February 7, 2017

Cardiovascular disease (CVD) is a broad term for a range of diseases affecting the heart and blood vessels. A heart attack or stroke may be the first warning of an underlying disease. It includes all the diseases of the heart and circulation including coronary heart disease, angina, heart attack, congenital heart disease and stroke. It’s also known as heart and circulatory disease.

The cardiovascular system, also called the circulatory system, is the system that moves blood throughout the human body. It is composed of the heart, arteries, veins, and capillaries. It transports oxygenated blood from the lungs and heart throughout the whole body through the arteries. Blood goes through the capillaries – vessels situated between the veins and arteries.

When the blood has been depleted of oxygen, it makes its way back to the heart and lungs through the veins.

The circulatory system may also include the circulation of lymph, which is essentially recycled blood plasma after it has been filtered from the blood cells and returned to the lymphatic system. The cardiovascular system does not include the lymphatic system. In this article, the circulatory system does not include the circulation of lymph.

CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause. An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. Over three quarters of CVD deaths take place in low- and middle-income countries. Out of the 16 million deaths under the age of 70 due to non-communicable diseases, 82% are in low and middle income countries and 37% are caused by CVDs. Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies. People with cardiovascular disease or who are at high cardiovascular risk (due to the presence of one or more risk factors such as hypertension, diabetes, hyper-lipidaemia or already established disease) need early detection and management using counseling and medicines, as appropriate.

Types of CVD

Coronary heart disease – Also known as ischemic heart disease, this is the most common form of heart disease in America.

The two major forms of coronary heart disease are heart attack (also known as acute myocardial infarction) and angina. A heart attack is caused when blood supply to the heart is blocked completely, often causing damage to the heart muscle and its function.

Angina is a chronic condition where short episodes of chest pain occur periodically, caused by a temporary shortage of blood supply to the heart. Angina is not usually life-threatening, but can be associated with increased risk of heart attack.

Heart failure & cardiomyopathy – Heart failure is a life-threatening condition that occurs when the heart is unable to maintain a strong enough blood flow to meet the body’s needs. It usually develops over many years, although it can also occur more suddenly. Heart failure can result in chronic tiredness, reduced ability for physical activity and shortness of breath. Cardiomyopathy occurs when the heart muscle becomes thickened, enlarged or stiff which can reduce the effectiveness of the heart. Cardiomyopathy and heart failure commonly occur together.

Congenital heart disease – A broad term for any defect of the heart or central blood vessels that is present from birth. It can include abnormalities of the heart or heart valves, such as a hole between chambers of the heart, or narrowing of major blood vessels, or combinations of disorders.

Rheumatic heart disease – Rheumatic heart disease is caused by one or more attacks of rheumatic fever, which then do damage to the heart, particularly the heart valves. Rheumatic fever usually occurs in childhood, and may follow a streptococcal infection. In some cases, the infection affects the heart and may result in scarring the valves, weakening the heart muscle, or damaging the sac enclosing the heart. The valves are sometimes scarred so they do not open and close normally.

Inflammatory heart disease – Inflammation of the heart muscle (myocarditis), the membrane sac (pericarditis) which surround the heart, the inner lining of the heart (endocarditis) or the myocardium (heart muscle). Inflammation may be caused by known toxic or infectious agents or by an unknown origin.

Hypertensive heart disease – High blood pressure of unknown origin (primary hypertension) or caused by (secondary hypertension) certain specific diseases or infections, such as tumor in the adrenal glands, damage to or disease of the kidneys or their blood vessels. High blood pressure may overburden the heart and blood vessels and cause disease.

Peripheral vascular disease – This term refers to disease of large arteries that supply blood to the peripheries and can be caused by blockage of arteries due to cholesterol or fatty substances, or caused by widening of the arteries such as the aorta, which in severe cases can lead to rupture of the arterial wall.

Stroke – Stroke is a type of cerebrovascular disease and occurs when an artery supplying blood to the brain either suddenly becomes blocked or begins to bleed. This may result in part of the brain dying, leading to sudden impairment of one or more capacities, such as speaking, thinking and/or movement.

