Cardiovascular disease

Cardiovascular disease, in most cases, is due to arteriosclerosis as it causes the arteries to harden and narrow. The arteries transport blood through the body, delivering both oxygen and nutrients as needed. Arteriosclerosis reduces the space available for effective blood flow, in turn, reducing the amount of oxygen delivery to affected areas. Most people in the western world develop arteriosclerosis beginning in their twenties with numbers increasing with age. Several risk factors contribute to arteriosclerosis:

  • Smoking
  • Increased blood cholesterol levels
  • Type I and Type II diabetes
  • High blood pressure
  • Obesity
  • Stress
  • Lack of exercise

What are the different types of cardiovascular disease?

The disease spectrum includes several conditions affecting the blood vessels in the heart and the rest of the body. The diseases are primarily caused by arteriosclerosis due to deposits of fat in the arterial walls, usually referred to as plaque.

What are the symptoms of cardiovascular disease?

The symptoms in the heart are mainly angina pectoris and, in severe cases, blood clots in the heart. Arteriosclerosis in the brain can cause temporary or permanent paralysis and speech disorders (apoplexia). Arteriosclerosis in the legs can cause muscle pain when walking (claudication) and may result in necrosis.

Types of cardiovascular diseases

Heart attack

Occurs when blood flow from one of the coronary arteries of the heart becomes clogged and the heart is not supplied to oxygen.
Blood clots cause severe chest pain and often heart rhythm disturbances, which can lead to heart failure. Most cardiac arrest is due to a blood clot in the heart.

Angina pectoris / angina

Is chest pain and due to the calcification and narrowing of the coronary arteries.

Heart failure

This means that the heart does not pump blood sufficiently. Heart failure may be a result of blood clots in the heart, cardiovascular disease, untreated hypertension or atrial fibrillation. Symptoms include shortness of breath, fatigue, fluid in the body and swollen legs.
Atrial fibrillation
Is a condition where the heartbeat becomes irregular because the normal pulse conduction in the heart is not functioning. Symptoms are palpitations, rapid heartbeat or heart failure with shortness of breath.

Abnormal heart rhythms

Is when the heart does not beat at normal pace. This may be due to a rapid heartbeat such as in atrial fibrillation, extra heartbeats, irregular heartbeats or a slow heartbeat

Heart valve regurgitation

Can be both narrowing and leakage of the heart valves. This is usually due to age but can also be caused by heart inflammation. Some leaks are due to heart failure. May cause shortness of breath, heart rhythm and heart rhythm disturbances.

Inflammation of the heart

Occurs most commonly in patients with heart valve disease. Symptoms typically begin with long periods of fever and fatigue along with weight loss. Symptoms related to the heart usually present themselves after these initial ones are experienced

Cardiomyopathy

Is a disease of the heart muscle without a known cause. As a rule, the heart is considerably enlarged and does not pump effectively because of this. It can lead to heart failure, angina pectoris and cardiac arrhythmias.

Symptoms of arteriosclerosis in the coronary arteries around the heart

In mild arteriosclerosis – no symptoms
In severe arteriosclerosis – angina pectoris
If one of the coronary arteries is congested, it may cause a blood clot in the heart.
Chest pain, triggered by physical exertion, often with left ventricular radius (angina pectoris).

Symptoms of arteriosclerosis in the arteries in the brain

Blood clot in the brain (apoplexy)
Declining mental abilities due to several smaller blood clots in the brain (multi infarct dementia)

Symptoms of arteriosclerosis in the arteries of the legs

Muscle pain in the legs, mostly in lower muscles after shorter or longer walks. After five to ten minutes of rest, the pain is over. The pain is caused by a reduced supply of oxygen to the muscles due to the narrowed blood vessels.
More severe arteriosclerosis can cause sores and necrosis in the toes and feet. Blood clots can also occur in the legs.

Treatment

Prevention of arteriosclerosis in the blood vessels

  • No smoking
  • Healthy diet: vegetables, whole grains, fat free and varied. Avoid saturated fatty acids
  • If overweight: weight loss
  • Exercise, at least half an hour or an hour’s walk each day
  • If you are diabetic – monitoring your blood sugar levels
  • If you have high blood pressure – monitoring your blood pressure

How is the research organized?

It starts with the first line researchers, who can be doctors, pharmacists or biochemists. They can be employed by either the pharmaceutical industry or by independent research institutes. The researchers experiment with gene therapy, new active substances and new technology. Initial testing is conducted on mice or rats in the lab to document its effects.

If the results of the animal testing prove successful, the next step is testing the drug on human subjects in clinical trials, which always take place in the hospitals and clinics where the patients are. It is here, in the hospitals and clinics, that responsibility for the next step of research is granted to the study nurses and doctors. These roles are defined as an investigator. The initial researchers are not allowed to be involved with the clinical trials to ensure they cannot affect the outcome of the clinical trials.
Before a clinical trial can start, it must be approved by the health authorities in every country where the trial takes place. The medical trial, in the form of a protocol, describes in detail the purpose of the study as well as how it is to be conducted. In addition, the Ethics Committee in all participating countries must approve the trial after carefully considering the ethical protection of the participants.
The clinical trials are conducted in four phases – read more here. It starts with phase 1, with a small number of participants and proceeds to phase 4, with several thousand participants.

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