Introduction

According to Townsend et al. (2021), One of the leading causes of morbidity and mortality is
cardiovascular disease (CVD). Specific preventive measures might be considered to lower the
disease burden. Moreover, CVD includes around 1/3 rd of the deaths around the world. About
17 million deaths were reported in 2012 due to CVD. The global shift in the form of the
disease from infectious diseases to chronic diseases has been noticed, with coronary heart
disease topping the list of deaths for more than a decade.

Additionally, the major contributors and risk factors to CVD include high blood pressure,
raised body mass index, and hypercholesterolemia (Rehman et al. 2018). Therefore,
prevention must involve avoiding these risk factors. In addition, early diagnosis and changing
lifestyle and risk factors are included in primary prevention, whereas reducing the pace of
disease progression by accurate risk reduction is included in secondary prevention. Hence, to
enhance the efficiency of treatment and prevention, an appropriate system to identify the
people with risk factors and existing CVD and monitoring systems must be developed.

The analysis of big data sets provides a real-life vision of the epidemiology of chronic
diseases such as CVD, which then enhances the level of health care provided. Nevertheless,
the use of digital medical data available in research that encourages big data for CVD-related
studies still needs to be expanded. Furthermore, the majority of research opportunities for the
management of CVD are provided in primary care (Dai et al., 2022). To achieve the
management and identification of indicator thresholds for chronic diseases, the UK
introduced performance-based pay and outcome quality outlines for the incentives for
practitioners. Hence, to enhance the accuracy of the UK's primary care, the use of digital
medical records must be encouraged.

The current essay is focused on the epidemiology of cardiovascular diseases in the UK and
different regions within the UK. Moreover, it discusses preventive measures, early diagnosis,
risk factors, and interventions to reduce the risk of CVD in the UK's population. Monitoring
and evaluation of the effectiveness of the proposed intervention have also been discussed.

Epidemiology of the disease in London 400

The epidemiology of a disease describes its prevalence, risk factors, preventive measures and
interventions to reduce the prevalence of the disease. However, the current essay focuses on
defining the risk factors for CVD in the UK, as well as its prevalence and interventions. The
prevalence is defined as the number of different conditions with different age groups. In
addition, the incidence of CVD is defined as the number of new cases over a specific period
for the diseased population or population at risk for CVD (Conrad et al., 2018). Moreover,
the significant risk factors involve hypertension, Obesity, Physical inactivity, Diabetes,
Alcohol, and malnutrition.

Additionally, the critical risk factors for most CVDs were analysed as high blood pressure
(above 140 mm Hg), stage 3 to 5 chronic kidney disease, and diabetes mellitus (Provenzano
et al. 2019). Furthermore, the Read codes were utilised to identify the social, demographic,
and clinical characteristics of the study population. The modern recorded code was used for
every patient to report smoking status. Moreover, the BMI index, categorised by WHO, was
also used to measure individuals' alcohol consumption.

The data was collected from the database of the English Royal College of General
Practitioners (RCGP) Research Surveillance Centre (RSC). In addition, the prevalence and
incidence, along with risk factors of CVD, were described by the RCGP RSC database. The
analysis of the data showed the prevalence of CVD and high blood pressure to be 21.3% and
more prevalent among the male population. However, among people with CVD, unsafe
drinking, smoking, and obesity were more prevalent for white ethnicity (Hinton et al. 2018).
Moreover, for mixed or Asian ethnicity, there was a lower number of people with CVD than
those without CVD.

Additionally, age caused an increase in the number of conditions and prevalence of the
disease. Whereas for people under 50 years, the presence of CVD was only 1%, while in
people from 70 to 79 years old, a quarter of people were affected with at least one condition.
People over 80 years had about 40% prevalence of CVD (Ruan et al. 2018). There are several
diseases related to CVD, including Coronary artery disease (CAD). Coronary artery disease
includes myocardial infarction and angina—furthermore, atrial fibrillation (AF), stroke,
Ischemic heart disease and congestive cardiac failure. Hence, the epidemiology of the disease
in well-developed urban areas of the UK, such as London, has started initiatives to reduce the
prevalence of CVD. The public health care department in London has started campaigns to
reduce air pollution, limit smoking, and encourage a healthy diet. This initiative has
contributed positively to the prevention of CVD.

