Developments in cardiovascular disease prevention
Clive Handler, Gerry Coghlan, Marie-Anne Essam in Preventing Cardiovascular Disease in Primary Care, 2018
General practitioners (GPs) could essentially abandon all responsibility for the management of cardiovascular diseases to the specialist 'expert' if they so wished, for several reasons –both professional and scientific. The major advances in cardiovascular disease prevention and management, which younger clinicians take for granted, have occurred in the last 25 years. As there was no agreement on how to administer optimal cardiac care, the quality of and waiting times for services varied widely between hospitals just a few miles apart, depending on local 'expert' advice and management competence. Guidelines have become an integral part of all areas of clinical practice and the management mindset of clinicians in Europe and the USA. Audit is a difficult discipline but it helps clinicians think about how they can improve their clinical practice and service, and provides objective information to help justify changes. The National Service Framework (NSF) documents changed our world dramatically.
Cardiovascular diseases
Mika Kivimäki, G. David Batty, Andrew Steptoe, Ichiro Kawachi in The Routledge International Handbook of Psychosocial Epidemiology, 2017
This chapter focuses on the role of stress in the aetiology and prognosis of cardiovascular disease, with particular emphasis on the underlying mechanisms. Chronic stress has been associated with a small or moderate excess risk of cardiovascular disease, such as coronary heart disease and stroke. The most commonly studied adult stressors include social isolation and stress at work, although marital problems and caring for a sick spouse or child at home, for example, have also been linked to the increased risk. Alongside modifiable physiological risk factors such as hypertension, dyslipidaemia, diabetes and obesity, lifestyle also plays a major role in the aetiology of cardiovascular disease. Lifestyle factors include smoking, physical activity, diet and energy intake, and alcohol consumption. Physiological changes, either as a consequence of repeated stress response or as a result of indirect effects of stress on lifestyle, represent the next stage in the disease process.
Nutrition and Cardiovascular Disease
James M. Rippe in Lifestyle Medicine, 2019
Cardiovascular disease (CVD) remains the leading killer of both men and women in the United States, resulting in over 37% of annual mortality. Nutritional practices play a pivotal role in the likelihood of developing CVD. The national guidelines on nutrition and cardiovascular health are also consistent with each other with regard to overall strategies for reducing cardiovascular health risk factors. Dietary patterns that include increases in fruits and vegetables, whole grains, seafood, legumes and nuts, and low- or non-fat dairy products, and that are lower in red meats and processed meats, and low in sugar-sweetened beverages and refined grains have been repeatedly shown to lower the risk of cardiovascular disease. Nutrition plays a key role in lowering the risk of cardiovascular disease and should be placed in the context of an overall healthy approach to lowering the risk of CVD, including increased physical activity, weight management, and avoidance of tobacco products.
Early Origins of Cardiovascular Disease in Pediatric Chronic Kidney Disease
Published in Renal Failure, 2010
The importance of cardiovascular disease in adults with chronic kidney disease is now well recognized. For children who develop chronic kidney disease, cardiovascular disease is also a leading cause of eventual morbidity and mortality. Although the clinical manifestations of cardiovascular disease may not be apparent until later, early subclinical findings can be observed even during childhood. This review updates the reader on the epidemiology of cardiovascular disease in pediatric chronic kidney disease, discusses risk factors and potential mechanisms of accelerated cardiovascular disease, reviews evidence of early manifestations of cardiovascular disease in pediatric chronic kidney disease, and briefly discusses prevention and treatment strategies.
Innovations in telemedicine for cardiovascular care
Published in Expert Review of Cardiovascular Therapy, 2016
Natale Daniele Brunetti, Simonetta Scalvini, Giuseppe Molinari
ABSTRACT Cardiovascular disease is one of the main fields of application for telemedicine, with benefits in almost all areas in the continuum of cardiovascular disease. The greatest impact has been shown in the early diagnosis of cardiovascular disease, in second consultation, between non-cardiologist and cardiologist and between cardiologists, and in follow-up and secondary prevention of cardiovascular disease. At present, the main area of implementation for telemedicine in cardiovascular disease is represented by pre-hospital triage, with telemedicine electrocardiogram in acute myocardial infarction. Significant results have also been achieved in the second opinion consultation of pediatric subjects with congenital cardiovascular disease, home-monitoring and the management of patients affected by chronic heart failure or with an implanted device. However, there is significant room for further improvement in delivering telemedicine assistance even in ‘very-remote’ populations, such as detainees, patients in developing countries or in underdeveloped areas of developed countries.
Advances in the management of hyperlipidemia-induced atherosclerosis
Published in Expert Review of Cardiovascular Therapy, 2008
Although hyperlipidemia clearly plays a role in developing cardiovascular disease, the 10% of the population with the highest LDL levels account for only 20% of cardiovascular disease events. Thus, in order to significantly reduce the burden of cardiovascular disease, subjects with only modest dyslipidemia need to be treated with lipid-lowering therapy. Current guidelines have recommended aggressive lipid-lowering therapy in subjects at high risk of cardiovascular disease. The rationale behind this and treatment options to achieve target lipid goals are discussed.