Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. They include:
--coronary heart disease – a disease of the blood vessels supplying the heart muscle;
--cerebrovascular disease – a disease of the blood vessels supplying the brain;
--peripheral arterial disease – a disease of blood vessels supplying the arms and legs;
--rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
--congenital heart disease – birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth;
--deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.
There are also a number of underlying determinants of CVDs. These are a reflection of the major forces driving social, economic and cultural change – globalization, urbanization and population ageing. Other determinants of CVDs include poverty, stress and hereditary factors.
In addition, drug treatment of hypertension, diabetes and high blood lipids are necessary to reduce cardiovascular risk and prevent heart attacks and strokes among people with these conditions.
The key to cardiovascular disease reduction lies in the inclusion of cardiovascular disease management interventions in universal health coverage packages, although in a high number of countries health systems require significant investment and reorientation to effectively manage CVDs.
Evidence from 18 countries has shown that hypertension programmes can be implemented efficiently and cost-effectively at the primary care level which will ultimately result in reduced coronary heart disease and stroke. Patients with cardiovascular disease should have access to appropriate technology and medication. Basic medicines that should be available include:
- . aspirin;
- . beta-blockers;
- . angiotensin-converting enzyme inhibitors;
- . statins.
An acute event such as a heart attack or stroke should be promptly managed.
Sometimes, surgical operations are required to treat CVDs. They include:
- . coronary artery bypass;
- . balloon angioplasty (where a small balloon-like device is threaded through an artery to open the blockage);
- . valve repair and replacement;
- . heart transplantation;
- . artificial heart operations.
Medical devices are required to treat some CVDs. Such devices include pacemakers, prosthetic valves, and patches for closing holes in the heart.