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Webpage about Atherosclerosis, addressing symptoms, diagnosis, causes and risk factors, prevention, treatment, living with the disease.
Cardiovascular disease (CVD), also called heart and circulatory disease, is an umbrella name for conditions that affect your heart or circulation. These include high blood pressure, stroke and vascular dementia.
Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.
It's usually associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots.
It can also be associated with damage to arteries in organs such
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as the brain, heart, kidneys and eyes.
CVD is one of the main causes of death and disability in the UK, but it can often largely be prevented by leading a healthy lifestyle.
more
What is blood pressure?
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is a
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t rest, between beats, your blood pressure falls. This is called diastolic pressure.
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What is high blood pressure in pregnancy?
Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps blood. High blood pressure, or hypertension, is when this force against your artery walls is too high. There are different types of high blood pressure
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in pregnancy:
Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. It sometimes can be severe, which may lead to low birth weight or preterm birth. Some women with gestational hypertension do go on to develop preeclampsia.
Chronic hypertension is high blood pressure that started before the 20th week of pregnancy or before you became pregnant. Some women may have had it long before becoming pregnant but didn't know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. In rare cases, symptoms may not start until after delivery. This is called postpartum preeclampsia. Preeclampsia also includes signs of damage to some of your organs, such as your liver or kidney. The signs may include protein in the urine and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.
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Peripheral arterial disease (PAD) in the legs or lower extremities is the narrowing or blockage of the vessels that carry blood from the heart to the legs. It is primarily caused by the buildup of fatty plaque in the arteries, which is called atherosclerosis. PAD can happen in any blood vessel, but
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it is more common in the legs than the arms.
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Treatment plan
Peripheral artery disease (PAD) is a disease of the blood vessels outside the heart and brain. PAD often occurs due to a buildup of fatty deposits in the arteries.
Peripheral artery disease is similar to coronary artery disease (CAD).
Peripheral artery disease is a narrowing of the peripheral arteries that carry blood away from the heart to other parts of the body. The most common type is lower-extremity PAD, in which blood flow is reduced to the legs and fee
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t. Upper-extremity PAD (arms, hands and fingers) is less common but affects about 10% of the population.
Both PAD and coronary artery disease are caused by atherosclerosis, the buildup of fatty plaque in the arteries that narrows and blocks them throughout the body, including in the heart, brain, arms, legs, pelvis and kidneys.
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Background: Data on burden of peripheral artery disease (PAD) and its attributable risk factors are valuable for policymaking. We aimed to estimate the burden and risk factors for PAD from 1990 to 2019.
Methods: We extracted the data on prevalence, incidence, death, years lived with disability (YLD
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s), and years of life lost (YLLs) from the Global Burden of Disease Study 2019 to measure PAD burden. Moreover, the attributable burden to PAD risk factors was also estimated.
Results: Globally, in 2019, 113,443,017 people lived with PAD and 10,504,092 new cases occurred, resulting in 74,063 deaths, 500,893 YLDs, and 1,035,487 YLLs. The absolute numbers of PAD prevalent and incident cases significantly increased between 1990 and 2019, contrasting with the decline trends in age-standardized prevalence and incidence rates. However, no statistically significant changes were detected in the global age-standardized death or YLL rates. The burden of PAD and its temporal trends varied significantly by location, gender, age group, and social-demographic status. Among all potentially modifiable risk factors, age-standardized PAD deaths worldwide were primarily attributable to high fasting plasma glucose, followed by high systolic blood pressure, tobacco, kidney dysfunction, diet high in sodium, and lead exposure.
Conclusion: PAD remained a serious public health problem worldwide. More strategies aimed at implementing cost-effective interventions and addressing modifiable risk factors should be carried out, especially in regions with high or increasing burden.
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La forte augmentation des taux de surpoids et d’obésité1 constitue une menace pour la santé de milliards
de personnes dans le monde. En 2016, plus de 1,9 milliard d’adultes âgés de 18 ans ou plus étaient en surpoid
Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to
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accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Heart failure is an important global health problem, and the associated public health and economic effect is increasing across all societies and geographies.
