Cardiovascular Diseases CVD’s In the Philippines

• From cardio + vascular (CVDs) • Cardiovascular diseases (CVD) are

among the top 5 causes of death in the
• A group of disorders of the heart and country (DOH).
blood vessels (WHO, 2017)
• Five years ago, CVDs only placed 7th
• Number 1 cause of death worldwide. as the leading cause of morbidities and
• An estimated 17.9 million people died mortalities but today it is among the top.
from CVDs in 2016, representing 31% • Mostly affect the female population and
of all global deaths. patients are getting younger.
• Average age group of heart attack
Coronary Heart Disease victims have lowered to 30s from 40s.

• Disease of the blood vessels supplying • DOH along with the local government
the heart muscle. units (LGU), has organized
hypertension and diabetes clubs.
Cerebrovascular Disease
• Disease of the blood vessels supplying
the brain. THE COMMON CVDs

Peripheral Arterial Disease

• Disease of blood vessels supplying the Atherosclerosis
arms and legs. • Derived from the word Atheroma “lump
Congenital Heart Disease of wax” and sclerosis “hardening of the
inside part of the body”
• Malformations of heart structure
existing at birth. • A condition in which artery wall
thickens, which is a result of a build-up
Rheumatic Heart Disease of plaques (fatty materials like
cholesterol) due to accumulation of
• Damage to the heart muscle and heart
macrophage white blood cells and
valves from, rheumatic fever, caused by
promoted by low density.
streptococcal bacteria.
Deep Vein Thrombosis and Pulmonary
Embolism Components of Plaques
• Blood clots in the leg veins, which can • Atheroma (“lump of wax”)
dislodge and move to the heart and
lungs. - The nodular accumulation of a soft,
flaky, yellowish material at the center of
large plaques, composed of
macrophages nearest to the lumen of the
artery
• Underlying Areas of Cholesterol
Crystal.
• Calcification at the base of older or Symptoms: Chest pain, Abdominal, neck,
more advanced lesions. back, jaw, or shoulder and arm pain,
nausea and vomiting sensation, fatigue,
Perspiration, Shortness of breath.
Plaque
• Sticky substance made up of fat, CAROTID ARTERY DISEASE
cholesterol (LDL), calcium, cellular
waste,etc. It builds up in the arteries, • The accumulation of plaque in the
resulting to the limited flow of oxygen- arteries leading to the brain. (Carotid
rich blood in the body. Artery)
• Cerebrovascular disease is caused due
to reduced supply of oxygen rich blood
Complications to brain.
• Heart Disease Symptoms: Inability to comprehend
• Heart Failure speech, or to have garbled speech,
muscle weakness, impairment of facial
• Heart Attack Kidney muscles, vertigo, involuntary or jerky
• FailureAneurysm movements on one side of the body.

• Stroke
• Arrhythmia PERIPHERAL ARTERY DISEASE
• Caused by the accumulation of plaque
in the arteries supplying blood to the
Symptoms hands and feet.
• Chest pain, chest tightness, chest Symptoms: Pain ,cramps, numbness,
pressure and chest discomfort (angina) and sense of fatigue in muscles of limbs,
diminished pulses in the hands and feet,
• Shortness of breath
reduced muscle mass, blowing sounds
• Pain, numbness, weakness or coldness that can be heard with the help of
in your legs or arms stethoscope indicating turbulence in
blood flow (also called “bruits”), Loss of
• Pain in the neck, jaw, throat, upper hair, thickening of nails, Smooth and
abdomen or back. shiny skin surface, gangrene .

CORONARY ARTERY DISEASE Abdominal Angina and Bowel

• The accumulation of plaque in the Infraction
arteries leading to the heart. • Caused by the narrowing of intestinal
• When the arteries are blocked, the cells arteries.
in the heart begin to die.
Abdominal Angina Treatments
• Poor blood supply to the small NONE
intestines.

Regulation
Bowel Infraction
Lifestyle Changes
• Injury in the intestine resulting from
• Weight Management
insufficient blood flow.
• Physical Activity
Symptoms: Cramping pain in the middle
of the abdomen, severe abdominal pain • Healthy Diet
with vomiting and diarrhea or abdominal
swelling.
Medications

Risk Factors Various Medication

• Unhealthy blood cholesterol level • Anti-platelet drugs

• High blood pressure • StatinsAngiotensin-converting enzyme

(ACE)
• Smoking
Surgical Interventions
• Insulin Resistance
• Angioplasty
• Overweight or Obesity
• Coronary Artery Bypass Grafting
• Lack of physical activity (CABG)
• Age (In men, risk increases after age
45, in women, risk increases after age
55) Stroke

• Family History • A condition that may be caused by a

blocked artery or the leaking or bursting
of a blood vessel in the brain.
Other Factors • Some experience only a temporary
disruption of blood flow.
• Sleep Apnoea
• It is a medical emergency.
• Stress
• Alcohol
Types of Stroke
• Having diabetes
• Dyslipoproteinemia ✓ Ischemic Stroke


 ✓ Hemorrhagic Stroke
✓ Transient Ischemic Stroke (Mini
Stroke)
Ischemic Stroke Kinds of Hemorrhagic Stroke
• About 80% of stroke ➢ AIntracerebral Stroke
- Occurs when the arteries to your brain • A blood vessel in the brain bursts and
become narrowed or clogged with spills into the surrounding brain tissue,
plaque, causing severely reduced blood damaging brain cells.
flow (ischemia).

