Mineral
supplements have also not been found to be useful. Niacin, a type of vitamin B3,
may be an exception with a modest decrease in the risk of cardiovascular events in
those at high risk. Magnesium supplementation lowers high blood pressure in a
dose-dependent manner. Magnesium therapy is recommended for people with
ventricular arrhythmia associated with torsades de pointes who present with long
QT syndrome, and for the treatment of people with digoxin intoxication-induced
arrhythmias. There is no evidence that omega-3 fatty acid supplementation is
beneficial. A
2022 review found
that
some dietary
including micronutrients, may reduce risk factors for cardiovascular disease.
Management
Cardiovascular disease is treatable with initial treatment primarily focused on
diet and lifestyle interventions.
Influenza may make heart attacks and strokes more
likely and therefore influenza vaccination may decrease the chance of
cardiovascular events and death in people with heart disease.
Proper CVD management necessitates a focus on MI and stroke cases due to
their combined high mortality rate, keeping in mind the cost-effectiveness of any
intervention, especially in developing countries with low or middle-income
levels. Regarding MI, strategies using aspirin, atenolol, streptokinase or tissue
plasminogen activator have been compared for quality-adjusted life-year (QALY)
in regions of low and middle income. The costs for a single QALY for aspirin and
atenolol were less than US$25, streptokinase was about $680, and t-PA was
$16,000. Aspirin, ACE inhibitors, beta-blockers, and statins used together for
secondary CVD prevention in the same regions showed single QALY costs of $350.
There are also surgical or procedural interventions that can save someone's life
or prolong it. For heart valve problems, a person could have surgery to replace the
valve. For arrhythmias, a pacemaker can be put in place to help reduce abnormal
heart rhythms and for a heart attack, there are multiple options two of these are
a coronary angioplasty and a coronary artery bypass surgery.
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
588
There is probably no additional benefit in terms of mortality and serious
adverse events when blood pressure targets were lowered to ≤ 135/85 mmHg from
≤ 140 to 160/90 to 100 mmHg.
Epidemiology
Cardiovascular diseases deaths per
million persons in 2012
318–925
926–1,148
1,149–1,294
1,295–1,449
1,450–1,802
1,803–2,098
2,099–2,624
2,625–3,203
3,204–5,271
5,272–10233
Disability-adjusted
life
year
for
cardiovascular diseases per 100,000 inhabitants in 2004
no data
<900
900–1650
1650–2300
2300–3000
3000–3700
3700–4400
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
589
4400–5100
5100–5800
5800–6500
6500–7200
7200–7900
>7900
Cardiovascular diseases are the leading cause of death worldwide and in all
regions except Africa. In 2008, 30% of all global death was attributed to
cardiovascular diseases. Death caused by cardiovascular diseases are also higher in
low- and middle-income countries as over 80% of all global deaths caused by
cardiovascular diseases occurred in those countries. It is also estimated that by 2030,
over 23 million people will die from cardiovascular diseases each year.
It is estimated that 60% of the world's cardiovascular disease burden will occur
in the South Asian subcontinent despite only accounting for 20% of the world's
population. This may be secondary to a combination of genetic predisposition and
environmental factors. Organizations such as the Indian Heart Association are
working with the World Heart Federation to raise awareness about this issue.
References
1.
. Mayo Clinic. 2022-08-25.
2.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ,
Berry JD, Borden WB, et al. (January 2013).
"Heart disease and stroke statistics--
. Circulation.
127
(1): e6
3.
M, Pekka P, Norrving B (2011).
Global Atlas on Cardiovascular Disease Prevention
(PDF). World Health Organization in collaboration with the World
Heart Federation and the World Stroke Organization. pp. 3–18.
(PDF) from the original on 2014-08-17.
4.
Naghavi M, Wang H, Lozano R, Davis A, Liang
X, Zhou M, et al. (GBD 2013 Mortality and Causes of Death Collaborators) (January
2015).
"Global, regional, and national age-sex specific all-cause and cause-specific
. Lancet.
385
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
590
5.
Wang H, Naghavi M, Allen C, Barber RM, Bhutta
ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators)
(October 2016).
"Global, regional, and national life expectancy, all-cause mortality,
. Lancet.
388
(10053): 1459–
6.
Petersen KS, Kris-Etherton PM (2021-11-28).
assessment and the relationship between diet quality and cardiovascular disease
risk"
. Nutrients.
13
(12):
7.
