CARDIOVASCULAR DISEASES AND DRUG THERAPY OPTIONS

Cardiovascular diseases (CVDs) are a group of numerous disorders of the heart and blood vessels. CVDs are the number one cause of death globally. The most important behavioural risk factors of heart disorders are unhealthy diet, physical inactivity, tobacco use and alcohol abuse.

Many of heart problems are related to a process called atherosclerosis. Atherosclerosis develops when plaque builds up on the inner walls of the blood vessels that supply the heart or brain. This buildup narrows and thickens the arteries. If a blood clot forms, it can stop the blood flow. Atherosclerosis usually doesn't cause any signs and symptoms until it leads to a medical emergency, such as a heart attack or stroke. However, if signs and symptoms are experienced, they depend on the artery affected and include: angina, dyspnea, arrhythmia, hypertension, fatigue, confusion, dizziness, sudden and severe headache, sleep problems and lack of energy.

In addition to lifestyle changes and low cholesterol diet effective drug therapy options are available. Statins are recommended for most patients. They are most effective at decreasing LDL (bad) cholesterol, but also have modest effects on reducing triglycerides (blood fats) and raising HDL (good) cholesterol.

A heart attack (a myocardial infarction) occurs when the blood flow to a part of the heart muscle is blocked by a blood clot. Symptoms of a heart attack include pain or discomfort in the center of the chest radiating to the arms, the left shoulder, elbows, lower jaw, or upper back. In addition the person may experience shortness of breath, vomiting, light-headedness, breaking into a cold sweat.

Most patients survive their first heart attack and return to their normal lives.Heart attack treatment involves a variety of drugs. Anticoagulants are used to inhibit the formation of blood clots by affecting blood coagulation factors. Antiplatelet agentskeep blood clots from forming by preventing blood platelets from sticking together. Beta blockers decrease the heart rate and cardiac output, which lowers blood pressure. Combined alpha and beta blockers are used for those patients experiencing a hypertensive crisis. Calcium channel blockers interrupt the movement of calcium into the cells of the heart and blood vessels, decrease the heart's pumping strength and relax blood vessels. Cholesterol-lowering medications (statins) reduce high cholesterol levels. Digitalis glycosidesincrease the force of the heart's contractions, which can be beneficial in heart failure and for irregular heartbeats. Diuretics cause the body to excrete excess fluids and sodium through urination. They help to relieve the heart's workload. Vasodilatorsrelax blood vessels and increase the supply of blood and oxygen to the heart.

An ischemic stroke (the most common type) happens when a blood vessel that feeds the brain is blocked, usually by a blood clot. A hemorrhagic strokeoccurs when a blood vessel within the brain bursts. The most common symptom of a stroke is sudden weakness or paralysis of the face, arm, or leg, most often on one side of the body. Other symptoms include sudden onset of: numbness of the face, arm, or leg; confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache; unconsciousness.

Tissue plasminogen activator (tPA) is a thrombolytic (a “clot-busting” drug) given to break up blood clots if the victim gets to the hospital within 3 hours of the first symptoms of an ischemic stroke. To prevent further attacks of stroke the doctor usually prescribes anticoagulants, antiplatelet medicines, statins, blood pressure medications, and medicines to deal with depression and pain.

Cessation of tobacco use, reduction of salt in the diet, consuming fruits and vegetables, regular physical activity and avoiding harmful use of alcohol generally reduce the risk of cardiovascular diseases.