3-PAGES SUMMARY FOR CARDIOVASCULAR HEALTH AND RISK

CVD is a non-communicable disease as it doesn’t spread between individuals. Smoking increases the
probability/risk of CVD. Therefore, it’s a risk factor for CVD. This is because smoking can be a
causation for atherosclerosis. Smoking is not the only factor, so CVD is a multifactorial disease. Still,
smoking does make a correlation with mortality data from atherosclerosis. Studying the patterns of
CVDs with smoking causation of atherosclerosis is a basis of CVD epidemiology. Our personal
perceptions of risk are based on our familiarity, enjoyment, approvement of the activity.

…………………………………………………………………………………………………………………………………………………………….

When designing a study, it should be made bigger. This will make it more meaningful and will make
more space for patterns to occur (epidemiology). If extra value is wanted, longitudinal studies can
be used where the same individuals are tracked over time with the changes in their lifestyle. When
data from all available studies are analysed, a metadata analysis is formed. The way we may know
which advises from TV studies are best is to check three main things.

 Validity – if it answers the scientists’ questions.

 Precision – If the range of measurements is close.
 Reliability- if it is repeatable by other scientists who got similar results.

Then who and where may be known to decide if it got biased. Evaluation of the studies’ conclusions
can then be carried out. The 3 non-modifiable CVD risk factors are.

 Genes: Arteries easily damaged, tendency to develop hypertension, cholesterol balance

problems are all genetic; Identical twins are excellent to carry out a genetic study.
 Age: decreasing elasticity and decreasing lumen in vessels with age.
 Gender: Under 50, women are less likely to get CVD as oestrogen partially protects against
CVDs.

…………………………………………………………………………………………………………………………………………………………….

Lifestyle also applies to CVRs. These are.

 Smoking: contains nicotine which damages artery lining and narrows the arteries increasing
blood pressure.
 Inactivity: Activity lowers blood pressure, stress, obesity & diabetes, blood cholesterol levels,
and it also balances lipoproteins. These reduce CVRs. Many studies show that regular
exercise reduces CVRs and mortality risks of CVDs. They also show that activity reduces the
formation of plaques and keeps them more stable.
 Hypertension (High blood pressure): can damage lining of arteries. Can be caused by
obesity, inactivity and a salty diet which narrow the arteries or affect the heart pumping. Can
be an indication of atherosclerosis as plaques narrows arteries. 120/80 is normal blood
pressure. 140/90 is the beginning of hypertension.
 Diet and obesity: Being overweight is an important indicator of risk. It causes hypertension.
Type 2 diabetes: which can also result into damage to blood vessel linings. A study showed
aerobically fit and obese people have less CVR than unfit and lean people.

CVD is a multifactorial disease. Evidence now suggests that smoking also changes the balance of
lipoproteins in your blood in a way which raises your risk of dying from CVDs. Current evidence
shows that eating a balanced diet with a variety of fats and plenty of fruit and vegetables help
prevent atherosclerosis. It helps prevent smoking, hypertension, type 2 diabetes, constant stress,
 3-PAGES SUMMARY FOR CARDIOVASCULAR HEALTH AND RISK
and help maintain healthy weight and plenty of exercise. However, these may change in future as
studies become more complex and scientific. Scientists think the best predictors of future CVDs are:

 Where fat is stored in your body.

 How much exercise you do.
 Levels of different fats in your blood.

…………………………………………………………………………………………………………………………………………………………….

Weight (Kg)
BMI (Body massindex)=
Height 2 (m)
For adults: 18.5 to 25 is normal and 25 to 30 is overweight. Outside this range is obese and
underweight. Young people grow and their body composition changes as they mature, so both age
and gender are important in calculating what is normal until they become adults. BMI does not
recognise the difference between fat and muscle. This underestimates muscles in athletes and
underestimates fats in old people.

waist −¿−hip ratio=Waist ¿ x ¿ ¿

Hip( x)
Is by far, agreed to be the best measure only for obesity and the best way to predict an increased
risk of CVDs. For males: >0.85 is obese. For females: >0.9 is obese. Being seriously underweight is
not good either, it leads to muscle wasting, heart damage, etc… As lifestyle advanced, average
energy input has increased or stayed the same, the energy input has decreased, and people are
gaining weight. Solutions to this include taxes on fatty foods, town planning to make walking and
cycling easier and educating children to prevent childhood obesity. Studies have shown that there is
a correlation between diets high in saturated fat with incidence of and mortality from CVDs. A
suggested cause is that a high intake of saturated was often associated with high blood cholesterol
levels and that cholesterol is involved in atherosclerosis plaque formation. However, further studies
have shown that this is just a correlation but not a cause. But scientists are now confident that the
balance of lipoproteins in your blood is a good indication of atherosclerosis risk.