Development of an intervention:
Cardiovascular diseases require the development of strategies by the governing bodies,
stakeholders and practitioners. Epidemiological data must be analysed before the
development of an intervention to plan and strategise an effective intervention. Moreover, the
health care department must include health care plans such as prevention of risk factors to
reduce the prevalence of the disease. Additionally, the gap in the literature and clinical
interventions already available must be taken into account to improve their efficacy (Kaptoge
et al. 2019). Populations with a higher risk of developing CVD, such as aged people and
smokers, must be monitored closely for future progression of the disease. Early detection and
diagnosis should be encouraged among people to mitigate the possibility of CVD.

Furthermore, the intervention development should also include collaboration with the
healthcare department to highlight national care. Evidence-based intervention (EBI) must be
developed to increase the effectiveness of the potential intervention. In addition, EBI includes
running campaigns to reduce smoking, avoid environmental factors, and control the diet of
susceptible individuals (Pallazola et al. 2019). To reduce the risk factor of physical inactivity,
active transportation should be suggested by the practitioners. Moreover, lipid levels and high
blood pressure should be controlled. Likewise, these factors will decrease the risk of the
development of CVD while reducing disease burden.

Utilising existing knowledge:

The existing knowledge about CVD must be reviewed to enhance the effectiveness of the
interventions. A literature review of the data from hospitals and healthcare organisations is
also helpful in identifying gaps in the research. Moreover, collaboration with different
organisations involved in similar areas of research should be encouraged to share the data and
introduce collaborative insights. In addition, systematic research and meta-analysis of the
databases are used to analyse the data (Chowdhury et al. 2018). Furthermore, evidence-based
intervention plans must be incorporated to decrease the risk factors and progression of the
disease in high-risk populations. These interventions include lifestyle modifications such as
termination of smoking. Practitioners must strongly highlight the issues related to smoking
and as risk factors for CVD.

Additionally, eating a healthy diet along with physical activities to reduce hyperlipidemia
was recommended. To reduce risk factors, individuals with hypertension should avoid stress.
Nevertheless, systematic analysis and randomised controlled trials should be used to increase
the effectiveness of the interventions.
Statistics from previous studies suggest that the number of prescriptions for circulatory
diseases increased between 1991 and 2014 in England. Additionally, this increase was
noticed to be around 78%. Wales reported about 5.5 million (23%), Scotland saw 2.3 million
(9%) and Northern Ireland reported a 2.5 million (28%) rise in CVD medications between
2005 and 2014. Moreover, between 1980 and 2013, more surgical procedures were
performed for cardiovascular disease. In comparison with two decades earlier (1993), the
number of percutaneous coronary procedures was more than seven times higher in 2013
(Bhatnagar et al. 2016). After overtaking PCI as the most common cardiac surgery, the
number of bypass coronary artery grafts peaked in the late 1990s and eventually dropped by
33%. Furthermore, these statistics show the importance of data analysis in case of
interventions or gaps to be filled within the literature.

Incorporation of medical expertise:

Medical expertise in the treatment or prevention of CVD is necessary to decrease disease

progression. In addition, several technologies can be used to diagnose the disease, including
an electrocardiogram (ECG), which uses electrical signals in the heart. ECGs tell about the
heart rate of the patient, which can be helpful in the diagnosis of CVD. Moreover, an
echocardiogram is also a type of non-invasive test that develops an image of a moving heart
using sound waves. The flow of blood through the heart and valves is shown on this test (if a
valve is narrowed).

Additionally, healthcare practitioners must use prior knowledge to treat or avoid the risk
factors (Fairy, Hassan and Mahmoud 2019). However, collaboration between healthcare
organisations and practitioners is needed to communicate specific problems and increase
collaborative solutions. In addition, this strategy provides the communication of the
effectiveness of specific potential interventions. Likewise, different types of CVD are
discussed, which can ultimately cause serious complications. These complications can be
handled with medical expertise by incorporating a particular treatment plan. Hence, the
collaboration provides insights into handling these treatment plans by sharing prior case
reports and experience among personnel. Interventions do not only include lifestyle
modifications; they include the use of medications with evidence-based treatments.

