# Cardiovascular Diseases, Blood Pressure #
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## 1 what kind of Cardio-vascular diseases of the people ##
A sedentary lifestyle, alcohol, and cigarette consumption increase body weight which in turn hinders healthy blood circulation and strength of arteries and veins. This results in high blood pressure. So, if you’re overweight, you need to monitor your blood pressure frequently.
Cardiovascular disease: Definition and an important Form of coronary heart disease
Cardiovascular or circulatory-related diseases (in German often as cardiovascular diseases referred to) are a group of diseases that affect the heart and blood vessel system. These diseases are among the leading causes of death in the world and include a variety of different diseases.
One of the most common and important forms of cardiovascular diseases coronary heart disease (Coronary heart disease, English, Coronary Artery Disease, CAD) is.
Definition and pathophysiology
Coronary heart disease is characterized by a narrowing or occlusion of the coronary arteries, the blood vessels that supply the heart muscle tissue (myocardium) with oxygen-rich blood. The underlying cause of these changes of atherosclerosis, the formation of Plaques (deposits) is usually in the inner vessel wall.
These Plaques are made up of lipids (especially cholesterol), inflammatory cells, smooth muscle cells and fibrous tissue. Over time, they lead to calcification and stiffening of the arterial wall, as well as a restrictive narrowing of the vessel lumen (stenosis).
Follow and clinical manifestations
Due to the reduced blood flow to the heart muscle can lead to a lack of oxygen (ischemia), which can cause the following clinical pictures:
Angina pectoris: episodic chest pain or tightness due to myocardial ischemia during physical exertion or Stress.
Myocardial infarction: an acute occlusion of a coronary artery leads to the death of a part of the heart muscle.
Congestive heart failure: long-term damage to the heart can interfere with its function.
Arrhythmias: disturbances of the heart rhythm as a result of damage to the electrical conduction system of the heart.
Risk factors
One of the most important modifiable risk factors for the development of coronary heart disease include:
Hypertension (High Blood Pressure)
Hyperlipidemia (elevated blood fats, in particular, LDL‑cholesterol)
Tobacco use
Diabetes mellitus
Overweight and obesity
Lack of exercise
Eating habits
Non-modifiable factors are age, gender (men are affected up to the menopause age) and a family history of early cardiovascular events.
Conclusion
Coronary heart disease as a Central Form of cardiovascular disease demonstrates the importance of prevention and early Intervention. Through the influence of risk factors and early diagnosis of the disease risk can be significantly lower, and the quality of life and expectations of the individuals.
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Cardiovascular disease and blood pressure: the context and clinical relevance of
Cardiovascular diseases (CVD) are one of the leading causes of death worldwide. A major risk factor for the development of the blood pressure, especially if it is increased over a longer period of time.
Blood pressure is expressed in two values: the systolic and the diastolic pressure. The systolic (upper value) indicates the pressure in the arteries when the heart beats, and blood repetitive. The diastolic (lower value) describes the pressure when the heart is in the rest break. Normal blood pressure values in a healthy adult is approximately 120/80 mmHg. Who increase the risk for cardiovascular diseases significantly, begins the hypertension diagnosis (hypertension) from a value of 140/90 mmHg.
Pathophysiological Contexts
Persistent hypertension leads to a chronic Overload of the cardiovascular system. Thus, the following pathological changes:
Left heart enlargement (hypertrophy) of The heart has to work against an increased resistance, which leads to a thickening of the heart muscle wall.
Atherosclerosis: The increased pressure damages the inner layer of blood vessels (endothelium), which favors the deposition of lipids and the formation of Plaques.
Damage to the kidneys: The kidneys are particularly sensitive to high blood pressure, a reduction in kidney function, in turn, can aggravate the hypertension and in a vicious circle.
Clinical consequences of untreated hypertension
Untreated hypertension increases the risk of the following illness:
Heart attack;
Stroke (cerebral infarction or cerebral hemorrhage);
Congestive heart failure;
peripheral arterial disease (leg pain when walking);
Dementia (due to cerebral micro-vasculopathies).
Diagnosis and therapy
The diagnosis of hypertension is based on repeated blood pressure measurements, ideally complemented by a 24‑hour blood pressure monitoring (ABPM). The goal of therapy is to keep the blood pressure in the long term under 140/90 mmHg (in patients with Diabetes or kidney disease, even under 130/80 mmHg).
The therapeutic measures include:
Lifestyle changes:
Reduction of salt consumption (< 5 g per day);
Weight reduction in Overweight;
regular physical activity (at least 150 minutes of moderate load per week);
Avoid alcohol and nicotine;
Stress management.
Drug Therapy:
ACE inhibitors or AT1‑receptor blocker;
Beta-blockers;
Calcium antagonists;
Diuretics.
Conclusion
The blood pressure diseases is a key Parameter to assess the risk for cardiovascular disease. Early detection and adequate treatment of hypertension can reduce the incidence of serious cardiovascular complications significantly and the quality of life and life expectancy of the Affected significantly improve.
## Pain in cardiovascular diseases ##
Pain in cardiovascular diseases
Pain in the area of the chest are often an important Symptom of cardiovascular disease and require careful medical examination. Your exact description and differentiation is crucial for diagnosis and therapy.
