Journal of Pharmacy and Pharmacology 10 (2022) 139-142

doi: 10.17265/2328-2150/2022.04.005
D DAVID PUBLISHING

Factors Influencing the Incidence of Heart Disease

Iliadis Christos1, Tsaloglidou Areti2, Koukourikos Konstantinos2 and Kourkouta Lambrini2

1. Private Diagnostic Health Center of Thessaloniki, 54623, Greece
2. Nursing Department, International Hellenic University, Thessaloniki, 57400, Greece

Abstract: Introduction: Understanding the causes of heart disease is a relatively new field in medicine. In fact, heart disease was
relatively rare before the early 1900s. Aim: The aim of this review study is to investigate the risk factors associated with the
development of heart disease and its prevention. Material Methodology: A scrutinized review of the Greek and international
literature was carried out. The material of the study was manuscripts on the subject found in Greek and international electronic
databases such as: Google Scholar, Mednet, PubMed and the Association of Hellenic Academic libraries (HEAL-Link). Results: The
risk factors for the development of heart disease are metabolic factors, i.e., hypertension, diabetes, cholesterol and obesity;
environmental factors, i.e., smoking, lack of physical activity or exercise, poor dietary patterns and alcohol consumption; and other
factors such as age, gender, heredity, socioeconomic status and psychological factors. Conclusions: Heart diseases are multifactorial
diseases and the only way to successfully treat them is to take into account all the risk factors for their development, and to treat them
systematically.

Key words: Factors, etiology, incidence, heart disease, prevalence.

1. Introduction to cardiovascular disease today follows

socioeconomic progress and can be observed
Understanding the causes of heart disease is a
throughout the third world and in developing countries
relatively new field in medicine. In fact, heart disease
[2].
was relatively rare before the early 1900s.
Heart disease is the leading cause of death
Traditionally, humanity had been troubled more with
worldwide. In 2016, around 17.9 million people died
infectious diseases than with non-infectious diseases
from cardiovascular disease, which represents 31% of
such as heart disease and diabetes. With the
all deaths from all causes worldwide. 85% of these
development of antibiotics, mortality from infectious
deaths were caused by heart failure and stroke,
diseases has declined significantly [1].
diseases that are both acute events [3]. The morbidity
On the other hand, however, the industrialization of
caused by heart disease is also significant. In Europe,
societies together with the development of technology
the DALY (disability-adjusted life years lost due to
and the growth of retail food stores, have reduced the
disability) due to heart disease, although it has
need for individuals to grow and self-supply their own
decreased over the last ten years, has reached 64
food. Agriculture declined and sedentary lifestyles
million [4].
were enhanced. All of these factors together
Heart disease contributes to physical disability and
contributed to the rapid increase in the prevalence of
increased care costs. Physical limitations, as well as
heart disease. This transition from a society with the
limitations in social activities, may consequently
majority of mortality coming from infectious diseases
cause psychological distress, anxiety and depression,
reducing the quality of life of patients [5].
The aim of this review study is to investigate the
Corresponding author: Kourkouta Lambrini, Professor,
research fields: history of nursing, ethics and deontology. risk factors associated with the development of heart
Email: laku1964@yahoo.gr. disease and its prevention.
140 Factors Influencing the Incidence of Heart Disease

