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Clustering of risk factors for cardiovascular disease

  • 2021-01-07
  • Loreti

Approximately 50% of cardiac arrests occur in individuals without known heart disease, but most suffer from Coronary artery disease (CAD), also known as coronary heart disease (CHD), ischemic heart disease (IHD), or simply heart disease, which refers to most conditions caused by atherosclerosis, or the buildup of plaque in the heart’s arteries. Most frequently, it takes the form of heart attack, stroke, arrhythmia, or heart valve problems.

Heart disease is also the leading cause of death in the United States and worldwide, although the healthcare community has had significant success in prevention and treatment: Over the last several decades, there has been a decline in the number of deaths due to heart disease or heart attack.

But the reality is that heart diseases are also caused by other factors like muscle function, valve function, the lining of the heart, and the electrical system. It’s much broader than blockages, although that tends to be the most common presentation of heart disease,” says Northwestern Medicine Cardiologist Micah J. Eimer, MD.

 

 Facts About Heart Disease

What behaviors increase the risk of heart disease?

Your lifestyle can increase your risk of heart disease.

  • Eating a diet high in saturated fats, trans fat, and cholesterol has been linked to heart disease and related conditions, such as atherosclerosis. Also, too much salt (sodium) in the diet can raise blood pressure.
  • Not getting enough physical activity can lead to heart disease. It can also increase the chances of having other medical conditions that are risk factors, including obesity, high blood pressure, high cholesterol, and diabetes. Regular physical activity can lower your risk for heart disease.
  • Drinking too much alcohol can raise blood pressure levels and the risk of heart disease. It also increases levels of triglycerides, a fatty substance in the blood that can increase the risk of heart disease.
    • Women should have no more than 1 drink a day.
    • Men should have no more than 2 drinks a day. 
  • Tobacco use increases the risk of heart disease and heart attack:
    • Cigarette smoking can damage the heart and blood vessels, which increases your risk for heart conditions such as atherosclerosis and heart attack.
    • Nicotine raises blood pressure.
    • Carbon monoxide from cigarette smoke reduces the amount of oxygen that your blood can carry.
    • Exposure to secondhand smoke can also increase the risk for heart disease, even for nonsmokers.

 

 

 When you find out what’s going on early, almost all these things are preventable. 

— Micah J. Eimer, MD

Heart Disease Prevention

Many risk factors are preventable. The first step in prevention is to know your family’s heart disease history. “It’s not the most comfortable conversation, but you want to have time on your side,” explains Dr. Eimer. “And when you find out what’s going on early, almost all these things are preventable if given time and proper treatment.”

High blood pressure, high LDL cholesterol and smoking are among the major risk factors for heart disease, and 47 percent of people in the U.S. have at least one of these three risk factors. Diabetes is also another major risk factor, and almost 7 in 10 people with diabetes over age 65 will die of some type of heart disease. There are ways to reduce these and other risks, like adopting a healthy diet and incorporating physical activity into your routine. The key is to find something you enjoy doing, like walking with friends.

 When you find out what’s going on early, almost all these things are preventable. 

— Micah J. Eimer, MD

And while there are some symptoms associated with heart disease, not everyone experiences them. “The misconception is an individual feels fine, so they don’t think they have a problem,” explains Dr. Eimer. “People should be finding out if they have non-obstructive coronary disease. These are minor blockages that aren’t causing symptoms or detected by a stress test, but can lead to a heart attack in the future.” Your primary care provider or cardiologist may use a blood test or recommend a coronary calcium scan to better determine your risk.

Discover other things about heart disease that can help you understand and manage your risk.

 

Wearable Devices for Ambulatory Cardiac Monitoring.

Remote and ambulatory monitoring is becoming increasingly popular among health care practitioners and patients for the long-term continuous monitoring and diagnosis of cardiac diseases (1). Hardware and software advancements have led to the development of novel devices, which are both practical and affordable, and enable monitoring of vulnerable populations from the comfort of their homes, while at the same time providing critical alerts for events requiring prompt medical attention or hospitalization (2). Wearable devices can also enable virtual or remote care, which can help bridge the health care divide between urban and rural settings.

Today, terminologies such as remote health care, virtual care, mobile health, or e-health all essentially refer to the range of solutions and paradigms that are enabled by ambulatory devices for continuous and remote monitoring. These technologies have the potential to provide a reliable clinical diagnosis by collecting physiological health data over long periods of time and reduce hospitalization expenses for vulnerable patients by making it possible to monitor for critical health conditions at home (2). Furthermore, they are opening the door for personalized health care and medicine by enabling a deeper understanding of an individual patient's (patho)physiological state and daily activities.

Cardiologists in the United States are increasingly utilizing technology to provide remote health care–based solutions and diagnostics made partly possible through implantable or wearable devices. These devices provide early detection of critical physiological events, giving patients more time to seek medical help (2). Remote monitoring and management techniques can further lead to the optimization of implantable cardioverter-defibrillator leads as well as reduce the chances of any inappropriate shock related to such devices (3).

Furthermore, there is a shifting trend toward wearable and non-invasive devices, which have the potential of capturing multiple data streams of vital physiological parameters while being easy to wear, operate, and maintain and are also affordable (2). This is because developments in both hardware and software technology have enabled the development of sensors and algorithms that can acquire and process high-quality data noninvasively and through minimal skin contact.

The 3 main components of a remote monitoring health care system are: 1) a wearable sensor collecting the data on physiological parameters; 2) a network and communications interface that enables the transfer of these data to a remote monitoring station such as a nurse or physician’s terminal or a smartphone; and 3) a remote cloud analytics platform that enables integration of large volumes of data, mines useful information, identifies key patterns and parameters critical for patient’s health and recommends most optimal ways of treatment (1).

 

References

  1. Fryar CD, Chen T-C, Li X. Prevalence of uncontrolled risk factors for cardiovascular disease: United States, 1999–2010 pdf icon[PDF-494K]. NCHS data brief, no. 103. Hyattsville, MD: National Center for Health Statistics; 2012. Accessed May 9, 2019.
  2. National Diabetes Statistics Report, 2017 pdf icon[PDF-1.4M]. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Preventions, 2017. Accessed May 9, 2019.
  3. National Center for Health Statistics. Health, United States, 2017. Table 19: Leading Causes of Death and Numbers of Deaths, by Sex, Race, and Hispanic Origin: United States, 1980 and 2016 pdf icon[PDF-776M]. Hyattsville, MD: National Center for Health Statistics; 2018. Accessed May 9, 2019.
  4. Myerburg RJ, Kessler KM, Castellanos A. Sudden cardiac death. Structure, function, and time-dependence of risk. Circulation1992;85:I2–10. Google ScholarPubMed 
  5. Lloyd-Jones DM, Wilson PW, Larson MG, Beiser A, Leip EP, D'Agostino RB, Levy D. Framingham risk score and prediction of lifetime risk for coronary heart disease. Am J Cardiol2004;94:20–Google ScholarCrossrefPubMed 

 

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