Causes

  • Hypertension (high blood pressure) – this is the one major risk factor for CVD by far. If hypertension is poorly controlled, the artery walls may become damaged, raising the risk of developing a blood clot.
  • Radiation therapy – Studies suggest that radiation therapy can increase the risk of cardiovascular disease later in life.
  • Smoking – Regular smoking can narrow the blood vessels, especially the coronary arteries.
  • Lack of sleep – People who sleep less than 7.5 hours each day have a higher risk of developing cardiovascular disease.
  • Having a partner with cancer – A person whose partner has cancer has a nearly 30% higher risk of developing stroke or coronary heart disease.
  • Diabetes – This includes both types 1 and 2. High blood sugar levels can harm the arteries. People with type 2 diabetes are often overweight or obese, which are also risk factors for cardiovascular disease. People with diabetes are 2 to 4 times more likely to die from heart disease than non-diabetics. Experts say that blood glucose control measurements can help predict a diabetes patient’s cardiovascular disease risk.
  • Unhealthy eating – Diets which are high in fat combined with carbohydrates, especially if they consist mainly of fast foods, can accelerate the accumulation of fatty deposits inside the arteries, which raise the risk of obesity, hypertension and hyperlipidemia. Diets which lack adequate amounts of fruit, vegetables, fiber, whole grains and essential nutrients are not good for cardiovascular health.
  • Physical inactivity – People who lead predominantly sedentary lives tend to have higher blood pressure, more stress hormones, higher blood cholesterol levels, and are more likely to be overweight. These are all risk factors for cardiovascular diseases.
  • Drinking too much alcohol – People who drink too much tend to have higher blood pressure and blood cholesterol levels.
  • Stress – Hormones associated with (mental) stress, such as cortisone, raise blood sugar levels. Stress is also linked to higher blood pressure.
  • Air pollution – Studies suggest that air pollution causes about the same number of heart attacks as other individual risk factors. The investigators assessed 36 separate studies that focused on air pollution.
  • COPD and reduced lung function – People with COPD (chronic obstructive pulmonary disease) have a significant risk of developing cardiovascular disease.
  • The age of first menstruation – Females who start menstruating early are more likely to become obese, and have cardiovascular disease risk factors.

Symptoms

Cardiovascular disease is caused by narrowed, blocked or stiffened blood vessels that prevent your heart, brain or other parts of your body from receiving enough blood. Cardiovascular disease symptoms may be different for men and women. For instance, men are more likely to have chest pain; women are more likely to have symptoms such as shortness of breath, nausea and extreme fatigue.

Symptoms can include –

  • Chest pain (angina)
  • Shortness of breath
  • Pain, numbness, weakness or coldness in your legs or arms if the blood vessels in those parts of your body are narrowed
  • Pain in the neck, jaw, throat, upper abdomen or back
  • Fluttering in your chest
  • Racing heartbeat (tachycardia)
  • Slow heartbeat (bradycardia)
  • Chest pain or discomfort
  • Shortness of breath
  • Lightheadedness
  • Dizziness
  • Fainting (syncope) or near fainting

Serious congenital heart defects — defects you’re born with — usually become evident soon after birth. Heart defect symptoms in children could include –

  • Pale gray or blue skin color (cyanosis)
  • Swelling in the legs, abdomen or areas around the eyes
  • In an infant, shortness of breath during feedings, leading to poor weight gain

Less serious congenital heart defects are often not diagnosed until later in childhood or during adulthood. Signs and symptoms of congenital heart defects that usually aren’t immediately life-threatening include –

  • Easily getting short of breath during exercise or activity
  • Easily tiring during exercise or activity
  • Swelling in the hands, ankles or feet

