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Cardiovascular Disease

Cardiovascular disease is a wide-encompassing category that includes all conditions that affect the heart and the blood vessels.

Cardiovascular disease is the number one cause of death in the United States. This introductory article briefly discusses several diseases that have a role in the development of cardiovascular disease. Many risk factors are associated with cardiovascular disease; most can be managed, but some cannot. The aging process and hereditary predisposition are risk factors that cannot be altered. Until age 50, men are at greater risk than women of developing heart disease, though once a woman enters menopause, her risk triples.1

Many people with cardiovascular disease have elevated or high cholesterol levels.2 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 is total cholesterol.3 A blood test, administered by most healthcare professionals, is used to determine cholesterol levels.

Atherosclerosis (hardening of the arteries) of the vessels that supply the heart with blood is the most common cause of heart attacks. Atherosclerosis and high cholesterol usually occur together, 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, a high triglyceride level is an independent risk factor for heart disease in some people.4

High homocysteine levels have been identified as an independent risk factor for heart disease.5 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.6 Glucose intolerance and diabetes constitute separate risk factors for heart disease. Smoking increases the risk of heart disease caused by hypertension.

Abdominal fat, or a “beer belly,” versus fat that accumulates on the hips, is associated with increased risk of cardiovascular disease and heart attack.7 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.

What are the symptoms of cardiovascular disease?

People with cardiovascular disease may not have any symptoms, or 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.

Dietary changes that may be helpful for cardiovascular disease overview

Preliminary evidence has linked high salt consumption with increased cardiovascular disease incidence and death among overweight, but not normal weight, people. Among overweight people, an increase in salt consumption of 2.3 grams per day was associated with a 32% increase in stroke incidence, an 89% increase in stroke mortality, a 44% increase in heart disease mortality, a 61% increase in cardiovascular disease mortality, and a 39% increase in death from all causes.8 Intervention trials are required to confirm these preliminary observations.

Moderate alcohol consumption appears protective against heart disease.9 However, regular, light alcohol consumption in men with established coronary heart disease is not associated with either benefit or deleterious effect.10

A high intake of carotenoids from dietary sources has been shown to be protective against heart disease in several population-based studies.11 12 A diet high in fruits and vegetables,13 fiber,14 and possibly fish15 appears protective against heart disease, while a high intake of saturated fat (found in meat and dairy fat) and trans fatty acids (in margarine and processed foods containing hydrogenated vegetable oils)16 may contribute to heart disease. In a preliminary study, the total number of deaths from cardiovascular disease was significantly lower among men with high fruit consumption17 than among those with low fruit consumption. A large study of male healthcare professionals found that those men eating mostly a “prudent” diet (high in fruits, vegetables, legumes, whole grains, fish, and poultry) had a 30% lower risk of heart attacks compared with men who ate the fewest foods in the “prudent” category.18 By contrast, men who ate the highest percentage of their foods from the “typical American diet” category (high in red meat, processed meat, refined grains, sweets, and desserts) had a 64% increased risk of heart attack, compared with men who ate the fewest foods in that category. The various risks in this study were derived after controlling for all other beneficial or harmful influencing factors.

A parallel study of female healthcare professionals showed a 15% reduction in cardiovascular risk for those women eating a diet high in fruits and vegetablescompared with those eating a diet low in fruits and vegetables.19

Lifestyle changes that may be helpful for cardiovascular disease overview

Both smoking20 and exposure to secondhand smoke21 increase cardiovascular disease risk.

Moderate exercise protects both lean and obese individuals from cardiovascular disease.22