➢ Subarachnoid Stroke
Kinds of Ischemic Stroke
• An artery in your brain bursts and spills
➢ Thrombotic Stroke into the space between the surface of
your brain and your skull.
• Occurs when a blood clot (thrombus)
forms in one of the arteries that supply - One of its symptoms is severe
blood to your brain. It may be caused headache.
by the build-up of plaque in arteries and
can reduced blood flow.
Transient Ischemic Stroke (Mini
Stroke)
➢ Embolic Stroke
• It is a temporary period stroke.
• Occurs when a blood clot (embolus) or
.- Caused by a temporary decrease in
other debris forms away from your brain
blood supply to part of your brain, which
(usually the heart), and is swept
may last as little as 5 minutes.
through your bloodstream to lodge in
narrower brain arteries.

Risk Factors
Hemorrhagic Stroke Lifestyle Risk Factors
• Occurs when a blood vessel in your • Being overweight or obese
brain leaks or ruptures.
• Physical Inactivity
Brain hemorrhages is a result of:
• Heavy or binge drinking
- Uncontrolled high blood pressure
• Use of illicit drugs such as cocaine and
- Over-treatment with anticoagulants methamphetamines
- Weak spots in your blood vessel walls
(aneurysm)
Medical Risk Factors
• Blood pressure readings higher than
120/80 millimeters of mercury.
• High Cholesterol
• Diabetes
• Obstructive sleep apnea • Exercising regularly
• Cardiovascular Diseases • Drinking alcohol in moderation
• Personal or family history of stroke, • Treating obstructive sleep apnea
heart attack or transient ischemic attack
• Avoiding illegal drugs

Other Factors
Preventive Medications
• Age
Various Medication
• Race
• Anti-platelet drugs
• Sex
• Anticoagulants
• Hormones

Medications
Complications
Ischemic Stroke and TIA
• Paralysis of loss of muscle movement
• Anti-platelet and Anticoagulants
• Difficulty talking or swallowing
• Clot-breaking drugs
• Memory loss or thinking difficulties
• Mechanical Thrombectomy
• Emotional Problems
• Stents
• Pain or Numbness
• Surgery behavior and self-care ability
• Changes in behavior and self-care
Hemorrhagic Stroke
ability
• Medications
• Coiling
Regulation
• Clamping
Lifestyle Changes
• Surgery
• Controlling or lowering high blood
pressure 

Recovery
• Lowering the amount of cholesterol and
saturated fat in your diet • Speech Therapy
• Quitting tobacco use • Cognitive Therapy
• Controlling diabetes • Relearning Sensory Skills
• Maintaining a healthy weight • Physical Therapy
• Eating a diet rich in fruits and
vegetables
How to spot a stroke • Dementia
Balance - loss of balance, headache, or • Heart failure and heart attacks
dizziness
• Kidney failure
Eyes - blurred vision
• Diabetes
Face - one side of the face is drooping
• Aneurysm, or abnormal bulge in the
Arms - arm or leg weakness wall of artery that can burst
Speech - speech difficulty • Stroke
Time - time to call for ambulance • Amputation
immediately
• Hypertensive retinopathies in the eye,
which can lead to blindness
Blood Pressure • DEATH
• The force that a person’s blood exerts
against the walls of their blood vessels.
Symptoms
This pressure depends on the
resistance of the blood vessels, and • Fatigue or Confusion
how hard the heart has to work.
• Trouble breathing or shortness of
• Systolic pressure - occurs as the breath
blood pumps out of the heart and into the
arteries (the heart beats) • Severe headache and dizziness

• Diastolic pressure - created as the • Vision problems

heart rests between beats. • Nosebleeds
• Irregular heartbeat or pounding in the
Hypertension chest, neck, or ears

• Also known as high blood pressure • Blood in the urine

(HBP).
• The force of the blood pushing against Diagnosis
the walls of your blood vessels is
consistently too high. • Sphygmomanometer

• The more blood your heart pumps and

the narrower your arteries, the higher Risk Factors
the blood pressure.

• Smoking or exposure to second-hand
smoke
Complications
• Diabetes
• Atherosclerosis
• Obese or overweight
• Metabolic syndrome
• High cholesterol • Angiotensin-converting enzyme (ACE)
inhibitors
• Unhealthy diet
• Angiotensin II receptor blockers (ARBs)
• Physical inactivity
• Calcium channel blockers


Family history
• Race/Ethnicity Coronary Heart Disease
• Increasing age • Also known as CHD, or coronary
artery disease (occurs in the arteries of
• Gender (males) the heart).
• Chronic kidney disease • It is the narrowing or blockage of the
• Obstructive sleep apnea coronary arteries that supply oxygen
and blood to the heart.


