Cardiovascular Diseases
• From cardio + vascular (CVDs)
• A group of disorders of the heart and
blood vessels (WHO, 2017)
• Number 1 cause of death worldwide.
• An estimated 17.9 million people died
from CVDs in 2016, representing 31%
of all global deaths.
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.
Congenital Heart Disease
• Malformations of heart structure
existing at birth.
Rheumatic Heart Disease
• Damage to the heart muscle and heart
valves from, rheumatic fever, caused by
streptococcal bacteria.
Deep Vein Thrombosis and Pulmonary
Embolism
• Blood clots in the leg veins, which can
dislodge and move to the heart and
lungs.
CVD’s In the Philippines
• Cardiovascular diseases (CVD) are
among the top 5 causes of death in the
country (DOH).
• Five years ago, CVDs only placed 7th
as the leading cause of morbidities and
mortalities but today it is among the top.
• Mostly affect the female population and
patients are getting younger.
• Average age group of heart attack
victims have lowered to 30s from 40s.
• DOH along with the local government
units (LGU), has organized
hypertension and diabetes clubs.
THE COMMON CVDs
Atherosclerosis
• Derived from the word Atheroma “lump
of wax” and sclerosis “hardening of the
inside part of the body”
• A condition in which artery wall
thickens, which is a result of a build-up
of plaques (fatty materials like
cholesterol) due to accumulation of
macrophage white blood cells and
promoted by low density.
Components of Plaques
• Atheroma (“lump of wax”)
- The nodular accumulation of a soft,
flaky, yellowish material at the center of
large plaques, composed of
macrophages nearest to the lumen of the
artery
• Underlying Areas of Cholesterol
Crystal.
• Calcification at the base of older or
more advanced lesions.
Plaque
• Sticky substance made up
cholesterol (LDL), calcium,
waste,etc. It builds up in the
resulting to the limited flow of
rich blood in the body.
Complications
• Heart Disease
• Heart Failure
• Heart Attack Kidney
• FailureAneurysm
Symptoms: Chest pain, Abdominal, neck,
back, jaw, or shoulder and arm pain,
nausea and vomiting sensation, fatigue,
Perspiration, Shortness of breath.
of fat, CAROTID ARTERY DISEASE
cellular
arteries, • The accumulation of plaque in the
oxygen- arteries leading to the brain. (Carotid
Artery)
• Cerebrovascular disease is caused due
to reduced supply of oxygen rich blood
to brain.
Symptoms: Inability to comprehend
speech, or to have garbled speech,
muscle weakness, impairment of facial
muscles, vertigo, involuntary or jerky
movements on one side of the body.

• Stroke
• Arrhythmia PERIPHERAL ARTERY DISEASE
• Caused by the accumulation of plaque
in the arteries supplying blood to the
Symptoms hands and feet.
• Chest pain, chest tightness, chest Symptoms: Pain ,cramps, numbness,
pressure and chest discomfort (angina) and sense of fatigue in muscles of limbs,
diminished pulses in the hands and feet,
• Shortness of breath
reduced muscle mass, blowing sounds
• Pain, numbness, weakness or coldness that can be heard with the help of
in your legs or arms stethoscope indicating turbulence in
blood flow (also called “bruits”), Loss of
• Pain in the neck, jaw, throat, upper hair, thickening of nails, Smooth and
abdomen or back. shiny skin surface, gangrene .

CORONARY ARTERY DISEASE Abdominal Angina and Bowel

• The accumulation of plaque in the Infraction
arteries leading to the heart. • Caused by the narrowing of intestinal
• When the arteries are blocked, the cells arteries.
in the heart begin to die.
Abdominal Angina Treatments
• Poor blood supply to the small NONE
intestines.

Regulation
Bowel Infraction
Lifestyle Changes
• Injury in the intestine resulting from
• Weight Management
insufficient blood flow.
• Physical Activity
Symptoms: Cramping pain in the middle
of the abdomen, severe abdominal pain • Healthy Diet
with vomiting and diarrhea or abdominal
swelling.
Medications

Risk Factors Various Medication

• Unhealthy blood cholesterol level • Anti-platelet drugs

• High blood pressure • StatinsAngiotensin-converting enzyme

(ACE)
• Smoking
Surgical Interventions
• Insulin Resistance
• Angioplasty
• Overweight or Obesity
• Coronary Artery Bypass Grafting
• Lack of physical activity (CABG)
• Age (In men, risk increases after age
45, in women, risk increases after age
55) Stroke

• Family History • A condition that may be caused by a

blocked artery or the leaking or bursting
of a blood vessel in the brain.
Other Factors • Some experience only a temporary
disruption of blood flow.
• Sleep Apnoea
• It is a medical emergency.
• Stress
• Alcohol
Types of Stroke
• Having diabetes
• Dyslipoproteinemia ✓ Ischemic Stroke