 Low-density lipoproteins (LDLs): Made from cholesterol, proteins, and saturated fats. High
levels of LDLs make cell membranes saturated. They flow in the blood and could build up in
the damaged walls of arteries and as other substances join, a plaque could be formed.
 High-density lipoproteins (HDLs): Made from cholesterol, proteins, and unsaturated fats.
They carry cholesterol from body tissues and from fatty plaques to the liver to be broken
down, lowering the risk of atherosclerosis.

LDLs and HDLs are not all about the diet. The genetic make-up of some people could make them
metabolise any amount of fat and maintain a good balance of LDLs and HDLs. The genetic make-up
of other people could be the opposite.

…………………………………………………………………………………………………………………………………………………………….

Studies have shown that eating 5+ fruits lowers CVRs and some used antioxidants found in some
vitamins as the reason. Later, other studies inhibited this reason. Vitamin C is important in the
formation of vessels’ endothelial lining, so in theory it reduces CVR. A study assured this practically.
Later, other studies also inhibited this conclusion. These are an example of conflicting evidence and
conclusions. Yes Vitamin C is good & fruits & vegetables are good for reducing CVRs but using
antioxidants & Vitamin C supplements as in conclusion is what has been inhibited.
 3-PAGES SUMMARY FOR CARDIOVASCULAR HEALTH AND RISK
………………………………………………………………………………………………………………………………………………

Organisations and efforts have been designed to persuade people to quit their lifestyle habits and
that prevention is better than cure partially because of the costs. However, people won’t often
change their lifestyle habits. They find it difficult to distinguish between perceived risks that can
come from their own experience with actual risk. This makes them underestimate CVRs associated
with smoking, obesity, etc… There are other reasons including that some people would overestimate
the risks of obesity and so would not quit smoking and ignore the risks of smoking. Moreover,
smoking is addictive, eating gives pleasure, and not exercising doesn’t need effort. So, people will
often think that these benefits are more important than the apparently low risk of heart disease.

…………………………………………………………………………………………………………………………………………………………….

Diuretics Increase urine volume produced, The benefits apply to CVDs, eyes,
eliminating excess fluids and salts, and kidneys. Risks are: too low blood
decreasing blood volume. pressure that may be serious. Side
Anti- Beta Block response of the heart to hormones effects are separate but usually are
blockers such as adrenaline, which speeds up heart coughs, ankles swelling, weakness,
hypertensive rate.
tiredness and fatigue, constipation.
Sympathetic Inhibit sympathetic nerves (they stimulate
(Drug which
nerve artery constriction) keeping arteries dilated.
reduces
inhibitors
hypertension.) ACE Block angiotensin hormones (they stimulate
inhibitors blood vessel constriction).
Statins Drugs that block the enzyme in the liver that Muscle and joint aches and nausea,
makes cholesterol and block LDLs constipation and diarrhoea MAY be
(Substances production, improving LDL:HDL and side effects. Exceedingly rare: myositis
reducing inflammation in the arteries’ lining. & damage to liver. Subtle risk: Person
which reduce
Benefits: reduce CVR more than placebo & may no longer try to eat healthy diet.
blood
reduce CVR for up to 10 years.
cholesterol
Plant Sold as food to reduce cholesterol absorbed It has not been tested like statins, but
levels.) stanols and from your gut into your blood, making it obviously side effects can include fat
sterols easier to metabolise cholesterol and reduce in the stool or diarrhoea.
LDL levels in blood.
Anticoagulant Warfarin Low prothrombin levels make blood clot Main side effect is obviously bleeding.
(interferes harder. Benefits: can be used as rat poison. Others are red urine, bloody stool,
building Iin humans, however, it should be carefully coughing up blood, vomiting of blood.
prothrombin.) monitored.

Aspirin Aspirin is the most common and cheapest form. Clopidogrel is also common. The risks
Platelet
of taking aspirin are known: irritates stomach lining and bleeding in the stomach which
inhibitory drug
Clopidogrel can be serious. Clopidogrel also causes nausea and stomach ache/abdominal pain.
(Drug used to Obviously, in both of them it will take longer to clot so there will be increased bleeding
prevent blood if skin is cut. A combination of clopidogrel and aspirin is possible, but it is also possible
clots forming by that their side effects outweigh their benefits as they cause major bleedings and major
preventing stomach bleedings. It is difficult to achieve the correct balance between preventing the
platelets blood from clotting too easily while allowing it to clot when necessary. The decision
clumping whether to give warfarin will depend on many factors, including the patient’s age and
together.) condition as well as other medication they may be taking.
3-PAGES SUMMARY FOR CARDIOVASCULAR HEALTH AND RISK