Cardiovascular Disease Overview

Also indexed as:

Circulatory Disease, Heart Disease

See also:

• Angina
• Atherosclerosis
• Cardiac Arrhythmia
• Cardiomyopathy
• Chronic Venous Insufficiency
• Type 2 Diabetes
• Heart Attack
• High Cholesterol
• High Homocysteine
• High Triglycerides
• Hypertension
• Insulin Resistance Syndrome
• Mitral Valve Prolapse
• Stroke

What you need to know

A heart-to-heart on cardiovascular disease: Make simple changes to help you beat the odds against heart disease, a leading cause of death. According to research or other evidence, the following self-care steps may be helpful:

• Get smoke-free
• Quit smoking and stay clear of cigarette smoke to lower your risk of several types of cardiovascular disease

• Watch what you eat
• Eat lots of fruits, vegetables, legumes, whole grains, fish, and avoid fats from meat, dairy, and processed foods high in hydrogenated oils

• Stay active
• Couch potatoes have increased cardiovascular disease risk, so make sure you get regular exercise

• Get tested
• See your healthcare provider to find out if you have problems with high blood pressure or high blood levels of cholesterol, triglycerides, or glucose

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full cardiovascular disease article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About 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.⁷Overweight 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?

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

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,¹³fiber,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 vegetables-compared with those eating a diet low in fruits and vegetables.¹⁹

Lifestyle changes that may be helpful

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

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

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2. Kinosian B, Glick H, Garland G. Cholesterol and coronary heart disease: predicting risks by levels and ratios. Ann Intern Med 1994;121:641-7.
3. Kwiterovich PO Jr. The antiatherogenic role of high-density lipoprotein cholesterol. Am J Cardiol 1998;82:Q13-21 [review].
4. Gotto AM Jr. Triglyceride as a risk factor for coronary artery disease. Am J Cardiol 1998;1998;82:Q22-5 [review].
5. Seman LJ, McNamara JR, Schaefer EJ. Lipoprotein(a), homocysteine, and remnantlike particles: emerging risk factors. Curr Opin Cardiol 1999;14:186-91.
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15. Albert CM, Hennekens CH, O'Donnell CJ, et al. Fish consumption and risk of sudden cardiac death. JAMA 1998;279:23-8.
16. Hu FB, Stampfer MJ, Rimm E, et al. Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. Am J Epidemiol 1999;149:531-40.
17. Strandhagen E, Hansson PO, Bosaeus I, et al. High fruit intake may reduce mortality among middle-aged and elderly men. The Study of Men Born in 1913. Eur J Clin Nutr 2000;54:337-41.
18. Kinosian B, Glick H, Garland G. Cholesterol and coronary heart disease: predicting risks by levels and ratios. Ann Intern Med 1994;121:641-7.
19. Kannel WB. Hazards, risks, and threats of heart disease from the early stages to symptomatic coronary heart disease and cardiac failure. Cardiovasc Drugs Ther 1997;11 Suppl:199-212 [review].
20. Freund KM, Belanger AJ, D'Agostino RB, Kannel WB. The health risks of smoking. The Framingham Study: 34 years of follow-up. Ann Epidemiol 1993;3:417-24.
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Last Review: 09-07-2006

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