Typical Forms Of Pain
One of the most well-known types of Pain Angina pectoris, which is typically caused by a decreased blood flow to the heart muscle (myocardial ischemia) is. The patients describe this pain often than Press, Tight or Heavy behind the breastbone (Sternum). The pain may radiate to the left Arm, the shoulder, the neck or the jaw. They mostly occur during physical exertion, and after rest or after intake of nitrate preparations.
Another life-threatening event of acute myocardial infarction. This is a complete disruption of blood supply to part of the heart muscle, usually caused by a Thrombus in a coronary artery. The pain in acute myocardial infarction are usually more intense, last longer than 20-30 minutes, and not or only insufficiently respond to nitrates. Accompanying symptoms such as sweating, Nausea, shortness of breath or anxiety are common.
Among the less frequent but important causes:
Pericarditis: inflammation of the heart of the vagina can lead to sharp, stabbing pain that is intensified by the body, changes in posture (such as Lying), and by Sitting or bending forward to alleviate.
Aortic dissection: a crack in the wall of the main artery (Aorta) often causes sudden, tearing pain in the chest or in the back that can radiate to the back or belly. This is an emergency that requires immediate treatment.
Differential Diagnostic Considerations
Not all chest pain cardiovascular disease due. It is important for ruling out other possible causes:
Diseases of the musculoskeletal system (eg, muscle pain, ribs, bruises);
gastrointestinal problems (eg, reflux esophagitis, peptic ulcer disease);
Lung diseases (e.g., pleurisy, Pneumothorax);
psychosomatic complaints.
Diagnostic Measures
The following tests help to clarify the cause of the pain:
History and physical examination: a detailed description of the pain (quality, duration, triggers, relief factors).
Electrocardiogram (ECG): shows signs of ischemia or Infarction.
Laboratory tests: in particular, the measurement of cardiac enzymes (e.g., Troponin) for the diagnosis of myocardial infarction.
Imaging: echocardiography, Corona angiography, computer tomography (CT) or magnetic resonance imaging (MRI) with special Suspicion.
Stress testing: to assess the cardiac function during physical exertion.
Therapeutic Approaches
The treatment depends on the diagnosis:
In the case of Angina pectoris drugs are used for the improvement of blood circulation (nitrates), beta-blockers, calcium channel blockers, and cholesterol-lowering drug.
In the case of a myocardial infarction, immediate restoration of blood flow (thrombolysis or PTCA) life is important.
In the case of other diseases such as pericarditis or aortic dissection-specific approaches to therapy (anti-inflammatory medications, surgical interventions) are required.
Conclusion
Chest pain is a diverse and potentially dangerous Symptom. A timely and differentiated investigated by a specialist is crucial to recognize life‑threatening cardiovascular diseases in a timely manner and to treat adequately. Patients should be pain occurring at the chest, especially if they are new, intense, or with other symptoms go hand in hand, immediately seek medical advice.
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## Cardio Balance the risk of cardiovascular diseases ##
Framingham scale for the assessment of the risk of cardiovascular diseases
The Framingham heart study (engl. Framingham Heart Study), conducted since 1948 in the town of Framingham, Massachusetts (USA), is one of the most important long-term studies to investigate risk factors for cardiovascular disease (HKK). On the basis of this study, called the Framingham was developed scale — a tool for the quantitative evaluation of the individual 10‑year risk for cardiovascular events, especially heart attacks and strokes.
Development and methodological foundations
The scale is based on multi-variable statistical models, which have been validated in several cohorts of the Framingham study. The original models were initially developed for men and women separately and take into account the following main risk factors:
Age (Years);
Gender (male/female);
Total cholesterol (mg/dL);
HDL‑cholesterol (mg/dL, good cholesterol);
Blood pressure (systolic value in mmHg, and treatment with antihypertensive medications);
Smoking (Yes/no);
Diabetes mellitus (Presence of disease).
Application and Interpretation
With the help of the Framingham scale, the 10‑year can be the risk of a patient for a first cardiovascular event (e.g. myocardial infarction, unstable Angina, stroke, coronary revascularization) in a percentage likelihood to convert. Usually, the following risk can be distinguished categories:
low risk: <10%;
medium risk: 10-20%;
high risk: >20%.
A risk score of >20% is considered to be an indication for intensified preventive therapy, including lipid-lowering drugs (statins) and blood pressure lowering drugs.
Limitations and current developments
Although the Framingham scale is globally widespread, it has some limitations:
The models are based on data from a predominantly Caucasian population of the United States and can, therefore, deliver in other ethnic populations (e.g. Asian, African-American population) and the imprecise Risk estimates.
The scale is not taken into account all of the modern risk markers such as C‑reactive Protein (CRP) or a family history of early cardiovascular disease.
For younger persons (<40 years) is restricted to the validity of the scale, since the absolute risk probabilities are generally low, although the relative risk ratios of factors, such as Smoking and hypercholesterolaemia can be very high.
Now therefore, alternative models have been developed, including the QRISK‑scales in the UK and the SCORE scale (Systematic COronary Risk Evaluation) in Europe, based in part on the modified Framingham approaches, however, additional factors to include.
Conclusion
The Framingham scale remains an important tool in cardiovascular prevention and serves as a scientific basis for many subsequent risk assessment models. Their application, however, requires a critical Interpretation, taking into account the population characteristics and individual risk profiles. A combined evaluation with modern biomarkers and family history can improve the Prädiktivität and a personalized prevention strategies.
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