Proposed interventions:
Any efforts and policies that are attempted with expectations that these interventions will
help in the improvement of public health on a population level. All organisations, including
government health organisations and non-government organisations, which are NGOs, run
public health interventions. The interventions can be run on a variety of scales, such as
global, country, or community level. According to Spiegelman et al. (2018), the interventions
or integration are based on science and community preferences for improving the
population's health in the practice of evidence-based public health. In public health, evidence-
based practice is essential as it allows planning and delivery and also helps in the evaluations
of interventions that are effective and provide benefits to the population.

The key components of evidence-based public health are making decisions based on the best
available scientific evidence, engaging the community in the decision-making process, and
considering clinical circumstances.

Evidence-basedThe understanding of the hierarchy of evidence can promote evidence-based

practice. SS Wallace et al. (2022) say the hierarchy of evidence serves as a tool for the
evolution of the quality of evidence for the medical search. The biases and limitations of the
study should be considered for evidence-based practice. To answer specific questions, one
should first prioritise the randomised control trials (RCTs). The systemic reviews of SAs with
the use of meta-analysis MAs can be used to answer questions about the treatment of the
other. The best study design to be considered is RCT, which is used in comparative
interventions. For the deep analysis of a specific study, the highest quality of study design is
considered as SAs and Mas. The gold standard in clinical research is considered randomised
controlled trials. The reason it is considered the gold standard is because it reduces the
biasedness. By using primary and secondary interventions, the mortality rate for CVD can be
reduced. The primary interventions are the methods that are used so that the occurrence of
cardiovascular disease can be prevented. In contrast, secondary interventions or prevention
are the therapies that are used so that further cardiac damage can be prevented. Early
recognition of the disease and the management of the risk factors can decrease the motility
and mobility of the disease.

For CVD, a healthy diet is considered an intervention. A healthy diet is a balance of a variety
of foods that can be helpful in cardiovascular disease. Increasing the consumption of fruit and
vegetables as it helps in maintaining a healthy diet. According to the studies, the plant-based
Mediterranean diet is highly recommended. Replacing saturated fat with monounsaturated
and polyunsaturated diets can be found to be effective in the prevention and intervention of
diseases. Another intervention that can be helpful is physical activity. Winzer, Woitek and
Linke (2018) state that physical activity is broadly classified as an activity that can enhance
or maintain overall health and fitness.it is recommended to do at least 150 minutes per week,
which can be found effectively in moderate activities like the implementation of yoga and
swimming, while high-intensity workouts like jogging, running, and playing tennis can be
helpful for the prevention of cardiovascular diseases. Being overweight and obese both
contribute to increased risk factors for coronary heart disease. For the prevention of coronary
heart disease, annual weight calculations, lifestyle modification, and weight loss are
recommended. Hypertension is the primary cause of coronary heart disease. The patients that
are stage 1 of hypertension should implement non-pharmacological interventions. The DASH
diet and exercise are considered non-pharmacological interventions. For patients who are
suffering from diabetes, it is a significant risk factor for cardiovascular diseases. Statin of
moderate intensity is recommended. However, low intensity and a low dose of aspirin are
recommended for primary prevention.

The guidelines for secondary prevention are similar to those for primary prevention.
Pharmacological therapy is included in secondary prevention, while recommendations like
diet, exercise, and smoking cessation are the same.

Evaluation of the effectiveness of interventions:

Modifications in lifestyles from exercise and dietary interventions have been proven effective
toward cardiovascular disease. Diets rich in fruits, vegetables, whole grains, and lean protein
sources and the avoidance of processed foods are recommended by the guidelines of the
prevention. The Mediterranean diet, the DASH diet, and the plant-based diets are considered
effective diets for cardiovascular diseases. Diseases like CVD which is considered a chronic
disease. According to the research, those who have a higher adherence to the Mediterranean
diet showed a 24% lower risk of cardiovascular disease. With the help of meta-analysis, a
demonstration was done by Zampelas and Magriplis (2019), which shows that there is a
significant 24%reduction in cardiovascular disease for those who achieved high diet quality
scores, while there was a 19-28% reduction in women and a 14-26% in men. This amount can
be reduced by diet only. The concept of Mediterranean diet varies from country to country.

