1 / 56

Controlling Cardiovascular Disease (CVD)

Controlling Cardiovascular Disease (CVD). Dr Farid Najafi School of Population Health Kermanshah University of Medical Sciences. Objectives. Definition Coronary artery disease Stroke Burden of Disease Global Regional Trends Developed countries Developing countries Risk Factors

ankti
Download Presentation

Controlling Cardiovascular Disease (CVD)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Controlling Cardiovascular Disease (CVD) Dr Farid Najafi School of Population Health Kermanshah University of Medical Sciences

  2. Objectives • Definition • Coronary artery disease • Stroke • Burden of Disease • Global • Regional • Trends • Developed countries • Developing countries • Risk Factors • Prevention • Future

  3. Definition • A group of disorders of the heart and blood vessels and include: • Coronary artery disease • Cerebrovascular disease • Peripheral arterial disease • Rheumatic heart disease • Congenital heart disease • Deep vein thrombosis and pulmonary embolism

  4. Coronary artery disease (CAD) or coronary heart disease (CHD) • Definition and example: Disease of the blood vessels supplying the heart muscle- Angina and acute myocardial infarction are two important type of CAD

  5. Stroke • Definition: Disruption of the blood supply to the brain • Classification: • Ischaemic stroke: blockage of blood vessels • Haemorrhagic stroke: rupture of the blood vessels

  6. Significance of CVD(Public Health) • Leading cause of mortality in developed countries and a rising tendency in developing countries • Significantly contributes to morbidity and death rates in the middle aged population: major contribution to DALYs and economic cost • Cause of 30% of morbidity in population

  7. Different parts of CVD epidemiology • Descriptive epidemiology • Person, Time, Place • Analytic epidemiology • Relationship between CVD and risk factors • Experimental epidemiology • Strategies for prevention of CVD (primary, secondary and tertiary)

  8. Descriptive epidemiologyGlobal pattern • Number one cause of death globally (30%) • In 2005, 17.5 million deaths from CVDs, mainly from CAD and stroke=30% of all deaths • >80% of CVD deaths in low- and middle-income countries • CVD remain the single leading cause of death till 2015

  9. Mathers and loncar, 2006

  10. Mathers and loncar, 2006

  11. Descriptive epidemiologyImportance of chronic conditions in Iran • Communicable, maternal, perinatal and nutritional: 3338 DALY per 100,000 (18%) • Noncommunicable diseases: 16563 DALY per 100,000 (59%) • Injury: 4326 DALY per 100,000 (23%) • Conclusion: Chronic conditions are major public health problems in Iran and need more investigations WHO, December 2004

  12. Burden of Illness - CVD • Number one cause of death globally (30%) • 26% of all deaths in EMRO in 2002. • The prevalence of heart, stroke and vascular conditions increased over the last decade. • 12% of total burden in 2002 • The total burden of heart, stroke and vascular diseases is expected to increase over the coming decades due to the growing number of elderly people, among whom these diseases are most common.

  13. Descriptive epidemiologyAge • Death due to CVD in different age groups • Pathologic process (atherosclerotic plaques) starts from 20 years ago-lifestyle patterns start from childhood and youth (smoking, dietary habits, sport, etc.) • CVD morbidity and mortality: increase in middle age-group (30-44) • Premature death (<64)

  14. Descriptive epidemiologySex • CVD among men and women: • CVD is a prevalent condition among middle-aged men • Fatal cases are more common among men • Equal number of women are affected (older age group)

  15. Descriptive epidemiologysex • Women • Higher risk in women than men (triglyceride level) • Higher prevalence of certain risk factors in women (diabetes, depression, response to stress) • Gender-specific risk factors: • Oral contraceptive pills • hormone replacement therapy • Polycystic ovary syndrome

  16. Descriptive epidemiologyTime and place • Developed countries: Decreasing • Improvement of lifestyle factors, such as: a decrease of smoking and higher level of health consciousness • Better diagnosis and treatment of underlying causes • Developing countries: Increasing • Aging, western lifestyle, smoking, urbanization

  17. Mathers and Loncar, 2006

  18. Analytic epidemiologyCausation • Over 300 factors have been known as risk factors for CVD • 75% of CVD is due to conventional risk factors with greatest public health importance: • High prevalence in different population • Great independent effect on CVD • Their control has major effect on decrease of burden of CVD

  19. Major modifiable High BP Abnormal blood lipid Smoking Physical inactivity Obesity Unhealthy diet Diabetes Non-modifiable Age Gender (male) Family history Race Other modifiable Low SES Mental ill health (Depression) Stress Heavy alcohol use Lipoprotein a Certain medication “Novel risk factors Excess homocysteine Inflammatory markers Abnormal blood coagolation ( high level of fibrinogen) Analytic epidemiologyRisk factors • Current evidence suggest that smoking, BP, blood lipids and physical inactivity can explain greater then 80%

  20. Risk factors in developing countries

  21. High blood pressure • Definition: • A systolic blood pressure above 140 mmHg and/or a diastolic blood pressure (DBP) above 90 mmHg • One of the most important preventable causes of premature death worldwide • Even a BP at the top end of the normal range increases risk of CVD • BP rises with age, salt intake, low physical atctivity and obesity • Control of high blood pressure is possible with lifestyle change and medication

  22. Lipids • High level of LDL-cholesterol and other abnormal lipids are important risk factors for CVD • Cholesterol is transported in two kinds of lipoproteins: LDL and HDL • LDL can lead to increasing the risk of heart attack and ischaemic stroke • HDL reduces the risk of CHD • Female sex hormone tends to raise HDL levels

  23. Tobacco • First evidence in 1940 • Higher risk among those who started smoking before of 16 • Passive smoking is also an risk for CHD • Promote CHD via: • Damages the endothelium • Increases cholesterol plaques • Increase clotting • Raises LDL and lowers HDL

  24. Physical inactivity • >60% of the global population are not sufficiently active • Sufficient physical activity: • Doing more than 150 minutes of moderate physical activity or 60 minutes of vigorous physical activity a week • It can reduce the risk of CHD by 30%

  25. Obesity • Body mass index (BMI) is commonly used for classifying overweight and obestiy • In general, BMI>25 = overweight and BMI>30 = obese • Diabetes and CHD increase with increase in the value of BMI

  26. PreventionPersonal choices and action • Take moderate physical activity for a total of 30 minutes on most days of the week • Avoid tobacco use and exposure to environment smoke, make plans to quit if you already smoke • Choose a diet rich in fruits, vegetables and potassium, and avoid saturated fats and calorie-dense meals • Maintain a normal body weight, if you are overweight, loss weight by increasing physical activity and reducing calorie intake • Reduce stress at home and at work

  27. PreventionPopulation and systems approaches • There is a gap between what is known and what is done in practice • Governments have a fundemental responsibility • Mininstries of health can play various roles: • Making data available • Educating the public • Making treatment affordable and available • Advocating for policy and environmental change

More Related