An Introduction to Cardiovascular Disease

PocDoc's Introduction to Cardiovascular Disease

Authored by: Dr Matthew Lee; BMSc, MBBS, MSc

What’s In This PocDoc Article?

What is Cardiovascular Disease?
Epidemiology of Cardiovascular Disease
Understanding Risk Factors for Cardiovascular Disease
Assessing the Risk of Cardiovascular Disease
The Importance of Lipid Panel Testing
Minimising Cardiovascular Disease Risk
Prevention of Cardiovascular Disease
Frequently Asked Questions

What is Cardiovascular Disease?

Cardiovascular Disease (CVD) is an umbrella term for diseases of the heart and blood vessels including:

Coronary artery disease - This occurs when the heart's main blood vessels get hard or narrow because of plaque build-up, known as atherosclerosis. This can cause chest pain (angina), trouble breathing and heart attacks.

Heart failure – This condition doesn't mean the heart has stopped working, but that it isn't pumping blood as well as it should. Conditions like coronary artery disease or high blood pressure can leave the heart too weak or stiff to fill and pump efficiently.

Stroke - A stroke is a serious life-threating medical condition that happens when blood flow to part of the brain is blocked or a blood vessel in the brain bursts. This lack of blood flow starves brain cells of oxygen, causing them to die. This can result in serious disability or death.

Aortic Disease - This is the collective term for conditions affecting the aorta, the main and largest artery in the body. It can include aortic aneurysm (a bulge in the aorta that can burst) and aortic dissection (a tear in the aorta's inner layer), both of which can be life-threatening.

These conditions share common risk factors and causes. A key cause is atherosclerosis- the build-up of fatty deposits within the arteries. Understanding how and why this process happens is crucial to the prevention and management of CVD. A key cause is an imbalance in cholesterol levels in the blood; a condition called dyslipidaemia. Having too much "bad" non-HDL cholesterol and too little "good" HDL cholesterol increases the risk of CVD. HDL plays a vital role in the body transporting LDL particles away from the blood and preventing atherosclerosis. So having an imbalance in the types of cholesterol can lead to atherosclerosis and CVD.

Epidemiology of Cardiovascular Disease

CVD is the leading cause of death globally

According to the World Health Organization, CVD is the leading cause of death globally, causing 17.9 million deaths annually.

According to the British Heart Foundation in April 2023, 7.6 million people are living with CVD in the UK. 25% of all UK deaths are caused by cardiovascular disease. That’s 460 deaths each day.

CVD is a growing problem

Our modern way of living has amplified health problems such as obesity, high blood pressure and diabetes. This in turn has increased the incidence and burden of CVD.

Today, 42% of adults and 20% of children in the United States are obese. In the United Kingdom 25% of all adults are obese.

Some factors that contribute to these alarming obesity rates include:

Modern diets that contain an excess of ultra-processed foods, saturated fats, and sugars, all of which can lead to weight gain

This weight gain can then trigger further health issues like high blood pressure, diabetes and high cholesterol

The prevalence of sedentary lifestyles and a decrease in physical education have contributed to a general decline in physical activity

These dietary changes and decreased activity levels are large contributors to the growing obesity rates, which is a leading risk CVD risk factor. As these lifestyle trends continue to worsen, CVD will increasingly become a critical health concern.

The huge burden of CVD calls for an evidence-based approach by healthcare professionals to manage and decrease risk effectively. Incorporating technological innovations such as PocDoc’s cardiovascular disease risk assessment platform into healthcare practice has opened new novel approaches towards CVD risk management and promises to positively impact future epidemiology.

Understanding Risk Factors for Cardiovascular Disease

The complex nature of CVD requires a comprehensive understanding of its risk factors. Healthcare professionals consider all your risk factors to appropriately tailor their management plan to each person. There are two categories of risk factors:

1. Non-modifiable Risk Factors:

These are factors we cannot control and include age, sex, and genetics. They significantly impact our likelihood of developing CVD. For instance, the risk of developing CVD increases with age in both men and women due to the decline in sex hormones.

2. Modifiable Risk Factors:

We can change or control these risk factors to lower our risk of developing CVD. They include diet, BMI (Body mass index), physical activity levels, smoking, and dyslipidaemia

Diet: A healthy diet plays a crucial role in cardiovascular health. A 2020 Study on the Association Between Healthy Eating Patterns and Risk of Cardiovascular Disease showed that sticking to healthy eating patterns consistently showed lowers risks of developing cardiovascular disease

Physical Activity: A sedentary lifestyle is a well-recognized risk factor for CVD. Regular physical activity can help reduce this risk. The NHS recommends at least 150 minutes of moderate-intensity activity a week or 75 minutes of vigorous-intensity activity, and strength exercises on 2 or more days a week. Any activity is better than none though

Smoking: Smoking tobacco significantly increases the risk of CVD. The chemicals in tobacco smoke harm blood cells and can damage the heart's function and the blood vessels. This can increase the risk of atherosclerosis, leading to heart attacks and strokes

Dyslipidaemia: This condition is an imbalance in the types of lipids in your blood. It leads to atherosclerosis and increases the risk of CVD. A study published in 2017, involving more than 29,000 participants from 52 countries, found that dyslipidaemia was the most significant modifiable risk factor for a first heart attack. Because of this link with cardiovascular disease, medical bodies such as the American Heart Association, recommend routine checks on lipid levels for adults from 20 years old

Tackling these modifiable risk factors through lifestyle changes and medical interventions can help reduce the incidence and impact of CVD.

