Cardiovascular Disease (CVD)

“More women are dying from Cardiovascular Disease (CVD) than breast cancer. A woman is five times more likely to die from a heart attack or stroke (22% chance) than from breast cancer (3% chance) (Leening, 2014).

For both men and women, statistics from the Australian Heart Foundation show that one Australian dies every 12 minutes as a result of CVD, and it is the leading cause of death in the western world” (WHO, 2012)

CVD is a term that encompasses a wide variety of diseases but primarily includes heart attacks, angina, and strokes. Heart attacks occur more often in men, while women tend to be more likely to suffer from a stroke.

Research suggests that a CVD episode in men is more often triggered by a highly stressful incident whereas episodes in women are more often the result of high levels of chronic ongoing stress (Leening, 2014). Two out of three people will experience CVD at some point in their life.

High blood pressure
Of interest, the latest research assessing high blood pressure monitoring has raised new concerns because current guidelines were found to be inadequate.

SPRINT (Systolic Blood Pressure Intervention Trial), a trial that was published in 2015 in the New England Journal of Medicine (Group, 2015), was a large randomised controlled trial whose aim was to identify the optimal level of blood pressure control for those suffering from high blood pressure (HBP) and at high risk of CVD.

The results were critical as the study found that the risk of dying was reduced by 27% if participants were treated with blood pressure medication that targets their systolic blood pressure (the upper reading) to bring it below 120 millimetres of mercury. Currently, medical protocol recommends that the target systolic blood pressure be 140, however researchers found this systolic level left people at high risk.

Low blood pressure
Low blood pressure, which is often overlooked is also of concern, and a recent study at Johns Hopkins University has identified that a low diastolic blood pressure (the bottom number on a blood pressure reading) can also predict increased risk of heart attack and stroke. (McEvoy, 2016).

Atrial Fibrillation
Atrial fibrillation, is an abnormal heart rhythm that can cause blood to pool in the left atrium of the heart, causing clots to develop that may lead to a stroke.
Symptoms of atrial fibrillation include breathlessness, chest discomfort, and palpitations and although these symptoms can be mild, the condition still poses a significant risk of stroke.

Encouragingly, according to the INTERHEART study, which examined CVD risk factors in 51 countries, nine out of the ten strongest risk factors are modifiable by changes in diet and lifestyle (Yusef, 2004).

References
1. M.J.G.Leening et all (2014) Sex Differences in lifetime risk and first manifestation of Cardiovascular Disease: prospective population based cohort study. The British Medical Journal: 2014; 349: g5992.
2. World Health Organisation – The top 10 causes of death – http://www.who.int/mediacentre/factsheets/fs310/en/
3. Chowdhury, R. et al (2014) Association of dietary, circulating, and supplemental fatty acids with coronary risk: a systematic review and meta analysis. Internal Medicine 160(6): 398-406.
4. Fuller, NR et al (2015) The effect of a high egg diet on cardiovascular risk factors in people with type 2 diabetes: a three month randomised controlled trial. The American Journal of Clinical Nutrition 101(4): 705-13.
5. Houston M, MD, IFM Annual International Conference 2012, Scottsdale, AZ.
6. Group S R, Wright J T Jr., Williamson J D, et al; for the SPRINT Research Group. (2015) A randomized trial of intensive vs standard blood-pressure control. New England Journal of Medicine. 2015; 373: 2103-2116. doi: 10.1056/ NEJMoa1511939.
7. McEvoy J W, Chen Y, Rawlings A, et al. (2016) Diastolic blood pressure, subclinical myocardial damage, and cardiac events. Implications for blood pressure control. Journal of the American College of Cardiology. 2016. doi: 10.1016/ j.jacc.2016.07.754.
8. Stewart, S. (2015) Health Report: Atrial Fibrillation in Australia.
9. Yusef. S et al (2004) Effect of Potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case control study. The Lancet: 2004: 364: 937-95.2
10. Marchioli. R et al (2002) Early protection against sudden death by n-3 Polyunsaturated Fatty Acids after myocardial infarction. Time course analysis of the results of the GISSI. Circulation 105: 1897-1903.
11. Mortenson. SA. et al (2014) The Effect of Coenzyme Q10 on Morbidity and Mortality in Chronic Heart Failure: Results from Q-Symbio: A Randomised Double Blind Trial. The Journal of the America College of Cardiology 2014: 2: 641-649.
12. Maier. JAM. (2012) Endothelial cells and magnesium: implications in atherosclerosis. Journal of Clinical Science 122: 397-407.
13. Lu et al, Effects of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. American Journal of Cardiology. 2008; 101 (12): 1689-1693.
14. Luo J, Xu H. Outcome measures of Chinese herbal medicine for coronary heart disease: an over view of systematic reviews. Evidenced based complementary and alternative medicine. 2012; 2012:9
15. Oiu et al, Traditional Chinese Herbal products for coronary heart disease: an overview of Cochrane reviews. Evidence-based, complementary and Alternative Medicine. 2012; 2012:5 pages 417387.
16. Tachjian et al, Use of herbal products and potential interactions in patients with cardiovascular diseases. Journal of the American college of cardiology. 2010; 55 (6): 515-525.