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Cardiovascular Disease (CVD) - Coggle Diagram
Cardiovascular Disease (CVD)
Death Statistics (European Cardiovascular Disease Statistics, 2017)
Death causes (MALES)
19% Ischemic/coronary heart disease
Diseases which affect the blood supply to heart
9% stroke/cerebral vascular disease
Disease which affect the blood supply to brain
12% Other CVD (including congenital heart disease)
OVERALL: 40% CVD as cause of death in males
Death causes (FEMALES)
20% ischemic/coronary heart disease
13% stroke/cerebral vascular disease
16% other CVD
OVERALL: 49% CVD as cause of death in females
CVD
total
death accounts for
greater
proportion in
females
than males
However, premature death (Before 65 y/o)
25% males
16% females
CVD accounts for
more premature
deaths in
males
than females
CVD Europe
CVD causes more than half of all deaths in EU (WHO)
Most common single cause of feath and major cause of admission to hospital which applies
economic burden
Major cause of DALYs (Disability Adjusted Life Years)
Number of years one loses due to ill health
Contributory factors
Diet
High sodium and fat diet (BRING BACK TO NANS STUDY
**
)
Physical activity
Sedentary lifestyle triggers CVD
High blood pressure and smoking
Global burden of CVD
2013: 1/3 of all deaths globally attributable to CVD (17 million)
Deaths mainly attributable to IHD or Cerebrovascular disease
Understanding the global distribution of CVD is essential to develop strategies to
reduce
burden of non-communicable diseases i.e. CVD
Factors affecting disease distribution
Gender differences
Premature CVD deaths (Roth
et al.,
2015)
Males
greater risk
as probability of 0.108
Females risk lower as probability 0.067
Probability of 1 means event will definitely occur and 0 defo will not occur
Overall CVD deaths
Females have greater risk of CVD death (why?)
Oestrogen production in females at young age protective against premature death bc
Oestrogen
increases HDL levels
and
decreases LDL levels
(Premenopausal)
Postmenopausal oestrogen levels drop so risk of CVD increases (no protective effect of oestrogen no more)
Other contributing factors specific to females
Preeclampsia in pregnancy (High BP) less favourable outcomes of CVD
Gestational diabetes increases likelihood of developing type II diabetes and in turn CVD
Polycystic ovarian syndrome increased risk of CVD
Socio-economic differences (Roth
et al.,
2015)
Low and middle income countries
(LMIC) deaths increased
from 7.21 million (1990) to 12 million (2013)
High income countries
(HIC) death decreased
from 283 to 160 per 100,000 (1990-2013)
Shift due to LMIC in
nutrition transition
Shift in dietary consumption and physical activity levels which coincide with economic changes
As a country becomes more developed the economy develops and change in age of population so shifts in PA and Diet
HIC reducing due to changes in risk factors and exposures at population level and advancements of healthcare
LIC have poorer healthcare and aging population groups
Geographical Variations
Communities following
traditional lifestyles
have lower rates than more industrialised countries
Environmental and behaviour differences (diet, lifestyle, healthcare)
Differences in diagnostic practise and coding of death certs (can be miscoded)
Migration
If migrate from low risk country (Japan) to high risk (USA) likely to have rates approaching those of host country
EUROPE
Low rates in France, Spain, Switzerland, Italy
Low rate attributable to Mediterranean diet (Large % energy from cereals, fruits & veggies, most fats from veggie sources (unsaturated)
French paradox: low CHD rate despite diet rich in animal (saturated) fats but this is attributable to high consumption of wine which contains phytochemicals
High rates in Germany, Austria, Finland, Sweden
Variation likely reflects case ascertainment (mis/underreporting in other countries) and quality of health care services
Eastern Europe
High rates reflect complex combo of social and political forces
Fall of Soviet Union= Morality crisis -> led to increased poverty (bad living standards), more disease and inequality
Heavy alcohol (increased BP and obesity) and tobacco use (increased oxidation)
East and Southeast Asia (Indonesia)
Fast growing economies w/ CVD death rates similar to HICs even though not classified as HIC due to lower access to health care
South Asia (India, Sri Lanka)
Increase deaths suggests change in risk exposures
CVD burden likely to rise higher as populations move to
urban areas
and adopt behaviours that increase risk for vascular disease
Latin America & Caribbean
Higher rates in HIC AND LIC due to many things not just one
HIC i.e. Brazil, Argentina increased abdominal obesity (diet related)
LIC i.e. Cuba, Suriname high tobacco consumption (Suriname highest tobacco rate per consumption per smoker in the world)
Complicated by burden of CVD attributable to Chagas disease leading to misclassification of some death certs
Chagas = endemic to Latin America 6% of population have it, parasitic disease from insects & after 30 years causes heart failure
Middle East and North Africa
2013 leading causes of disease was IHD and cerebrovascular disease
Due to change in dietary patterns from shift to processed foods, increased obesity, tobacco smoking in men and variations of PA
Temporal Changes
Mortality rates reduced but incidence rates increased
Reflects advancements in healthcare and treatment knowledge
Reducing death rate alone is not enough as puts strain on healthcare resources
Primary care is important as well as preventative measures on public health level
Large scale preventative programmes
Smoking ban, public more aware of CVD risk and healthy eating
Death rate from stroke reduced from 1980 to 2015 but decrease more pronounced in countries w/ med diet
Reflects public health initiatives and provision of better health care
IHD rates mostly maintained/decreased over time but not seeing increased death rate
Fruit consumption increased from 1986-2011 but veggie consumption stayed relatively same but some increase in other countries