Other Factors
• Socio-economic status Symptoms

• Psychosocial stress • Dizziness

• Anxiety

Treatments • Chest pain, heart burn, irregular heart

rate
NONE
• Weakness
• Nausea
Regulation
• Cold sweat
• Heart-healthy and less salt diet
• Burning sensations
• Regular physical activity
• Maintaining healthy weight
Complications
• Limiting alcohol drinking
• Chest pain (angina)
• Quit smoking
• Abnormal heart rhythm (arrhythmia)
• Cut back on caffeine
• Heart failure
• Reduce stress
• Heart attack
• DEATH
Medications
• Thiazide diuretics (diuretics)
Diagnosis Medications
• Electrocardiogram • Cholesterol-modifying medications
• Cardiac Catherterization • Aspirin
• Echocardiogram • Beta blockers
• CT Scan • Calcium channel blockers
• Ranolazine
Risk Factors • Nitroglycerin
• Age • Angiotensin-converting enzyme (ACE)
inhibitors
• Sex
• Angiotension II receptor blockers
• Family history (ARBs)
• Smoking
• High blood pressure Procedures
• High cholesterol levels • Angioplasty
• Diabetes • Stent placement
• Overweight or obesity
• Physical inactivity Heart Attack
• High stress • Also known as CHD, or coronary
• Unhealthy diet artery disease (occurs in the arteries of
the heart).
• It is the narrowing or blockage of the
Treatments coronary arteries that supply oxygen
NONE and blood to the heart.

Regulation Complications

• Quit smoking • Cardiac arrest

• Control conditions (high blood pressure, • Cardiomyopathy

high cholesterol, and diabetes) • Heart failure
• Be physically active • Arrhythmias (ventricular fibrillation)
• Eat a low-fat, low-salt diet • Long Q-T syndrome
• Maintain a healthy weight • DEATH
• Reduce and manage stress
Symptoms • The risk of CVD increases with the
number of cigarettes smoked per day,
• Heavy chest pain and when smoking continues for
• Cold and sweaty many years.

• Pain in the neck or left arm

• Nausea How Does Smoking Damage the
Heart?
• Sudden onset of symptoms
• Chemicals in cigarette smoke cause the
• Shortness of breath cells that line blood vessels to become
• More tired than useless swollen and inflamed. This can narrow
the blood vessels and increases the risk
• Flu-like symptoms of developing cardiovascular
diseases.
• Feeling of indigestion or heartburn
• Smoking damages the lining of your
• Symptoms for a number of days
arteries, leading to a build up of fatty
material (atheroma) which narrows the
artery. This can cause angina, a heart
Risk Factors attack or a stroke.
• Smoking • Your blood is more likely to clot,
• Infections which increases your risk of having a
heart attack or stroke.
• Sedentary lifestyle
• Genetic predisposition
Cigarette and Tobacco
• Blood pressure
• The carbon monoxide in tobacco
• Alcohol smoke reduces the amount of oxygen in
• Age your blood. • The nicotine in cigarettes
stimulates your body to produce
• Unhealthy food adrenaline, making your heart work
harder.
• Obesity
• Total cholesterol
Effects of Regular Exercise on
Cardiovascular Disease
Cigarette Smoking and Cardiovascular
Disease
American Heart Association
• Smoking is a major cause of
Recommendations
cardiovascular disease (CVD).
• Causes approximately 1 of every 4 ✓ 30 minutes of moderate-intensity
aerobic activity at least 5 days
deaths (2014 Surgeon General’s
Report).
 per week for a total of 150 Psychological Benefits
minutes
• Reduced risk of depression
✓ 25 minutes of rigorous aerobic
• Reduced stress and better control of it
activity at least 3 days per week
for a total of 75 minutes (or a • Increased social activity and support
combination of moderate and
rigorous aerobic activity) • Protection from decline of cognitive
function as we age
✓ Moderate-to-high intensity
muscle strengthening activity at
least 2 days per week for Protection Against Blood Clots
additional health benefits (Thrombosis)
• Reduced platelet stickiness
Benefits Directly on Heart Muscle • Decreased blood viscosity
(Myocardium)
• Increased ability to break down clots
• Decreased oxygen demand by the
heart muscle
• Improved blood flow through the Protection Against Blood Arrhythmias
coronary blood vessels • Increased vagal tone (“breaks”)
• Improved responsiveness to nitric oxide • Reduced sympathetic activity (“gas”)
• Decreased dysfunction of the cells • Improved heart rate variability
lining the heart (endothelium)
• Improved activity of the stem cells of
the heart (endothelial proginator cells, Other Cardioprotective Benefits
circulating angiogenic cells)
• Reduction in weight
• Increase in exercise tolerance
Protective Effects on Blood Vessels
• Increased skeletal muscle function and
• Improved lipid profile: lowers strength
cholesterol, LDL, and triglycerides
• Improved lung function
• Improves HDL
• Reduced risk of smoking
• Lowers Blood Pressure
• Improve aerobic capacity

Reduction in total body fat

• Increased Insulin Sensitivity
• Decreased inflammation (reduced C-
reactive protein)