 ✓ Hemorrhagic Stroke
✓ Transient Ischemic Stroke (Mini
Stroke)
Ischemic Stroke
• About 80% of stroke
- Occurs when the arteries to your brain
become narrowed or clogged with
plaque, causing severely reduced blood
flow (ischemia).
Kinds of Ischemic Stroke
➢ Thrombotic Stroke
• Occurs when a blood clot (thrombus)
forms in one of the arteries that supply
blood to your brain. It may be caused
by the build-up of plaque in arteries and
can reduced blood flow.
➢ Embolic Stroke
• Occurs when a blood clot (embolus) or
other debris forms away from your brain
(usually the heart), and is swept
through your bloodstream to lodge in
narrower brain arteries.
Hemorrhagic Stroke
• Occurs when a blood vessel in your
brain leaks or ruptures.
Brain hemorrhages is a result of:
- Uncontrolled high blood pressure
- Over-treatment with anticoagulants
- Weak spots in your blood vessel walls
(aneurysm)
Kinds of Hemorrhagic Stroke
➢ AIntracerebral Stroke
• A blood vessel in the brain bursts and
spills into the surrounding brain tissue,
damaging brain cells.
➢ Subarachnoid Stroke
• An artery in your brain bursts and spills
into the space between the surface of
your brain and your skull.
- One of its symptoms is severe
headache.
Transient Ischemic Stroke (Mini
Stroke)
• It is a temporary period stroke.
.- Caused by a temporary decrease in
blood supply to part of your brain, which
may last as little as 5 minutes.
Risk Factors
Lifestyle Risk Factors
• Being overweight or obese
• Physical Inactivity
• Heavy or binge drinking
• Use of illicit drugs such as cocaine and
methamphetamines
Medical Risk Factors
• Blood pressure readings higher than
120/80 millimeters of mercury.
• High Cholesterol
• Diabetes
• Obstructive sleep apnea
• Cardiovascular Diseases
• Personal or family history of stroke,
heart attack or transient ischemic attack
• Exercising regularly
• Drinking alcohol in moderation
• Treating obstructive sleep apnea
• Avoiding illegal drugs

Other Factors
Preventive Medications
• Age
Various Medication
• Race
• Anti-platelet drugs
• Sex
• Anticoagulants
• Hormones

Medications
Complications
Ischemic Stroke and TIA
• Paralysis of loss of muscle movement
• Anti-platelet and Anticoagulants
• Difficulty talking or swallowing
• Clot-breaking drugs
• Memory loss or thinking difficulties
• Mechanical Thrombectomy
• Emotional Problems
• Stents
• Pain or Numbness
• Surgery behavior and self-care ability
• Changes in behavior and self-care
Hemorrhagic Stroke
ability
• Medications
• Coiling
Regulation
• Clamping
Lifestyle Changes
• Surgery
• Controlling or lowering high blood
pressure 

Recovery
• Lowering the amount of cholesterol and
saturated fat in your diet • Speech Therapy
• Quitting tobacco use • Cognitive Therapy
• Controlling diabetes • Relearning Sensory Skills
• Maintaining a healthy weight • Physical Therapy
• Eating a diet rich in fruits and
vegetables
How to spot a stroke • Dementia
Balance - loss of balance, headache, or • Heart failure and heart attacks
dizziness
• Kidney failure
Eyes - blurred vision
• Diabetes
Face - one side of the face is drooping
• Aneurysm, or abnormal bulge in the
Arms - arm or leg weakness wall of artery that can burst
Speech - speech difficulty • Stroke
Time - time to call for ambulance • Amputation
immediately
• Hypertensive retinopathies in the eye,
which can lead to blindness
Blood Pressure • DEATH
• The force that a person’s blood exerts
against the walls of their blood vessels.
Symptoms
This pressure depends on the
resistance of the blood vessels, and • Fatigue or Confusion
how hard the heart has to work.
• Trouble breathing or shortness of
• Systolic pressure - occurs as the breath
blood pumps out of the heart and into the
arteries (the heart beats) • Severe headache and dizziness

• Diastolic pressure - created as the • Vision problems

heart rests between beats. • Nosebleeds
• Irregular heartbeat or pounding in the
Hypertension chest, neck, or ears

• Also known as high blood pressure • Blood in the urine

(HBP).
• The force of the blood pushing against Diagnosis
the walls of your blood vessels is
consistently too high. • Sphygmomanometer

• The more blood your heart pumps and

the narrower your arteries, the higher Risk Factors
the blood pressure.

• Smoking or exposure to second-hand
smoke
Complications
• Diabetes
• Atherosclerosis
• Obese or overweight
• Metabolic syndrome
• High cholesterol • Angiotensin-converting enzyme (ACE)
inhibitors
• Unhealthy diet
• Angiotensin II receptor blockers (ARBs)
• Physical inactivity
• Calcium channel blockers


Family history
• Race/Ethnicity Coronary Heart Disease
• Increasing age • Also known as CHD, or coronary
artery disease (occurs in the arteries of
• Gender (males) the heart).
• Chronic kidney disease • It is the narrowing or blockage of the
• Obstructive sleep apnea coronary arteries that supply oxygen
and blood to the heart.


