Cardiovascular disease

Cardiovascular disease (CVD) is an umbrella term for disorders of the heart (‘cardio’) and blood vessels (‘vascular’). Cardiovascular diseases lead to a gradual or sudden reduction of blood supply to the heart, brain, legs and other parts of the body due to:

  • Thrombosis - sudden obstruction of a blood vessel by a blood clot
  • Atherosclerosis - hardening and narrowing of arteries due to fatty deposits (atherosclerotic plaques) 

Types of CVD

  • Coronary artery disease (CAD)
    , also called coronary heart disease (CHD) or ischaemic heart disease (IHD)
  • Cerebrovascular disease (CVD), including a stroke and TIA (mini-stroke)
  • Peripheral vascular disease (PVD), sometimes called peripheral arterial disease (PAD)

Coronary artery disease

CAD is due to a build-up of atherosclerotic plaques in coronary arteries that supply the heart muscle. The plaques narrow the coronary arteries reducing blood flow and, therefore, supply nutrients and oxygen to the heart muscle, which manifests with angina, exertional chest discomfort. Anginal pain feels like a tightness, heaviness, squeezing or constricting sensation across the chest, radiating to the left arm, neck and jaw. It is triggered by physical exercise or mental stress and relieved with rest or medicines, such as nitrate (GTN) spray. In a heart attack, the blood supply to the heart muscle is suddenly cut off by an atheroma or blood clot, which blocks the coronary artery and can lead to scarring of the heart. 

Cerebrovascular disease

A stroke is a serious medical emergency where the blood supply to a part of the brain is restricted or blocked. Like all other organs, the brain also receives oxygen and nutrients from the blood. If the blood supply to an area of the brain is cut off or an artery in the brain bursts, the brain cells get damaged, which leads to serious and usually permanent consequences. Therefore, prompt treatment is required to restore sufficient blood flow to the brain or stop the bleeding.

There are two types of stroke:

  • Ischaemic stroke- blood clot restricts blood supply to certain brain areas.
  • Haemorrhagic stroke- blood leaks out of the weakened blood vessels and causes damage to the surrounding brain tissue.

Peripheral vascular disease

Peripheral arterial disease or peripheral vascular disease occurs when arteries in the legs are narrowed or blocked by atherosclerotic plaques. Pain in the legs called intermittent claudication is the most common symptom of peripheral vascular disease. It can involve one or both legs, hips or calves. Intermittent claudications may feel like a cramp or dull ache in the legs. This cramp or heaviness in the legs worsens during activities, such as walking or climbing stairs.

Impact on public health

Cardiovascular disease is the top cause of mortality in the UK and other developed countries. CVD cause 1/3 of all deaths (about 150,000 cases annually) in England, out of which approx. 70,000 are due to coronary artery disease, and 40,000 are caused by stroke.

At present, about 5.6 million people are living with cardiovascular disease in England. Lifestyle changes and medication can prevent premature deaths caused by CVD. It has been estimated that 1/3 and 1/5 premature deaths in men and women respectively are caused by cardiovascular disease.

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