Jackson CL, Redline S, Emmons KM (March
"Sleep as a potential fundamental contributor to disparities in cardiovascular
. Annual Review of Public Health.
36
8.
Wang R, Dong Y, Weng J, Kontos EZ, Chervin RD,
Rosen CL, et al. (January 2017).
"Associations among Neighborhood, Race, and
Sleep Apnea Severity in Children. A Six-City Analysis"
. Annals of the American
Thoracic
Society.
14
9.
McGill HC, McMahan CA, Gidding SS (March
"Preventing heart disease in the 21st century: implications of the
. Circulation.
117
(9): 1216–
10.1161/CIRCULATIONAHA.107.717033
10.
O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H,
"Global and regional effects of potentially modifiable risk
factors associated with acute stroke in 32 countries (INTERSTROKE): a case-
control study"
. Lancet.
388
11.
Spinks A, Glasziou PP, Del Mar CB (2021-12-09).
treatment of sore throat in children and adults"
. The Cochrane Database of
Systematic
Reviews.
2021
(12):
10.1002/14651858.CD000023.pub5
12.
Sutcliffe P, Connock M, Gurung T, Freeman K, Johnson S,
Ngianga-Bakwin K, et al. (2013).
"Aspirin in primary prevention of cardiovascular
disease and cancer: a systematic review of the balance of evidence from reviews of
randomized
. PLOS
ONE.
8
(12):
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
591
13.
Sutcliffe P, Connock M, Gurung T, Freeman K, Johnson S,
Kandala NB, et al. (September 2013).
"Aspirin for prophylactic use in the primary
prevention of cardiovascular disease and cancer: a systematic review and overview
of
17
(43): 1–
14.
Institute of Medicine of the National Academies
"Epidemiology of Cardiovascular Disease"
. In Fuster V, Kelly BB
(eds.). Promoting cardiovascular health in the developing world : a critical challenge
to achieve global health. Washington, DC: National Academies Press.
from the original on 2017-09-08.
15.
Moran AE, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M,
Murray CJ, et al. (April 2014).
"Temporal trends in ischemic heart disease mortality
in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010
study"
. Circulation.
129
(14): 1483–
10.1161/circulationaha.113.004042
16.
. World Health Organization. 2009. Archived from
11-11.
17.
. www.nlm.nih.gov.
Retrieved 2015-06-23.
18.
Fuster V, Kelly BB, eds. (2010). Promoting Cardiovascular Health
in the Developing World: A Critical Challenge to Achieve Global Health.
Washington, DC: National Academies Press.
19.
Finks SW, Airee A, Chow SL, Macaulay TE, Moranville MP,
Rogers KC, et al. (April 2012).
"Key articles of dietary interventions that influence
. Pharmacotherapy.
32
20.
Micha R, Michas G, Mozaffarian D (December
"Unprocessed red and processed meats and risk of coronary artery disease
and type 2 diabetes--an updated review of the evidence"
. Current Atherosclerosis
Reports.
14
21.
Ciaccio EJ, Lewis SK, Biviano AB, Iyer V, Garan
"Cardiovascular involvement in celiac disease"
. World
Journal
of
Cardiology (Review).
9
(8): 652–
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 3, ISSUE 01, 2025. YANUARY
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
592
22.
Duell PB, Welty FK, Miller M, Chait A, Hammond G, Ahmad Z,
"Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: A
Scientific Statement From the American Heart Association"
. Arteriosclerosis,
Thrombosis,
and
Vascular
Biology.
42
(6): e168
23.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al.
(2004). "Effect of potentially modifiable risk factors associated with myocardial
infarction
in
52
countries
(the
INTERHEART
study):
case-control
study". Lancet.
364
24.
Current medical diagnosis & treatment
. New
York: McGraw-Hill Medical. pp.
25.
Eckel RH (November 1997). "Obesity and heart disease: a
statement for healthcare professionals from the Nutrition Committee, American
Heart
Association". Circulation.
96
(9): 3248–
26.
Kathiresan S, Srivastava D (March 2012).
. Cell.
148
(6): 1242–
27.
Semsarian C, Ingles J, Ross SB, Dunwoodie SL,
Bagnall RD, Kovacic JC (2021-05-25).
"Precision Medicine in Cardiovascular
Disease: Genetics and Impact on Phenotypes: JACC Focus Seminar 1/5"
. Journal of
the
American
College
of
Cardiology.
77
(20): 2517–
28.
https://en.wikipedia.org/wiki/Cardiovascular_disease
