Editorial on Cardiovascular & Cerebrovascular Diseases

Author(s): Dr. Karl J Nesser

A: Cardiovascular disease is a disease of the blood vesselsin the heart, and cerebrovascular disease is a disease of theblood vessels in the brain. The same risk factors cause them.The term cerebrovascular disease includes all disorders in which an area of the brain is temporarily or permanently affected by ischemia or bleeding and one or more of the cerebral blood vessels are involved in the pathological process.
Cerebrovascular disease includes stroke, carotid stenosis, vertebral stenosis and intracranial stenosis, aneurysms, and vascular malformations. Cardiovascular diseases, conditions of the heart and blood vessels, are leading causes of morbidity and mortality throughout the world. Largely diseases of lifestyle and affluence, they account for a majority of deaths in some industrialized countries. They are a coming epidemic in the developing world as communities and individuals attain richer and less healthy lifestyles. The leading cardiovascular diseases are coronary heart disease, hypertension, stroke, and heart failure. They are frequently interconnected with the underlying
pathology atherosclerosis, a condition damaging medium and large arteries. There are also other important diseases which, while less common, present considerable health burden including rheumatic heart disease, peripheral artery disease, cardiomyopathy, and congenital heart disease. Unlike many lifestyle related conditions, the causes or risk factors for the leading cardiovascular diseases are well
known. They are diet resulting in hyperlipidemia, elevated blood pressure leading to hypertension, diabetes mellitus, physical inactivity, and cigarette smoking. There are also other identified characteristics but this group of risk factors underlies the epidemic. As well studied conditions, much is known about the pathophysiology of risk factors and cardiovascular disease. In addition, knowledge from clinical trials
dictates treatment of risk for primary and secondary prevention. Few chronic diseases had such an extensive scientific basis for the prevention and treatment. Prevention starts at the community level where unhealthy diets, smoking and physical inactivity can be confronted and reduced. Clinical presentations of individual risk factors such as hypertension, hyperlipidemia and diabetes mellitus can be treated with lifestyle modification and/or medication. The implementation of prevention programmes at the community and clinic level results in population-wide changes and disease reduction. The potential for continuing improvement in the industrialized world and blunting the epidemic in the developing world is substantial.