Cardiovascular disease

Cardiovascular disease (CVD) is an umbrella term for disorders of the heart (‘cardio’) and blood vessels (‘vascular’). Consequence of a cardiovascular disease is a reduction in blood flow to the heart, brain, legs and other parts of the body due to:

  • Thrombosis- blood clot suddenly obstructing blood vessels
  • Atherosclerosis- hardening and narrowing of arteries due to fatty deposits (atherosclerotic plaques)

Types of CVD

Major types of cardiovascular disease include:

  • Coronary artery disease (CAD), sometimes also called coronary heart disease (CHD) or ischaemic heart disease (IHD)
  • Cerebrovascular disease, stroke and TIA (mini stroke)
  • Peripheral arterial disease (PAD)

These three types of CVD are briefly described below.

Coronary artery disease (CAD)

There are two arteries that supply blood to the heart called right and left coronary arteries. CAD occurs when a blood clot or atheroma (fatty deposits) blocks the coronary arteries.

Built-up fatty deposits narrow the coronary arteries causing an exertional chest discomfort called angina. If an atheroma or blood clot completely blocks the coronary artery it causes heart attack. Anginal pain feels like a squeezing or constricting sensation across the chest. It is triggered by physical exercise or mental stress and relieved with rest or medicines, such as nitrate spray. In heart attack, blood supply to heart muscle is suddenly cut off which leads to damage and scar.

Cerebrovascular disease, stroke and TIA

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 this blood supply to an area of brain is cut off, the cells of brain begin to die causing serious and usually permanent damage. Therefore, prompt treatment is required to restore sufficient blood flow to the brain and avoid irreversible problems.

Stroke can be of two types:

  • 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 arterial disease (PAD)

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. You may feel like a cramp or dull ache in your legs. This cramp or heaviness in the legs comes and goes, becoming worse during the activity like walking or climbing stairs.

Impact on public health

Cardiovascular disease is the top cause of mortality in England as well in the world. CVD caused 1/3rd (about 159,000 cases) of deaths 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 in 3 and 1 in 5 premature deaths in men and women respectively are caused by cardiovascular disease.