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)
    , sometimes 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 (fatty deposits) in coronary arteries that supply the heart muscle with blood. The plaques lead to narrowings in the coronary arteries which reduce blood flow and therefore supply of nutrients and oxygen to the heart muscle which manifests with exertional chest discomfort called angina. Anginal pain feels like a tightness, heaviness, squeezing or constricting sensation across the chest which can radiate 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, blood supply to the heart muscle is suddenly cut off by a blockage of coronary artery with an atheroma or blood clot which leads to damage and scarring of the heart. 

Cerebrovascular disease

Stroke is a serious medical emergency where blood supply to a part of the brain is restricted or blocked. Like all other organs, brain also receives oxygen and nutrients through the blood. If blood supply to an area of brain is cut off or an artery in the brain bursts, the brain cells begin to die which leads to a serious and usually permanent damage. 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 the certain areas of the brain
  • 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 legs are narrowed or blocked by atherosclerotic plaques. Pain in 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 comes and goes, becoming worse during the activity, such as walking or climbing stairs.

Impact on public health

Cardiovascular disease is the top cause of mortality in the UK as well as in other developed countries. CVD caused 1/3rd of deaths (about 159,000 cases) in England in 2007, out of which 74,000 were due to coronary artery disease and 44,000 were 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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