Interdisciplinary Concepts in Cardiovascular Health: Volume I: Primary Risk Factors

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It can also contribute to high triglycerides, and produce irregular heartbeats. Additionally, excessive alcohol consumption contributes to obesity, alcoholism, suicide and accidents. If you drink, limit your alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women. It is not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.

Read our recommendation on alcohol and cardiovascular disease.

Risk Factors for Heart Disease - Dr. Ravi H. Dave - UCLA Health

A healthy diet is one of the best weapons you have to fight cardiovascular disease. What you eat and how much can affect other controllable risk factors, such as cholesterol, blood pressure, diabetes and being overweight. Choose nutrient-rich foods, which have vitamins, minerals, fiber and other nutrients, but are lower in calories than nutrient-poor foods. Choose a diet that emphasizes vegetables, fruits and whole grains. A heart-healthy diet also includes low-fat dairy products, poultry, fish, legumes, nuts and nontropical vegetable oils.

Be sure to limit your intake of sweets, sugar-sweetened beverages and red meats. A heart attack can occur at any age. Heart attack prevention is critical. It should begin early in life.

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Start with an assessment of your risk factors. Then develop a plan you can follow to maintain a low risk for heart attack. For many people, their first heart attack is disabling or even fatal. Do everything you can to lower your risk.

Three Metaphors to Aid Interdisciplinary Dialogue in Public Health | AJPH | Vol. Issue 11

Many survivors feel scared, confused and overwhelmed after a heart attack. Read the first in our four-part series to help guide your steps and connect with resources to support your recovery. Up and At 'em! In the 50s, a patient was likely to have their doctor prescribe 12 weeks of bedrest. This article focuses on the importance of cardiac rehabilitation.

Feelings After a Heart Attack People typically have a spectrum of emotions after a heart attack. Common feelings include fear, anxiety, depression, anger, loneliness - but also hope for the future as well as relief at having another chance. Knowledge is power. Understand the risks you face for heart attack. Increasing Age The majority of people who die of coronary heart disease are 65 or older. Male gender Men have a greater risk of heart attack than women do, and men have attacks earlier in life. Heredity including race Children of parents with heart disease are more likely to develop heart disease themselves.

Major risk factors you can modify, treat or control Tobacco smoke The risk that smokers will develop coronary heart disease is much higher than that for nonsmokers. Learn about smoking and cardiovascular disease High blood cholesterol As your blood cholesterol rises, so does your risk of coronary heart disease. However, your LDL number should not be the main factor in guiding treatment to prevent heart attack and stroke, according to the latest guidelines from the American Heart Association. In addition, patients taking statins no longer need to get LDL cholesterol levels down to a specific target number.

Intra-abdominal fat affects your blood pressure; your blood lipid levels and interferes with your ability to use insulin effectively. If you cannot use insulin properly you may develop diabetes, a risk factor of cardiovascular disease. As you become overweight, your risk of developing Type 2 diabetes and hypertension rises steeply. If a first-degree male relative e. Your chance of having a stroke is increased if first-degree relatives have had strokes. If they were young when they had their stroke, then the risk is slightly higher. Studies have shown that the risk increases if you are a woman and your mother has suffered a stroke.

Studies have shown a genetic component for both hypertension and abnormal blood lipids, factors related to the development of cardiovascular disease. One of the inherited factors is high cholesterol level, known as familial hypercholesterolemia. If you have inherited this condition then you will experience a build up of low-density lipoprotein cholesterol in the blood. This can lead to coronary heart disease. Type 2 diabetes also has a genetic component, so if one of your parents developed the condition you are at greater risk of developing it too.

Type 2 diabetes is another risk factor for the development of cardiovascular disease. In the case of stroke, it is believed that inheriting hypertension is a key factor in the familial link of ischemic stroke. However, you can protect yourself by taking care of your hear t , as the development of cardiovascular disease involves many different factors, not just your family history. If you have diabetes you are two to four times more likely to develop cardiovascular disease than people without diabetes.

Cardiovascular disease is the leading cause of mortality for people with diabetes. If you have diabetes your risk of cardiovascular disease rises for a number of reasons. Hypertension, abnormal blood lipids and obesity, all risk factors in their own right for cardiovascular disease, occur more frequently in people with diabetes. People with diabetes develop atherosclerosis at a younger age and more severely than people without diabetes.