Other Factors
• Socio-economic status Symptoms

• Psychosocial stress • Dizziness

• Anxiety

Treatments • Chest pain, heart burn, irregular heart

rate
NONE
• Weakness
• Nausea
Regulation
• Cold sweat
• Heart-healthy and less salt diet
• Burning sensations
• Regular physical activity
• Maintaining healthy weight
Complications
• Limiting alcohol drinking
• Chest pain (angina)
• Quit smoking
• Abnormal heart rhythm (arrhythmia)
• Cut back on caffeine
• Heart failure
• Reduce stress
• Heart attack
• DEATH
Medications
• Thiazide diuretics (diuretics)
Diagnosis Medications
• Electrocardiogram • Cholesterol-modifying medications
• Cardiac Catherterization • Aspirin
• Echocardiogram • Beta blockers
• CT Scan • Calcium channel blockers
• Ranolazine
Risk Factors • Nitroglycerin
• Age • Angiotensin-converting enzyme (ACE)
inhibitors
• Sex
• Angiotension II receptor blockers
• Family history (ARBs)
• Smoking
• High blood pressure Procedures
• High cholesterol levels • Angioplasty
• Diabetes • Stent placement
• Overweight or obesity
• Physical inactivity Heart Attack
• High stress • Also known as CHD, or coronary
• Unhealthy diet artery disease (occurs in the arteries of
the heart).
• It is the narrowing or blockage of the
Treatments coronary arteries that supply oxygen
NONE and blood to the heart.

Regulation Complications

• Quit smoking • Cardiac arrest

• Control conditions (high blood pressure, • Cardiomyopathy

high cholesterol, and diabetes) • Heart failure
• Be physically active • Arrhythmias (ventricular fibrillation)
• Eat a low-fat, low-salt diet • Long Q-T syndrome
• Maintain a healthy weight • DEATH
• Reduce and manage stress
Symptoms • The risk of CVD increases with the
number of cigarettes smoked per day,
• Heavy chest pain and when smoking continues for
• Cold and sweaty many years.

• Pain in the neck or left arm

• Nausea How Does Smoking Damage the
Heart?
• Sudden onset of symptoms
• Chemicals in cigarette smoke cause the
• Shortness of breath cells that line blood vessels to become
• More tired than useless swollen and inflamed. This can narrow
the blood vessels and increases the risk
• Flu-like symptoms of developing cardiovascular
diseases.
• Feeling of indigestion or heartburn
• Smoking damages the lining of your
• Symptoms for a number of days
arteries, leading to a build up of fatty
material (atheroma) which narrows the
artery. This can cause angina, a heart
Risk Factors attack or a stroke.
• Smoking • Your blood is more likely to clot,
• Infections which increases your risk of having a
heart attack or stroke.
• Sedentary lifestyle
• Genetic predisposition
Cigarette and Tobacco
• Blood pressure
• The carbon monoxide in tobacco
• Alcohol smoke reduces the amount of oxygen in
• Age your blood. • The nicotine in cigarettes
stimulates your body to produce
• Unhealthy food adrenaline, making your heart work
harder.
• Obesity
• Total cholesterol
Effects of Regular Exercise on
Cardiovascular Disease
Cigarette Smoking and Cardiovascular
Disease
American Heart Association
• Smoking is a major cause of
Recommendations
cardiovascular disease (CVD).
• Causes approximately 1 of every 4 ✓ 30 minutes of moderate-intensity
aerobic activity at least 5 days
deaths (2014 Surgeon General’s
Report).
 per week for a total of 150 Psychological Benefits
minutes
• Reduced risk of depression
✓ 25 minutes of rigorous aerobic
• Reduced stress and better control of it
activity at least 3 days per week
for a total of 75 minutes (or a • Increased social activity and support
combination of moderate and
rigorous aerobic activity) • Protection from decline of cognitive
function as we age
✓ Moderate-to-high intensity
muscle strengthening activity at
least 2 days per week for Protection Against Blood Clots
additional health benefits (Thrombosis)
• Reduced platelet stickiness
Benefits Directly on Heart Muscle • Decreased blood viscosity
(Myocardium)
• Increased ability to break down clots
• Decreased oxygen demand by the
heart muscle
• Improved blood flow through the Protection Against Blood Arrhythmias
coronary blood vessels • Increased vagal tone (“breaks”)
• Improved responsiveness to nitric oxide • Reduced sympathetic activity (“gas”)
• Decreased dysfunction of the cells • Improved heart rate variability
lining the heart (endothelium)
• Improved activity of the stem cells of
the heart (endothelial proginator cells, Other Cardioprotective Benefits
circulating angiogenic cells)
• Reduction in weight
• Increase in exercise tolerance
Protective Effects on Blood Vessels
• Increased skeletal muscle function and
• Improved lipid profile: lowers strength
cholesterol, LDL, and triglycerides
• Improved lung function
• Improves HDL
• Reduced risk of smoking
• Lowers Blood Pressure
• Improve aerobic capacity

Reduction in total body fat

• Increased Insulin Sensitivity
• Decreased inflammation (reduced C-
reactive protein)