Assessing the Risk of Cardiovascular Disease

Risk assessment is key to preventing and managing CVD. By measuring the risk of developing CVD, healthcare professionals help people make lifestyle changes or start treatments to lower their chance of developing CVD. The risk of CVD is typically evaluated by calculating a CVD risk score, which considers a wide range of factors, including:

Age
Sex
Ethnicity
Family history of CVD
Blood Pressure
Lipid Levels
Existing medical conditions (including diabetes and rheumatoid arthritis)

There are several algorithms available to calculate this risk score. In the UK, QRISK3 is widely used for calculating the risk of someone having a first cardiovascular disease event (a heart attack or stroke) within the next 10 years. PocDoc integrates QRISK3 into its cardiovascular disease risk assessment tool.

The risk scores provide valuable insight for an individual about their cardiovascular health, and can guide preventive strategies and treatment plans.

The Importance of Lipid Panel Testing

The lipid panel is a key tool when assessing CVD risk. The PocDoc Lipid test measures the blood levels of:

These markers provide a comprehensive view of an individual's lipid profile. The TC:HDL ratio directly inputs into QRISK3 allowing an accurate cardiovascular risk assessment. To learn more about lipid tests and why they're important for finding and managing cardiovascular disease, you can read our article on the different types of lipids.

Minimising Cardiovascular Disease Risk

Managing the risks identified in the risk assessment might involve lifestyle changes and medical treatment. Lifestyle changes may include changing your diet, increasing physical activity, stopping smoking and drinking less alcohol.

Medical treatment usually involves drugs to manage high blood pressure, diabetes and dyslipidaemia. For example, statins are commonly used to reduce “bad” cholesterol, which then reduces the risk of CVD due to atherosclerosis.

The National Institute for Health and Care Excellence (NICE) guidelines also offers information about managing lipid levels to lower CVD risk.

Prevention of Cardiovascular Disease

Prevention is always better than cure, particularly for CVD. A healthy lifestyle should be adopted and maintained from an early age to have long-term benefits and prevent CVD.

Primary Prevention

Primary prevention strategies are targeted towards those that have a high risk of developing CVD but have not yet had an event (like a heart attack or stroke). These strategies include lifestyle modification, control of hypertension, management of dyslipidaemia and diabetes and lipid-lowering therapy.

Secondary Prevention

Secondary prevention strategies are targeted towards individuals who have already had a CVD-related event. The aim is to prevent recurrence or worsening of the disease. These strategies involve a combination of medical therapy, lifestyle changes, and potentially invasive procedures. These are all dependent on the specific condition and severity.

PocDoc’s platform is a valuable tool for supporting the prevention and management of CVD. The convenience of point-of-care testing and the comprehensive results provided by PocDoc's lipid marker test, alongside the integrated QRISK3 assessment tool, can empower patients and healthcare professionals alike in the fight against CVD.

Download PocDoc's CVD Booklet PDF Here

FAQs About Cardiovascular Disease

1. What is cardiovascular disease (CVD)?

Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. It includes conditions such as coronary artery disease, heart failure and stroke

These disorders often share common risk factors and can lead to severe health complications, even death

2. What are the most common risk factors for CVD?

Risk factors for CVD can be divided into non-modifiable and modifiable categories. Factors that can be controlled and factors that cannot

Non-modifiable risk factors include age, sex, and genetic predisposition

Modifiable risk factors include BMI, diet, physical activity, smoking, and dyslipidaemia (a disorder of lipid metabolism). Addressing these modifiable risk factors can significantly decrease the risk of developing CVD

3. How can I assess my risk for CVD?

Healthcare professionals typically use a CVD risk score based on multiple factors like age, sex, blood pressure, and lipid levels

Tools like the QRISK3 algorithm can estimate a person's risk of having a CVD event over the next ten years if they haven’t already been diagnosed with CVD

PocDoc integrates the QRISK3 algorithm

4. What lifestyle changes can I make to reduce my CVD risk?

Lifestyle changes like maintaining a healthy BMI, eating a balanced diet, engaging in regular physical activity, quitting smoking, and moderating alcohol intake can greatly reduce your CVD risk

Consistently adopting these healthy habits can positively impact your overall cardiovascular health

5. How does point-of-care testing (POCT) aid in managing CVD risk?

Point-of-care testing (POCT) provides rapid results at the patient care site, aiding in decision-making and improving patient outcomes

POCT can offer immediate lipid profile results, which assist in assessing CVD risk and personalising a treatment plan

6. What is the role of technology in managing CVD?

Technological innovations, like the PocDoc cardiovascular health assessment tool, have enhanced the approach towards CVD risk management by making it more accessible and personalized

PocDoc enables quick and accurate assessments, fostering efficient patient care, and timely interventions