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Hypertension is more than twice as common in people with diabetes as in people with normal blood glucose levels. People with diabetes are more likely to have a heart attack or stroke, than people who do not, and their prognosis is worse. If you have diabetes you can have a heart attack without realizing it. If you have diabetes you have a two- to three-fold greater risk of heart failure compared to people without diabetes. Premenopausal women who have diabetes have an increased risk of heart disease because diabetes cancels out the protective effects estrogen.

Diabetes and stroke If you have diabetes and hypertension you are about twice as likely to have a stroke as somebody with hypertension alone. Your risk of transient ischemic attacks is between two and six times higher than somebody who does not have diabetes. Diabetes and peripheral arterial disease Diabetes can damage the blood vessels and over time this puts people with diabetes at far greater risk of intermittent claudication and lower-limb amputation compared to the general population. Intermittent claudication occurs three times more often in men with diabetes and almost nine times more often in women with diabetes than in their counterparts without diabetes.

Losing weight and maintaining a healthy diet will improve your diabetes status. If you have impaired glucose tolerance and lose weight, you can prevent the onset of diabetes. Stopping smoking will reduce your cardiovascular disease risk. Risk factors for diabetes The risk factors for Type 1 diabetes have not been proven yet. It is thought that environmental triggers like viruses, toxins in the food chain and dietary components, may play a role. The most significant modifiable risk factor for Type 2 diabetes is being overweight or obese. Smoking doubles the risk of cardiovascular disease if you have diabetes.

The most important non-modifiable risk factor is ethnicity, with Hispanics, Asians, Arabs, Africans, Pacific Islanders and indigenous American, Canadian and Australian populations at particular risk. Risk of stroke is similar for men and women. People with African or Asian ancestry are at higher risks of developing cardiovascular disease than other racial groups. Socioeconomic status : Being poor, no matter where in the globe, increases your risk of heart disease and stroke.

A chronically stressful life, social isolation, anxiety and depression also increase the risk. WHO launches new report on the global tobacco epidemic. Tobacco: totally avoidable risk factor of CVD. Diet, overweight and obesity. Protect your heart. Risk factors. Fact sheets Hypertension. Cardiovascular risk factors There are many risk factors associated with coronary heart disease and stroke.

Modifiable risks factors. Physical inactivity and cardiovascular disease The increasing urbanization and mechanization of the world has reduced our levels of physical activity. Tobacco and cardiovascular disease The evidence that tobacco use will kill you is incontrovertible. Diet and cardiovascular disease The role of diet is crucial in the development and prevention of cardiovascular disease. Alcohol Harmful uses of alcohol has been shown to damage heart muscle and increase the risk of stroke and cardiac arrhythmia.

Bad Fats Much of the food we eat every day contains saturated and trans fats. Blood lipids fats as a risk factor for cardiovascular disease Abnormal levels of lipids fats in the blood are risk factors for cardiovascular disease. European recommendations suggest the following targets: Optimal total cholesterol: less than 5. LDL cholesterol: 3. HDL cholesterol: 1.

Triglycerides: 1. American recommendations suggest the following targets: Optimal total cholesterol: 5.

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Overall, no significant differences in the risk for ischemic cardiovascular events have been reported between AIs and tamoxifen to date. Although variable effects on lipid levels have been observed with AIs, there has been no evidence to link these changes with clinical outcome. Furthermore, AIs may reduce the risk for venous thromboembolism and perhaps have a clinically beneficial effect on triglycerides. Greater awareness among primary care physicians, oncologists, and cardiologists of the cardiovascular risks associated with treating the EBC patient is needed.

Improving cardiovascular outcomes in patients with EBC requires appropriate risk assessment, monitoring, and long-term follow-up care.

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We thank Mary Ellen Shepherd, Ph. The technical-medical writers, Mary Ellen Shepherd and Brian Bass, from Health Learning Systems helped us organize the published literature and put together a first rough draft. Lenihan and Dr. Esteva revised the manuscript extensively to ensure its accuracy and balance. User Name Password Sign In. Lenihan a and Francisco J.

Esteva, M. Anderson Cancer Center, Holcombe Boulevard. Accepted November 11, Previous Section Next Section. Radiation Radiation therapy for breast cancer is associated with an increased risk for cardiovascular disease long after radiotherapy. Anthracycline-Based Chemotherapy Anthracycline-based regimens including epirubicin or doxorubicin are the standard of care for adjuvant chemotherapy in treating EBC.

