• Mary Hansbrough

Cardiovascular Disease: What you need to know

Updated: Sep 27, 2018

Cardiovascular disease or heart disease is the number one cause of death for both men and women in the United States, claiming approximately one million lives annually according to the Centers for Disease Control (2013). Cardiovascular disease and "heart disease" are often used interchangeably according to the Mayo Clinic (2014). Every 33 seconds someone in the United States dies from cardiovascular disease. Cardiovascular disease generally refers to conditions that involve narrowed or blocked vessels that can lead to a heart attack, chest pains (angina) or stroke.


Heart disease accounts for nearly 30% of the deaths in the United States every year. Coronary heart disease results from a reduction in blood flow through the coronary arteries, which supply the heart with blood. This type of heart disease causes about 90% of heart-related deaths. Atherosclerosis is the principal cause of coronary disease. Atherosclerosis is a gradual narrowing of the coronary arteries, usually caused by a buildup of fatty deposits and other debris on the inner walls. Narrowed coronary arteries may eventually lead to situations in which the heart is temporarily deprived of adequate blood flow, causing a condition known as myocardial ischemia. This ischemia may be accompanied by brief chest pain, called angina. If a coronary artery is blocked completely (by a blood clot, for instance), the abrupt interruption of blood flow can produce a full-fledged heart attack, or myocardial infraction (American Heart Association, 2012).


Other established risk factors for coronary disease include smoking, diabetes, high cholesterol levels, and high blood pressure. Smoking and diabetes are somewhat stronger risk factors for women than men. Contrary to public perception, cardiovascular diseases kill women just as much as men, but these diseases tend to emerge in women about 10 years later than in men (Stoney, 2003).


Recently, attention has shifted to the possibility that inflammation may contribute to atherosclerosis and elevated coronary risk. Evidence is mounting that inflammation plays a key role in the initiation and progression of atherosclerosis, as well as the acute complications that trigger heart attacks (Albert et al., 2002, Rodker & Maseri, 2002).

Clinical depression is linked to at least a doubled risk of heart attack and cardiovascular disease, according to several large-scale longitudinal studies that found that chronic, severe depression precedes the development of heart disease by many years (Frasure-Smith & Lesperaance, 2005). A recent theory suggests that because depression, anxiety, and anger-hostility often occur together, like branches of grapes, the real culprit in heart disease may be general disposition toward negative emotions (Suls & Bunde, 2005).


Research suggests that acute and chronic stresses are risk factors for the development and progression of coronary artery disease. Holmes and colleagues (2006), posit that several psychosocial variables have been identified as putative risk factors, including stress; emotional disorders, personality traits, depression and poor social support.

Stress can be effectively managed by understanding the sources that are triggering an individual's stress and formulating a plan of action to deal with the problem. There are a variety of techniques to manage stress, improve coping and reduce deleterious effects of stressors on physical and psychological health. The techniques that can be used are prayer and meditation, visual imagery, social support and cognitive behavioral stress management. A meta-analysis of 23 studies assessing the effectiveness of stress-management interventions in coronary artery disease suggests that psychosocial interventions combined with standard care may reduce morbidity and mortality, as well as psychological distress.

Sources

Albert, C.M., et al (2002). Prospective study of C-reactive protein, homocysteine, and plasma liquid levels as predicators of sudden cardiac death. Circulation, 105, 2595-2599

American Heart Association (2012). Heart disease statistics at a glance.

Centers for Disease Control and Prevention (2013). Health and Wellness

Frasure-Smith, N., Lesperance, F. (2005). Depression and coronary heart disease: Complex synergism of mind, body, and environment. Current Directions in Psychological Science 14, 39-43

Mayo Clinic (2014). Heart disease.

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