Ways you can avoid cardiovascular disease
Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, generally in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed cardiovascular disease.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelines allow treatment to be targeted according to simple predictions of absolute cardiovascular risk.
The debilitating and often fatal complications of cardiovascular disease are usually seen in middle-aged or elderly men and women. However, atherosclerosis – the main pathological process leading to coronary artery disease, cerebral artery disease and peripheral artery disease – begins early in life and progresses gradually through adolescence and early adulthood (15–17). It is usually asymptomatic for a long period.
The rate of progression of atherosclerosis is influenced by cardiovascular risk factors: tobacco use, an unhealthy diet and physical inactivity (which together result in obesity), elevated blood pressure (hypertension), abnormal blood lipids and elevated blood glucose (diabetes). Continuing exposure to these risk factors leads to further progression of atherosclerosis, resulting in unstable atherosclerotic plaques, narrowing of blood vessels and obstruction of blood flow to vital organs, such as the heart and the brain. The clinical manifestations of these diseases include angina, myocardial infarction, transient cerebral ischaemic attacks and strokes. Given this continuum of risk exposure and disease, the division of prevention of cardiovascular disease into primary, secondary and tertiary prevention is arbitrary, but may be useful for development of services by different parts of the health care system. The concept of a specific threshold for hypertension and high blood cholesterol is also based on an arbitrary dichotomy.
The purpose of applying the recommendations elaborated in these guidelines is to motivate and assist high-risk individuals to lower their cardiovascular risk by:
● Smoking cessation or reducing the amount smoked.
● Making healthy food choices.
● Being physically active and achieving the health recommendation goals of more than 10,000 steps a day.
● Lowering body mass index and waist–hip ratio (to less than 0.8 in women and 0.9 in men (these figures may be different for different ethnic groups).
● Lowering blood total cholesterol
● Controlling blood sugar levels, especially in those with impaired fasting blood sugars and impaired glucose tolerance or diabetes.
● Lowering blood pressure.
Taking aspirin (75 mg daily), once blood pressure has been controlled estimates of relative risk per unit increase in continuous risk factors.
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Cardiac Exercise Specialist