Treatment

  • Statins are medicines which lower cholesterol levels in people who cannot control them by diet alone. They also help to balance the amounts of good and bad cholesterol. They prevent many strokes and heart attacks.
  • Anticoagulants are medicines which help stop the blood clotting too easily. They are useful for preventing clots forming when people are at risk of heart attacks or strokes – for example if they suffer from atrial fibrillation.
  • Bypass surgery replaces blocked coronary arteries with healthy blood vessels from somewhere else in the body, often the legs or the chest. The surgery restores the blood supply to the heart muscle and prevents angina pain and heart attacks. This surgery involves opening up the chest of the patient to get at the heart so it takes a long time, costs a lot of money and carries a risk to the patient. In recent years doctors often avoid the need for bypass surgery by the use of stents.
  • Stents are special mesh tubes which can be inserted into an artery affected by atherosclerosis. The stent is opened up using a tiny balloon which inflates. This squashes the fatty deposits and opens up the blood vessel so the blood can flow freely again. Stents can be put in place in the coronary arteries by feeding them in through the blood vessels in the leg. This doesn’t need an operation so it is faster, safer for the patient and cheaper. Some stents are now made which contain medicines which reduce the risk of blood clotting even further.
  • Artificial Pacemakers are put into the body with two wires running to the heart. It’s job is to take over the function of natural pace maker region if it goes wrong. The pacemaker has a battery and sends a small shock into the heart muscle at regular intervals to stimulate it to beat normally.
  • Clot busting Medicines (thrombolytic medicines) are given to people to dissolve the clots in the coronary arteries that are causing a heart attack (or stroke). The sooner they are given, the more effective they are. If the ventricles of the heart stop pumping blood properly, or the heart stops completely, a defibrillator can be used. This gives the heart an electric shock and may start it beating again in a normal rhythm. Defibrillators are often used by doctors or paramedics in ambulances and hospitals. However every minute that passes after a cardiac arrest reduces the chances of survival by 14%. Automated defibrillators are sometimes found in pubs, swimming pools and shopping centres. They can be used by members of the public as they give clear automatic instructions about what to do to save a life.

Alternative Treatment

Chelation Therapy – Chelation therapy is a medical treatment commonly used to rid the body of heavy metals, like treating lead or mercury poisoning. Its use in treating heart disease is controversial and questionable. During chelation treatments, an amino acid called EDTA (ethylenediamine tetraacetic acid) is injected. It binds to heavy metals and minerals and leaves through the urine.

Niacin – This B vitamin works in the liver to reduce the fatty acids that form cholesterol. Niacin can help lower low-density lipoprotein (LDL) and triglyceride levels while boosting HDL. Potential side effects include nausea, intense flushing, and liver problems. Niacin should only be taken under a doctor’s supervision since special blood tests are necessary to monitor for liver damage.

Red yeast rice – Researchers have found that this Chinese supplement can lower LDL and triglycerides. Red yeast rice contains monacolin K, which is a statin — a chemical compound that lowers cholesterol. In fact, monacolin K is the principal ingredient in the prescription cholesterol drug lovastatin (Mevacor).

R-Lipoic Acid – R-lipoic acid improves endothelial function by, and the antioxidant also enhanced the benefits of a drug used to treat heart disease.

Curcumin – Curcumin is world-renowned for reducing inflammation and pain. Curcumin is the active ingredient in Turmeric.

Multivitamin – Vitamins help to prevent unnecessary blood clots that can block arteries. It is also necessary to control the amino acid homocysteine which appears to damage artery linings and encourage heart disease. itamin B12 deficiency has been associated with elevated levels of the dangerous homocysteine. Elevated levels of homocysteine, an amino acid produced by the body, can damage the inner surface of arteries. This can be treated and/or prevented with vitamin B12, vitamin B6 and folic acid. Many cardiologists are now using B-vitamins to help prevent coronary artery diseaseFolic Acid – Folic acid helps to control homocysteine, an amino acid that seems to play a major role in clogging the arteries.

Calcium – Calcium is believed to help keep cholesterol under control and may prevent dangerous blood clots. Too much calcium may increase the risk of heart disease, especially if there is much too much calcium in relation to magnesium.

Magnesium – Magnesium deficiency has been linked to an increased risk of CVD, heart attacks and improper heartbeats (ventricular tachyarrhythmias).

Phytosterols – These are found in unrefined vegetable oils, whole grains, nuts, and legumes. Eating foods enriched with at least 0.8 grams of plant sterols or stanols daily can reduce your LDL (bad) cholesterol.

Omega-3 fatty acids, derived from fatty fish, are thought to reduce inflammation in your body. Inflammation is a contributing factor in heart disease. Omega-3 fatty acids may also decrease triglycerides, lower blood pressure, and boost immunity.