Epidemiological studies have estimated that there are more than 25 million patients with heart failure globally, and population-based studie
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s from North America and Europe have estimated that 1–2% of people are living with heart failure. Factors such as ageing and expanding populations have contributed to increasing hospital admissions for heart failure.
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Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil.
Metho
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ds: A cross-sectional, population-based survey of non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern Brazil. Data were analysed as survey-weighted percentages of the sampled populations.
Results: 3035 surveys were completed. Overall, one-third of respondents was unable to identify at least one cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction symptom. A minority of respondents had received training in CPR or were able to identify an AED. Low levels of education and low socioeconomic status were consistent predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED use.
Conclusions: In three municipalities in Eastern Brazil, overall public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge of appropriate CPR and AED use was low. Our findings indicate the need for interventions to improve public knowledge and response to acute cardiovascular events in Brazil as a first step towards improving health outcomes in this population. Significant heterogeneity in knowledge seen across sites and socioeconomic strata indicates a need to appropriately target such interventions.
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Background: Peripheral artery disease is a growing public health problem. We aimed to estimate the global disease burden of peripheral artery disease, its risk factors, and temporospatial trends to inform policy and public measures.
Methods: Data on peripheral artery disease were modelled using the
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Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 database. Prevalence, disability-adjusted life years (DALYs), and mortality estimates of peripheral artery disease were extracted from GBD 2019. Total DALYs and age-standardised DALY rate of peripheral artery disease attributed to modifiable risk factors were also assessed.
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All health workers would benefit from gaining knowledge and skills to protect individuals and communities from air pollution exposure. This course examines the main health impacts of air pollution and which roles health workers can play to protect and promote people’s health.
Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns
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of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
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Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burden to the management of people with diabetes. According to pharmacopeia unopened insulin vials must be stored in a
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refrigerator (2–8°C), while storage at ambient temperature (25–30°C) is usually permitted for the 4-week usage period during treatment. In the present work we address a critical question towards improving diabetes care in resource poor settings, namely whether insulin is stable and retains biological activity in tropical temperatures during a 4-week treatment period. To answer this question, temperature fluctuations were measured in Dagahaley refugee camp (Northern Kenya) using log tag recorders. Oscillating temperatures between 25 and 37°C were observed. Insulin heat stability was assessed under these specific temperatures which were precisely reproduced in the laboratory. Different commercialized formulations of insulin were quantified weekly by high performance liquid chromatography and the results showed perfect conformity to pharmacopeia guidelines, thus confirming stability over the assessment period (four weeks). Monitoring the 3D-structure of the tested insulin by circular dichroism confirmed that insulin monomer conformation did not undergo significant modifications. The measure of insulin efficiency on insulin receptor (IR) and Akt phosphorylation in hepatic cells indicated that insulin bioactivity of the samples stored at oscillating temperature during the usage period is identical to that of the samples maintained at 2–8°C. Taken together, these results indicate that insulin can be stored at such oscillating ambient temperatures for the usual four–week period of use. This enables the barrier of cold storage during use to be removed, thereby opening up the perspective for easier management of diabetes in humanitarian contexts and resource poor settings.
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While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng
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es, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
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Epidemiology of type 2 diabetes in India
Pradeepa, R.; Mohan, V.
Indian Journal of Ophthalmology 69(11):p 2932-2938, November 2021.
(2021)
CC2
The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over
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134 million by 2045. Approximately 57% of these individuals remain undiagnosed. Type 2 diabetes, which accounts for majority of the cases, can lead to multiorgan complications, broadly divided into microvascular and macrovascular complications. These complications are a significant cause for increased premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and financial and other costs of diabetes leading to profound economic burden on the Indian health care system. The risk for diabetes is largely influence by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioral habits in addition to genetics and family history. Good control of blood sugar blood pressure and blood lipid levels can prevent and/or delay the onset of diabetes complications. The prevention and management of diabetes and associated complications is a huge challenge in India due to several issues and barriers, including lack of multisectoral approach, surveillance data, awareness regarding diabetes, its risk factors and complications, access to health care settings, access to affordable medicines, etc. Thus, effective health promotion and primary prevention, at both, individual and population levels are the need of the hour to curb the diabetes epidemic and reduce diabetes-related complications in India
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