• Overview
• Definition
• Incidence, prevalence and trends
• Risk factors
• Health consequences
• Costs
• Contributors

Definition

Cardiovascular disease

Most cardiovascular disease (CVD) is due to reduced blood flow to the heart, brain or periphery caused by atheroma or thrombosis.

CVD is increasingly common after the age of 60, but rare below the age of 30. Cardiovascular disease is a general term used to describe the various presentations of a single underlying pathology: atherothrombosis. Plaques (plates) of fatty atheroma build up in different arteries during adult life. These can eventually themselves cause narrowing, or trigger a local thrombosis (blood clot) which completely blocks the blood flow, resulting in a heart attack, stroke or ischaemic leg.

Depending on which artery is most severely affected by atheroma, the main CVD manifestation can be coronary heart disease (CHD), stroke or peripheral arterial disease (PVD).

Coronary heart disease (CHD)

This is a disease that results from narrowing of the arteries carrying blood to the heart muscle. CHD includes heart attack, sudden cardiac death, unstable angina, chronic angina and heart failure.

Stroke

Stroke is a neurological deficit caused by ischaemia due to impaired blood flow to the brain. This blockage or rupture of a brain artery produces sudden catastrophic damage in the brain.

The most common forms of stroke are cerebral infarct (about 80%), followed by a cerebral haemorrhage (about 15%). ¹

Peripheral vascular disease (PVD).

This is a deficit caused by ischaemia due to impaired blood flow to a limb. It most commonly affects one or both legs, causing intermittent claudication in a calf muscle, leg ulcers, or ischaemia/gangrene of the lower limb. Less commonly, PVD can cause an aortic aneurism.

CVD risk assessment

The National Service Framework for CHD recommends assessing each individual's absolute risk of CVD. This is most easily done using a standard paper-based or web-based risk assessment tool. Intervention is recommended if the individual has a greater than 20% risk of a CVD event in the next 5 years. Interventions include lifestyle advice such as smoking cessation and healthier diet, plus medication with statins, aspirin or anti-hypertensive drugs. ^{2 3}