Flax and flaxseed oil also contain beneficial omega-3 fatty acids, though studies have not found these sources to be as effective as fish. The shell on raw flaxseeds also contains soluble fiber, which can help lower blood cholesterol.

Selenium – The amount of selenium in the blood and red blood cells may be related to the risk of CHD and heart attacks. Lower the level of selenium, the more the risk. Selenium is an antioxidant that helps to prevent the conversion of LDL into its more artery-damaging, oxidized form. It may also help to “thin” the blood,” minimizing the blood clots and the heart attack.

Co-enzymes – Adequate levels of CoQ10 is necessary for a well functioning system. When the levels of CoQ10 drops below optimum levels, the disease takes over or already had done so. Heart muscle biopsies in patients with various cardiac diseases showed a CoQ10 deficiency in 50-75 percent of the cases. On the corollary, all the well functioning hearts had an adequate amount of CoQ10 in the tissue. When supplemental CoQ10 was introduced into the ailing hearts, they started getting signs of new life. CoQ10 increases oxygenation of heart tissue.

 

Reference –

http://www.world-heart-federation.org/fileadmin/user_upload/documents/Fact_sheets/2012/CVD_terms.pdf

http://www.heart.org/HEARTORG/Caregiver/Resources/WhatisCardiovascularDisease/What-is-Cardiovascular-Disease_UCM_301852_Article.jsp#

http://www.webmd.com/heart-disease/guide/heart-disease-symptoms-types

http://www.world-heart-federation.org/cardiovascular-health/cardiovascular-disease-risk-factors/

http://www.webmd.com/heart-disease/guide/heart-disease-symptoms-types

http://www.mayoclinic.org/diseases-conditions/heart-disease/basics/symptoms/con-20034056

http://www.health.gov.au/internet/main/publishing.nsf/content/chronic-cardio#tre

http://my.clevelandclinic.org/services/heart/prevention/emotional-health/holistic-therapies

Posted in NUTRITION
February 7, 2017

Cardio-metabolic syndrome (CMS) is characterized by a group of cardiovascular and metabolic risk factors. ​Cardio-metabolic syndrome is a combination or cluster of risk factors that, together, increase the risk of developing cardiovascular disease and diabetes. The risk factors that make up this cluster include –

  • Central obesity (waist circumference greater than the desired target level)
  • High triglycerides
  • High blood pressure
  • High fasting blood glucose
  • Low HDL (good cholesterol)
  • High LDL (lousy cholesterol)

If an individual has at least three of these conditions, the patient likely has metabolic syndrome, and the risk of developing cardiovascular disease or diabetes is greatly increased. That means an increased risk of complications, including loss of eyesight and kidney failure from diabetes, and heart attack and stroke from cardiovascular disease. This means that it is extremely important for people to work with their healthcare professional team to make changes to their lifestyle and possibly their medical care.

A wide range of traditional and newly recognized risk factors contribute to cardiometabolic disease, and it is important to review all of them during a patient examination.

Traditional cardio-metabolic risk factors –

  • Age
  • Sex
  • Family history
  • Hypertension
  • Dysglycemia
  • Dyslipidemia
  • Smoking

Other cardio-metabolic risk factors –

  • Abdominal obesity (measured by waist circumference)
  • Insulin resistance
  • Inflammation (measured by high-sensitivity C-reactive protein levels)
  • Lack of consumption of fruits and vegetables
  • Sedentary lifestyle
  • Psychosocial stress

Causes       

Genetics – Some people are genetically more inclined to develop insulin resistance, which can lead to metabolic syndrome. People from Asian, African-Caribbean and Hispanic (Latin-American) backgrounds have a higher risk of developing metabolic syndrome. People with a family history of type 2 diabetes, high blood pressure and early heart disease are are also more susceptible.

Obesity/overweight – Especially if the person continues gaining weight every year and has too much belly fat (abdominal obesity).

Physical inactivity – Lack of exercise is a major contributory factor towards metabolic syndrome risk. Women are more likely to develop metabolic syndrome due to lack of exercise than men.

