365DAYS CAMPAIGN AGAINST NON COMMUNICABLE

  

DAY 132 of 365

TREATMENT OF CARDIOVASCULAR DISEASE 

The treatment option that is best for a person will depend on their specific type of CVD.

However, some options include:

medication, such as to reduce low density lipoprotein cholesterol, improve blood flow, or regulate heart rhythm

surgery, such as coronary artery bypass grafting or valve repair or replacement surgery

cardiac rehabilitation, including exercise prescriptions and lifestyle counseling

Treatment aims to:

relieve symptoms

reduce the risk of the condition or disease recurring or getting worse

prevent complications, such as hospital admission, heart failure, stroke, heart attack, or death

Depending on the condition, a healthcare provider may also seek to stabilize heart rhythms, reduce blockages, and relax the arteries to enable a better flow of blood.

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365DAYS CAMPAIGN AGAINST NON COMMUNICABLE DISEASES

DAY 131 of 365

 SIGNS AND SYMPTOMS OF CARDIOVASCULAR DISEASE

The classic symptoms of angina, or pain from the heart, are described as a crushing pain or heaviness in the center of the chest with radiation of the pain to the arm (usually the left) or jaw. There can be associated shortness of breath sweating and nausea.

The symptoms tend to be brought on by activity and get better with rest.

Some people may have indigestion and nausea while others may have upper abdominal, shoulder, or back pain.

Unstable angina is the term used to describe symptoms that occur at rest, waken the patient from sleep, and do not respond quickly to nitro-glycerine or rest.

Not all pain from heart disease has the same signs and symptoms. The more we learn about heart disease, the more we realize that symptoms can be markedly different in different groups of people. Women, people who have diabetes and the elderly may have different pain perceptions and may complain of overwhelming fatigue and weakness or a change in their ability to perform routine daily activities like walking, climbing steps, or doing household chores. Some patients may have no discomfort at all.

Most often, the symptoms of cardiovascular disease become worse over time, as the narrowing of the affected coronary artery progresses over time and blood flow to that part of the heart decreases. It may take less activity to cause symptoms to occur and it may take longer for those symptoms to get better with rest. This change in exercise tolerance is helpful in making the diagnosis.

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365DAYS CAMPAIGN AGAINST COMMUNICABLE DISEASES

DAY 129 of 365

ETIOLOGY OF CARDIOVASCULAR DISEASE

Heart or cardiovascular disease is the leading cause of death in the World and often can be attributed to the lifestyle factors that increase the risk of atherosclerosis or narrowing of arteries. Smoking, along with poorly controlled hypertension (high blood pressure), and diabetes, causes inflammation and irritation of the inner lining of the coronary arteries. Over time, cholesterol in the bloodstream can collect in the inflamed areas and begin the formation of a plaque. This plaque can grow and as it does, the diameter of the artery narrows. If the artery narrows by 40% to 50%, blood flow is decreased enough to potentially cause the symptoms of angina (A chest pain or shortness of breath).

In some circumstances, the plaque can rupture or break open, leading to the formation of a blood clot in the coronary artery. This clot can completely occlude or block the artery. This prevents oxygen-rich blood from being delivered to the heart muscle beyond that blockage and that part of the heart muscle begins to die. This is a myocardial infarction or heart attack. If the situation is not recognized and treated quickly, the affected part of the muscle cannot be revived. It dies and is replaced by scar tissue. Long term, this scar tissue decreases the heart's ability to pump effectively and efficiently and may lead to ischemic cardiomyopathy (ischemic=decreased blood supply + cardio=heart +myo=muscle + pathy=disease).

Heart muscle that lacks adequate blood supply also becomes irritable and may not conduct electrical impulses normally. This can lead to abnormal electrical heart rhythms including ventricular tachycardia and ventricular fibrillation. These are the heart arrhythmias associated with sudden cardiac death.

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365 DAYS CAMPAIGN AGAINST COMMUNICABLE DISEASES

DAY 128 of 365

 STATISTIC AND FACTS ABOUT CARDIOVASCULAR DISEASE (CVD)

CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause.

An estimated 17.7 million people died from CVDs in 2015, 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 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2015, 82% are in low- and middle-income countries, and 37% are caused by CVDs.

Most cardiovascular diseases can be prevented by addressing behavioural 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, hyperlipidaemia or already established disease) need early detection and management using counselling and medicines, as appropriate.

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365 DAYS CAMPAIGN AGAINST NON COMMUNICABLE DISEASES

DAY 127 of 365

RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD)

The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of developing a heart attack, stroke, heart failure and other complications.

Cessation of tobacco use, reduction of salt in the diet, consuming fruits and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. In addition, drug treatment of diabetes, hypertension and high blood lipids may be necessary to reduce cardiovascular risk and prevent heart attacks and strokes. Health policies that create conducive environments for making healthy choices affordable and available are essential for motivating people to adopt and sustain healthy behaviour.

There are also a number of underlying determinants of CVDs or "the causes of the causes". These are a reflection of the major forces driving social, economic and cultural change – globalization, urbanization and population ageing. Other determinants of CVDs include poverty, stress and hereditary factors.

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365 DAYS CAMPAIGN AGAINST NON COMMUNICABLE DISEASES (NCDs)

Day 126 of 365 days Campaign

HOW TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE (CVD)

Cost effective interventions that are feasible to be implemented even in low-resource settings have been identified by WHO for prevention and control of cardiovascular diseases. They include two types of interventions: population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden.

Examples of population-wide interventions that can be implemented to reduce CVDs include:

comprehensive tobacco control policies

taxation to reduce the intake of foods that are high in fat, sugar and salt

building walking and cycle paths to increase physical activity

strategies to reduce harmful use of alcohol

Providing healthy school meals to children.

At the individual level, for prevention of first heart attacks and strokes, individual health-care interventions need to be targeted to those at high total cardiovascular risk or those with single risk factor levels above traditional thresholds, such as hypertension and hypercholesterolemia. The former approach is more cost-effective than the latter and has the potential to substantially reduce cardiovascular events. This approach is feasible in primary care in low-resource settings, including by non-physician health workers.

For secondary prevention of cardiovascular disease in those with established disease, including diabetes, treatments with medications are necessary.

The benefits of these interventions are largely independent, but when used together with smoking cessation, nearly 75% of recurrent vascular events may be prevented. Currently there are major gaps in the implementation of these interventions particularly at the primary health care level.

In addition costly surgical operations are sometimes required to treat CVDs. Medical devices are required to treat some CVDs. Such devices include pacemakers, prosthetic valves, and patches for closing holes in the heart.

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Campaign against Non Communicable Diseases

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Day 19 of 365

The burden of Diabetes.

More than 400 million adults live with diabetes globally. Causes more than 2 million deaths annually. More than 40% of such deaths occur among individuals of aged below 70 years. More than $ 2 Trillion is spent on diabetes management, treatment and care. This amount is about 50 times the Kenyan national annual budget. More than 3% of Kenyans live with diabetes while two thirds remain undiagnosed according to the WHO. This number is expected to rise beyond 4% by 2025. As the numbers are expected to rise, more money will be spent in the management of such diseases rather than personal and national development. Kenyans and everyone globally are hence expected to take up preventive measures.

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