Hormonal Therapy Cardiovascular Effects It is thought that reduced estrogen levels during the hormonal treatment of women with EBC may increase the risk for cardiovascular disease. View this table: In this window In a new window. Table 1. Lipid Effects Because elevations in total cholesterol, low-density lipoprotein cholesterol LDL-C , and triglycerides, and low levels of high-density lipoprotein cholesterol HDL-C are known risk factors for cardiovascular disease, it is important to evaluate the long-term effects of endocrine therapies on the lipid profiles of patients receiving these drugs [ 66 ].

Table 2. Summary of clinical effects of AIs and tamoxifen on lipids. Table 3. Previous Section. National Comprehensive Cancer Network. Breast cancer. Overall survival and cause-specific mortality of patients with stage T1a,bN0M0 breast carcinoma. J Clin Oncol ; 25 : - Multidisciplinary teams in cancer care: Are they effective in the UK? Lancet Oncol ; 7 : - CrossRef Medline Google Scholar. Risk of cardiac death after adjuvant radiotherapy for breast cancer.

J Natl Cancer Inst ; 97 : - Cardiovascular complications of cancer therapy: Diagnosis, pathogenesis, and management. Circulation ; : - Long-term cardiac tolerability of trastuzumab in metastatic breast cancer: The M. Anderson Cancer Center experience. J Clin Oncol ; 24 : - Early breast cancer therapy and cardiovascular injury. J Am Coll Cardiol ; 50 : - Understanding the divergent data on postmenopausal hormone therapy. N Engl J Med ; : - Effects of estrogen replacement on the progression of coronary-artery atherosclerosis. Conjugated equine estrogens and coronary heart disease: The Women's Health Initiative.

Arch Intern Med ; : - Cardiovascular disease outcomes during 6. JAMA ; : 49 - Increased cardiovascular mortality more than fifteen years after radiotherapy for breast cancer: A population-based study. BMC Cancer ; 7 : 9. Coronary artery findings after left-sided compared with right-sided radiation treatment for early-stage breast cancer.

Interdisciplinary Concepts in Cardiovascular Health

Late cardiac mortality and morbidity in early-stage breast cancer patients after breast-conservation treatment. Cardiac morbidity of adjuvant radiotherapy for breast cancer. J Clin Oncol ; 23 : - Long-term risk of cardiovascular disease in year survivors of breast cancer. J Natl Cancer Inst ; 99 : - Harris EE. Cardiac mortality and morbidity after breast cancer treatment. Cancer Control ; 15 : - Medline Google Scholar.

Polychemotherapy for early breast cancer: An overview of the randomised trials. Lancet ; : - Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and year survival: An overview of the randomised trials. Risk factors for doxorubicin-induced congestive heart failure. Ann Intern Med ; 91 : - Epirubicin cardiotoxicity: An analysis of patients with metastatic breast cancer.

J Clin Oncol ; 16 : - Improved outcomes from adding sequential paclitaxel but not from escalating doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol ; 21 : - Congestive heart failure in patients treated with doxorubicin: A retrospective analysis of three trials. Cancer ; 97 : - Perez EA. TAC—a new standard in adjuvant therapy for breast cancer? Left ventricular ejection fraction and cardiotoxicity: Is our ear really to the ground?

J Clin Oncol ; 26 : - Prognostic value of troponin I in cardiac risk stratification of cancer patients undergoing high-dose chemotherapy. Superior detection of cardiotoxicity during chemotherapy using biomarkers [abstract]. J Cardiac Fail ; 13 : S Google Scholar. N-terminal-proB-type natriuretic peptide as a marker for acute anthracycline cardiotoxicity in children. J Pediatr Hematol Oncol ; 29 : - Early detection of cardiotoxicity during chemotherapy using biomarkers [abstract].

J Clin Oncol ; 25 : Protective effects of carvedilol against anthracycline-induced cardiomyopathy. J Am Coll Cardiol ; 48 : - Doxorubicin cardiotoxicity in the elderly: Old drugs and new opportunities. Prevention of high-dose chemotherapy-induced cardiotoxicity in high-risk patients by angiotensin-converting enzyme inhibition.

Notable effects of angiotensin II receptor blocker, valsartan, on acute cardiotoxic changes after standard chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone. Cancer ; : - Cardinale D. Delval Ann Oncol ; — Ann Oncol ; 13 : - Lipshultz SE. Dexrazoxane for protection against cardiotoxic effects of anthracyclines in children.



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