Heart Disease and Stroke





What is Cardiovascular Disease?

From the World Health Organization (2013):

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and they 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.

Source: WHO. 2013. Cardiovascular diseases (CVDs). Fact sheet 317.

CVD Risk in Children

  • Atherosclerotic cardiovascular disease risk factors begin in childhood
  • A child’s health and behavior has long term consequences for their likelihood of developing Cardio-vascular Disease as an adult. According to the NIH, Atherosclerotic cardiovascular disease (CVD) is the leading cause of death in North Americans but it is rare for adolescents to develop the disease. However, there is a significant rise in the development of risk factors for CVD in youth.

Prevalence

  • The prevalence of obesity, a significant risk factor for CVD, is increasing in the U.S., particularly in children
  • African American adults have one of the highest rates of hypertension in the world at 44%

Source: AMA. Go A S et al. Circulation 2013;127:e6-e245.

Data Sources: CDC, National Vital Statistics System and the U.S. Census Bureau.

From the Centers for Disease Control (2012):

Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men.

  • About 600,000 Americans die from heart disease each year—that’s 1 in every 4 deaths.
  • Coronary heart disease is the most common type of heart disease, killing more than 385,000 people annually.
  • In the United States, someone has a heart attack every 34 seconds. Each minute, someone in the United States dies from a heart disease-related event.
  • Heart disease is the leading cause of death for people of most racial/ethnic groups in the United States, including African Americans, Hispanics, and whites. For Asian Americans or Pacific Islanders and American Indians or Alaska Natives, heart disease is second only to cancer.
  • Coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and lost productivity.

Source: Centers for Disease Control. 2012. Heart Disease Fact sheet.

Risk Factors

From the Centers for Disease Control (2012):

High blood pressure, high LDL cholesterol, and smoking are key heart disease risk factors for heart disease. About half of Americans (49%) have at least one of these three risk factors.5 Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including:

  • Diabetes
  • Overweight and obesity
  • Poor diet
  • Physical inactivity
  • Excessive alcohol use

Source: Centers for Disease Control. 2012. Heart Disease Fact sheet.

  • The following factors each individually put the child at greater risk for CVD, but when clustered together the risk increases.

    • Childhood obesity is strongly linked to obesity in adulthood. According to one study 84% of those with a high BMI as children were obese as adults and all children with a very high BMI were obese as adults.
    • High cholesterol and blood pressure as a child has consistently been found to be associated with high cholesterol and blood pressure as an adult. Children who are also obese have a higher risk.
  • Children who start tobacco use young are likely to persist use into adulthood and have an approximately 50% chance of becoming a lifetime smoker.
  • Lack of physical activity and poor nutritional diets are also risk factors for CVD which can follow from childhood to adulthood.
  • Socioeconomic factors such as low -income, low-education level, higher-unemployment households increase risk of obesity

Source: NHLBI. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report.

References