Evaluating the effect of interventions like physical activity is considered a significant

prevention technique that can be helpful and contribute to the prevention of disease.
Yamamoto et al. (2018) state that in government guidelines, physical activity is considered an
effective way to help prevent thrombosis. For people who are suffering from coronary heart
disease, physical activity can be helpful. Aerobic exercise can be helpful in many ways.
Aerobic exercise can be defined as low to moderate-intensity physical activity, which is
considered aerobic exercise. This aerobic exercise has effects like lipid metabolisms and
insulin resistance that have a direct relation with cardiovascular diseases. However, the study
by Neergaard-Petersen and Hvas (2018) shows that challenging short-term exercises are the
reason for platelet activation, which increases the aggregation of platelets. The aggregation of
the platelets is directly related to the reason for the cardiac arrest. Lobelo et al. (2018) say
that similar to aerobic exercise, anaerobic exercise also has many benefits. Anaerobic
exercise shows a positive influence on the body mass index and blood pressure. Moreover, a
study by Batacan et al. (2018) conducted and provided the conclusion that sometimes high-
intensity workouts are more effective than low-intensity workouts. According to Slater et al.
(2022), both men and women show promising results in the systematic review of randomised
controlled trials using physical activity.

Feedback on interventions:

Based on epidemiological insights and research data, therapies targeted at preventing

cardiovascular disease (CVD) have demonstrated promising efficacy. Numerous studies have
shown that promoting healthy diets—notably the DASH and Mediterranean diets—along
with frequent exercise can significantly lower the risk factors for cardiovascular disease.
Research by Wang, Liu and Lee (2022) shows that following these diets is associated with a
significant reduction in the incidence of CVD, emphasising their critical role in preventive
care. Furthermore, programs that emphasise changing one's lifestyle—such as quitting
smoking and controlling one's weight—have proved crucial in lowering the morbidity and
mortality rates related to cardiovascular disease. Modern medical technology supports these
treatments by enabling early detection and customised therapy regimens. Healthcare
professionals, legislators, and community stakeholders have worked together to develop
evidence-based practices and assess their effects. These therapies are being improved by
ongoing research and data-driven decision-making to ensure that they meet contemporary
needs and continue to be successful in reducing the worldwide burden of cardiovascular
disease. By using all-encompassing strategies based on epidemiological data, these treatments
open doors to better public health outcomes and higher standards of living for people with
CVD.
Conclusion:

Cardiovascular disease (CVD) remains a significant global health challenge, contributing

substantially to morbidity and mortality rates worldwide. As highlighted in this essay, CVD
encompasses a diverse spectrum of conditions, including coronary artery disease, stroke, and
heart failure, which collectively pose substantial burdens on healthcare systems and
communities.

The epidemiological analysis presented underscores the pervasive impact of CVD, with high
blood pressure, hyperparathyroidism, and obesity identified as primary risk factors driving
disease prevalence. This analysis has been crucial in shaping targeted interventions aimed at
both primary prevention—focused on mitigating risk factors—and secondary prevention—
aimed at slowing disease progression among those already affected.

Effective management and prevention strategies for CVD necessitate a multifaceted

approach. Evidence-based interventions, such as dietary modifications emphasising the
Mediterranean or DASH diets, along with regular physical activity, have demonstrated
efficacy in reducing cardiovascular risk. Furthermore, advancements in medical technologies,
including diagnostic tools like ECGs and echocardiograms, enhance early detection and
intervention capabilities.

The evaluation of interventions underscores the importance of data-driven decision-making

and ongoing research to refine and improve treatment outcomes. Collaborative efforts
between healthcare providers, policymakers, and community stakeholders are essential for
implementing and sustaining effective public health initiatives.

Moving forward, addressing the challenges posed by CVD requires a continued commitment
to advancing preventive measures, enhancing access to quality healthcare, and promoting
healthy lifestyle behaviours. By leveraging comprehensive epidemiological insights and
integrating innovative interventions, we can strive to reduce the global burden of
cardiovascular disease and improve overall population health.

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