HEART DISEASE

Heart Disease- The causes, the effects, treatments, and how to decline your chances of getting it

Heart Disease- The causes, the effects, treatments, and how to decline your chances of getting it

Introduction

Cardiovascular disease (CVD) is the number-one killer of men and women in industrialised countries. In men above age forty and in women above age sixty CVD is the most important cause of death. In older age groups, CVD is also the most important cause for hospitalization. Furthermore, in many countries, heart disease is an important cause of early retirement from work. Thus, CVD is associated with enormous costs for care and loss of productivity, as well as for disabilities, pensions, and so on. (Hill, 1965) Furthermore, it is the cause of acute and prolonged suffering in many people. All this has motivated clinicians and scientists to develop and implement new methodologies and technologies to better care for patients who are hospitalised for heart disease. Efforts to improve care in the acute phases of coronary heart disease (CHD), the most common CVD, have been very successful. In the 1960s and 1970s, the initiation of intensive coronary care units (ICCUs) with continuous monitoring of cardiac activity and prompt therapy of life-threatening complications substantially reduced mortality rates. In an early Swedish trial, patients were randomised to intensive coronary care or traditional inpatient care without continuous surveillance. (Biörck, 1973) Mortality fell by 50% in the former group.

During the last decade, the immediate mortality risk of a patient admitted to coronary care for a suspected myocardial infarction (MI) or other acute coronary syndrome has further decreased to less than 10%. This can be ascribed to various attempts to limit infarct size before the full development of the myocardial damage has occurred. Thrombolysis, beta blockade, angiotensin converting enzyme inhibitors for patients with early signs of heart failure, and acute surgery have all contributed to these remarkable gains in human lives and well-being

Despite these achievements, CVD continues to represent a major threat to the health of middle-aged and elderly men and women. This is particularly true for middle-aged men in high-risk groups. In men under 65, more than half of deaths from CHD are sudden cardiac deaths. (Wikland, 1971) This usually means that they occur before the patient has had a chance to be admitted to a hospital and benefit from the technological advancements of modern acute care. Sudden cardiac deaths often come as a complete surprise, without any known or noticed premonitory symptoms. In a few fortunate cases, the patient happens to be in a place where resuscitation competence and equipment are available. Most often, however, these deaths are medically unattended. Therefore, to prevent or postpone these deaths, it seems necessary to address the underlying process before it becomes symptomatic. Sudden cardiac death is less frequent in women than in men, and with increasing age its frequency decreases in both genders. However, the total number of sudden deaths is so large that powerful actions and measures are necessary to deal with the ...