The rapidly increasing worldwide prevalence of chronic diseases such as diabetes mellitus, hypertension and hyperlipidaemia as a result of population’s progress to adopt an unhealthy eating pattern and sedentary lifestyle has lead to a significant proportion of mortality and morbidity.
In view of this rising burden of chronic diseases, the Global Strategy for Diet, Physical Activity and Health was established by WHO in the year 2004 to promote primary prevention of chronic diseases via population-based approach. Hence, dietary component remains the cornerstone in chronic disease management for people who suffer from chronic diseases as well as for those who are at risk of developing diseases, apart from medication and physical activity as shown in Figure 1.1.
Cardiovascular disease (CVD) is the most common contributor of morbidity and mortality worldwide. The identification of major risk factors through epidemiological population based studies and effective control measures and health education programs along with targeted treatment of high risk individuals has contributed to the decline in the CVD mortality rates in several industrialized countries.
CVDs are the number one cause of death globally: more people die annually from CVDs than from any other cause.
- An estimated 17.3 million people died from CVDs in 2008, representing 30% of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease and 6.2 million were due to stroke.
- Low- and middle-income countries are disproportionally affected: over 80% of CVD deaths take place in low- and middle-income countries and occur almost equally in men and women.
- By 2030, almost 25 million people will die from CVDs, mainly from heart disease and stroke. These are projected to remain the single leading cause of death.
- Most cardiovascular diseases can be prevented by addressing risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, raised blood pressure, diabetes and raised lipids.
- 7.5 million deaths each year, or 13% of all deaths can be attributed to raised blood pressure. This includes 51% of deaths due to strokes and 45% of deaths due to coronary heart disease.
- In 2008, diabetes directly contributed to 1.3 million deaths.
Definition of Cardiovascular DiseasesCardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and they include:
- coronary heart disease – disease of the blood vessels supplying the heart muscle;
- cerebrovascular disease – disease of the blood vessels supplying the brain;
- peripheral arterial disease – disease of blood vessels supplying the arms and legs;
- rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
- congenital heart disease – malformations of heart structure existing at birth;
- deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.
Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by bleeding from a blood vessel in the brain or from blood clots.
Risk factors for cardiovascular disease
The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. Behavioural risk factors are responsible for about 80% of coronary heart disease and cerebrovascular disease.
The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of developing a heart attack, stroke, heart failure and other complications.
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