Diet – Some studies have linked sugary drinks with metabolic syndrome. High-fat diets can also induce insulin resistance, even after a few days.

Age – Metabolic syndrome rates are much higher among older people. Over 40% of people aged 60+ years have metabolic syndrome, compared to less than 10% among twenty-year-olds. However, metabolic syndrome can occur at any age.

Sleep apnea – People with sleep apnea are more likely to suffer from insulin resistance, which in turn raises the risk of metabolic syndrome.

Hormonal imbalance – People with hormonal problems may have a higher risk of developing metabolic syndrome. An example is PCOS (polycystic ovary syndrome).

Others

  • Sources of inflammation in the body
  • Existing nutrient deficiencies
  • The production of free radicals inside your body

Symptom

The symptoms include –

  • Obesity – especially if you have an apple shape, with too much fat built up around the waist, known as “central obesity” or “abdominal obesity”. A man’s waist will be at least 102 centimeters (40 inches) and a woman’s 89 centimeters (35 inches). The waist circumferences can vary, according to the height and frame of the individual.
  • Hypertension (high blood pressure) – blood pressure of at least 130/85mmhg. Some countries, such as the UK place the threshold at 140/90mmHg .
  • High blood sugar – a fasting blood glucose of at least 5.6 mmol/L (100 mg/dL). The person’s body is unable to control blood sugar levels, also known as insulin resistance.
  • Abnormal blood cholesterol – low levels of HDL, also known as high-density lipoprotein or “good cholesterol”, less than 40mg/dL (1.04mmol/L)
  • High blood triglycerides – triglycerides are a form of circulating fats. Levels of at least 150mg/dL or 1.7mmol/L.

People with metabolic syndrome also have a higher risk of deep vein thrombosis, and tend to develop inflammation.

Treatment

Lifestyle Modification – Lifestyle modification is the primary management strategy for cardiometabolic syndrome. This can be challenging to implement in a primary care practice because it requires simultaneous counseling on physical activity, diet, and smoking cessation with regular follow-up over a long period of time. Clinical guidelines recommend that lifestyle modifications be continued for 3 to 6 months before considering pharmacotherapy unless patients are at high risk. The importance of continuous, lifelong behavior change should be communicated to patients, even if they receive pharmacotherapy.

  • Eat better
  • Get active (exercise)
  • Lose weight
  • Take medications
  • Limit alcohol intake
  • Stop smoking

Nutritional Supplements

Protein and bioactive peptides – Milk protein, especially whey protein, has been shown to improve body composition and to have a positive impact on muscle protein synthesis. It has been demonstrated that whey protein helps in controlling blood glucose levels.

Vitamin D – Several epidemiological studies have demonstrated that adequate vitamin D intake and status may be protective against metabolic syndrome. Many mechanisms have been proposed to explain how vitamin D may modulate cardiometabolic health. These include the reduction of dyslipidemia through the maintenance of calcium homeostasis, the stimulation of insulin production and release, and the regulation of the renin-angiotensin-aldosterone system, which helps in blood pressure control.

Conjugated linoleic acid (CLA) and milk fat – Milk fat appears to improve the ratio of HDL-cholesterol to total cholesterol. Saturated fatty acids present in milk fat also have a favourable impact on triglyceride levels.

Calcium, potassium and magnesium – Evidence suggests that calcium may improve the blood lipid profile through the potential mediation of fecal fat excretion.

 

Reference –

http://www.repertoiremag.com/cardiometabolic-syndrome.html

http://www.sld.cu/galerias/pdf/servicios/hta/hypertension_and_the_cardiometabolic_syndrome_in_chile_a_review_of_concepts_and_consequences_for_the_developing_world.pdf

http://halleinstitute.emory.edu/combating_cms/

http://link.springer.com/article/10.1007%2Fs11892-006-0036-5#/page-1

http://link.springer.com/article/10.1007%2Fs11892-006-0036-5

http://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-10-71

http://www.healthsciences.okstate.edu/com/cme/pdf/Sun%203%20Chad%20Edwards%20DO%20Metabolic%20Syndrome.pdf

http://www.slideshare.net/hosamatef9/cardiometabolic-syndrome

Posted in NUTRITION