Cardiovascular Disease Overview

• Cardiovascular diseases are diseases of the heart and blood vessels.
• Common types of cardiovascular disease include hypertension, coronary heart disease, stroke, heart failure, and peripheral arterial disease.

Startling CVD Facts

• Every 37 seconds, someone dies from CVD in the U.S.
• Annually, CVD causes around death to 647,000 death in the US.
• CVD accounts for 1 in every 4 deaths. Coronary heart disease is the most prevalent form of CVD.

What is Coronary Heart Disease?

• Coronary Heart Disease (CHD), also known as Coronary Artery Disease

Heart Anatomy Basics

• The heart, a muscular pump, consists of four chambers: the upper atria and lower ventricles.
• The heart requires a constant supply of blood to provide oxygen for muscle contraction, similar to other tissues

Coronary Artery Disease

• CAD results from the buildup of fat and cholesterol deposits called plaques in the coronary arteries.
• Atherosclerosis is the process through which plaque partially or completely blocks blood flow to the heart.

CAD and Atherosclerosis

• Atherosclerosis involves the accumulation of lipid deposits, or plaque, in large and medium-sized arteries.
• Atherosclerosis is a gradual disease process that typically starts early in life.
• Atherosclerosis occurs because of the "response to injury".

Response to Injury

• Endothelial damage to the inner lining of blood vessels can be triggered by physical or toxic stress.
• Cardiovascular risk factors may potentially cause endothelial lining damage.

Inflammatory Response

• During inflammation, monocytes adhere to the injury site.
• Monocytes are white blood cells that ingest dead or damaged cells, then develop into macrophages.
• Macrophages at the injury site destroy foreign substances or antigens.
• Macrophages ingest modified lipids, such as oxidized LDL (bad cholesterol).
• Macrophages that have ingested modified lipids transform into foam cells, which develop into fatty streaks.

Cholesterol

• Cholesterol is a fat derived in the body that is needed for cell and hormone synthesis.
• LDL (low-density lipoprotein) transports cholesterol from the liver to the body's periphery and consists of protein, triglycerides, and mostly cholesterol.
• HDL (high-density lipoprotein) transports cholesterol toward the liver for breakdown and consists majorly of protein.
• LDL stores cholesterol in the bloodstream, but HDL regulates LDL storage and promotes excretion.

Attempt for Repair

• The body attempts to repair the injured site.
• Growth factors released lead to the formation of a connective tissue matrix.
• With the accumulation of additional lipids, smooth muscle cells, and toxins in the blood, the process will eventually result into a fibrous plaque.

Myocardial Infarction (Heart Attack)

• Heart attack happens when the blood supply to the heart muscle itself (the myocardium) is severely reduced or stopped.
• The blocked blood supply occurs from one or more of the coronary arteries to the heart muscle.
• Buildup of plaque (deposits of fat-like substances), in a process called atherosclerosis, causes the blockage.

Stressful Situations & Strenuous Activity

• Increases central nervous system stimulation, heart rate, and blood pressure.
• Atherosclerotic plaque restricts blood flow.
• Myocardial oxygen demand increases.
• Ischemia, indicated by a lack of oxygen occurs an oxygen supply is less than oxygen demand.
• A heart attack causes myocardial cell death.

Risk Factors for CAD

• Modifiable risk factors include behaviors and cardio-metabolic factors.

Modifiable Behaviors

• Smoking negatively affects endothelium function and exacerbates hypertension, a sedentary lifestyle, and an abnormal lipid profile.
• Chronic stress increases SNS activity & socioeconomic status and social interaction affect behaviors.
• Sedentary Lifestyle promotes physiological, biochemical, and metabolic adaptation that reduces cardio-metabolic risk factors, improving oxygen transport efficiency and reduces systemic inflammation.
• Increasing fruit and vegetable consumption leads to increasing anti-oxidant and phytochemical intake reduces oxidation and inflammation.

Modifiable Cardio-Metabolic Factors

• Abnormal blood lipids contribute to lipid deposits in vascular walls and to endothelium dysfunction.
• Hypertension strains vascular walls, potentially causing dysfunction and damage while incresing the load on the left ventricle.
• Obesity can increase inflammation.
• Behaviors that contribute to weight gain contributes to CAD simultaneously.
• Insulin resistance is associated with abnormal lipids and hypertension.
• Abdominal adiposity often coexists with other factors such as abnormal blood lipids, hypertension, and impaired fasting glucose.

Overview of cardiovascular diseases (CVD), including common types like hypertension and coronary heart disease. Learn about startling CVD facts, such as the frequency of deaths in the U.S. and the prevalence of coronary heart disease. Also, understanding heart anatomy and coronary artery disease.