2. Material and Methods cause of heart attack [8].

Heart failure is a clinical syndrome characterized by
The study consists of a review of Greek and
typical symptoms (e.g. breathlessness, ankle swelling
international bibliography. The study’s material
and fatigue) that may be accompanied by signs (e.g.
consists of articles related to the topic found in Greek
increased jugular vein pressure, pulmonary crackles
and international databases such as Google Scholar,
and peripheral edema) caused by a structural and/or
the Hellenic Academic Libraries Association
functional cardiac abnormality, resulting in reduced
(HEAL-Link), and with the use of keywords such as
cardiac output and/or increased endocardial pressures
factors, etiology, incidence, heart disease, occurrence.
at rest or during stress [9].
The exclusion criteria for the articles were the
Rheumatic heart disease is a condition in which the
language, except for Greek and English. For the most
heart valves are permanently damaged by rheumatic
part, only articles and studies accessible to authors
fever. The heart valves may become inflamed and
were used.
scarred over time. This can lead to narrowing or
3. Heart Diseases leakage of the heart valve, making it harder for the
heart to function normally. This can take years to
According to the World Health Organization,
develop and can lead to heart failure [10].
cardiovascular disease is a broad group of disorders of
Congenital heart disease is a general term for a
the heart and blood vessels, including hypertension
series of genetic abnormalities that affect the normal
(high blood pressure), coronary heart disease (stroke),
functioning of the heart. Congenital heart defects are
cerebrovascular disease (stroke), peripheral vascular
the most common type of birth defects. Defects can
disease, heart failure (syncope), rheumatic heart
include the walls of the heart, the valves of the heart
disease, congenital heart disease and cardiomyopathy
and the arteries and veins near the heart. They can
[6].
disrupt the normal flow of blood through the heart.
Coronary artery disease or heart disease or
[11].
atherosclerotic heart disease is the long-term result of
Finally, cardiomyopathies are defined as
the accumulation of atherosclerotic plaques
myocardial diseases associated with structural and
(atherosclerotic plaque is a combination of fat,
functional disorders of the myocardium, in which the
cholesterol, calcium and other substances found in the
myocardium is structurally and functionally abnormal
blood) in the walls of the arteries that supply the
in the absence of a specific disease capable of causing
myocardium (the muscle of the heart). After decades
the myocardial pathology. Dilated cardiomyopathy is
of progress, some of these atherosclerotic plaques can
the most common form of cardiomyopathy, and is
break down and (along with activation of the blood
characterized by left ventricular dilatation and systolic
clotting system) begin to restrict blood flow to the
dysfunction [12].
heart muscle [7].
Atherosclerotic plaque reduces the amount of 4. Etiology and Risk Factors for Heart Disease
oxygen in the blood that reaches the heart, which can
cause chest pain, also called angina. Angina usually The risk factors for the development of heart
manifests as a feeling of pressure in the chest, arm disease are metabolic factors, i.e. hypertension,
pain, jaw pain and other forms of discomfort. Angina diabetes, cholesterol and obesity; environmental
is essentially cramps in the heart muscle. factors, i.e. smoking, lack of physical activity or
Atherosclerotic plaque can also lead to blood clots, exercise, poor dietary patterns and alcohol
which block blood flow and are the most common consumption; and other types of factors such as age,
 Factors Influencing the Incidence of Heart Disease
gender, heredity, socioeconomic status and
psychological factors [13].
Hypertension is a risk factor when it comes to
cardiovascular disorders, both due to hemodynamic
causes (hemorrhagic stroke and aortic dissection) and
due to accelerated atherosclerosis [14].
Dyslipidemia can be defined as elevated levels of
serum total cholesterol (TC), low-density lipoprotein
cholesterol (LDL-C), triglycerides (TG) or reduced
serum high-density lipoprotein concentration
(HDL-C). Dyslipidemia is an established risk factor
for cardiovascular disease [15]. The role of diabetes in
the pathogenesis of heart disease is important.
Research has shown that at least 68% of people aged
65 years and older with diabetes die from some form
of heart disease and 16% die from stroke. It is also
well documented in the literature that adults with
diabetes are two to four times more likely to die from
heart disease than adults without diabetes [14].
Obesity has now become a global epidemic and is
clearly a risk indicator for heart disease, as it is
associated with many known risk factors such as
diabetes, elevated cholesterol, hypertension and a
sedentary lifestyle. One study, which examined 57
prospective studies with almost 900,000 participants,
showed a clear association between obesity and the
risk of developing coronary heart disease and other
heart diseases. It was found that for every additional 5
kg/m2 increase in BMI in people over 25 years of age,
the risk of heart disease mortality increased by a 40%
(increase in the risk of vascular mortality) [16].
5. Factors Influencing the Incidence of Heart
Disease
Smoking was initially the major cause of death
from heart disease, as well as a risk factor for its
development. Between 2005 and 2009, 32% of all
deaths from coronary heart disease were due to
smoking, making it the strongest risk factor for
coronary heart disease other than age. There are
approximately 1.1 billion smokers worldwide, 82% of
141
whom are in developing countries. The prevalence of
smoking has declined over recent years, but remains
high [17].
Smoking leads to the development of abnormalities
in the vascular system that eventually leads to
atherosclerosis and heart disease. One of these is
vasoconstriction due to endothelial dysfunction, as
well as inhibition of nitric oxide production, which
further reduces vasodilation. Smoking also appears to
contribute to the oxidation of LDL, which is another
important risk factor in the early development of
atherosclerosis. In addition to its role in the
development of atherosclerotic plaque, smoking has
been shown to increase levels of fibrinogen, which
increases thrombosis and therefore may contribute to
subsequent clot formation and plaque rupture leading
to acute myocardial infarction [17].
Sedentary lifestyle has also increased in recent
years, and even more recently with the widespread use
of smart phones. A large study in the US involving
123,216 patients who were followed for 14 years,
showed that after adjusting for age, smoking, BMI,
alcohol consumption and comorbidity index
(including hypertension, diabetes and cholesterol),
time spent sedentary and being (≥ 6 vs. < 3 hours/day)
was associated with a relative risk of mortality from
heart disease of 1.17 in men and 1.34 in women [18].
The link between diet and heart disease is also well
documented. The consumption of processed foods has
increased significantly, leading to an increased risk of
cardiovascular disease. Unhealthy dietary patterns
have been associated with higher concentrations of
pro-inflammatory markers linked to the development
of cardiovascular disease [19].
Finally, the incidence of cardiovascular disease is
higher in older people. Ageing is an inevitable part of
life and is the greatest risk factor for cardiovascular
disease. The risk of heart disease increases with age
and the risk increases significantly after the age of >
45 years in men and after the age of 55 years in
women [20].
142 Factors Influencing the Incidence of Heart Disease
In addition to the above, the average lifespan of
people is increasing, and at the same time, the
percentage of people entering the 65 age group is also
rising. The ageing trends of the planet are expected to
continue over the next 20 years. In this age group,
cardiovascular disease will remain the leading cause
of death and the costs associated with treatment will
continue to rise [20, 21].
6. Conclusions
Heart diseases are multifactorial diseases. The only
way to successfully treat them is to take into account
all the risk factors for their development and to treat
them systematically. When these measures do not
bring the expected result, medication is added, which
responds to the form of pressure and the patient's
body.
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