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from A-Z of Death and Dying, The: Social, Medical, and Cultural Aspects

Cardiovascular disease refers to a class of diseases that involve the heart or blood vessels (arteries and veins), often involving narrowed or blocked blood vessels that can lead to chest pain (angina), heart attack (myocardial infarction), or stroke. Other conditions affecting the heart muscle, valves, and beating rhythm are also considered forms of cardiovascular disease. The term “cardiovascular disease” is commonly used interchangeably with “heart disease.” Although the term technically refers to any disease affecting the cardiovascular system, it is also used specifically to refer to heart problems resulting from atherosclerosis (hardening of the arteries).

Atherosclerosis is a condition that develops when plaque builds up on the walls of the arteries, making them more rigid, narrow, and harder for blood to flow through. If a blood clot forms near a narrowed artery, it can block or dramatically restrict the flow of blood, leading to a heart attack or stroke. Cardiovascular disease is treated medically by cardiologists, vascular surgeons, neurologists, thoracic surgeons, and interventional radiologists.

Cardiovascular diseases include the following:

  • Aneurysm

  • Angina

  • Arrhythmia

  • Atherosclerosis

  • Cerebrovascular accident (stroke)

  • Cerebrovascular disease

  • Congestive heart failure

  • Coronary artery disease

  • Heart valve problems (stenosis, regurgitation, and prolapse)

  • Myocardial infarction (heart attack)

  • Peripheral vascular disease

Risk Factors

The primary risk factors for cardiovascular disease can be divided into two main groups:

  1. Uncontrollable risk factors

    • Family history of heart disease

    • Male sex

    • Older age

    • Post-menopausal

    • Race/ethnicity: African Americans, American Indians, and Mexican Americans have higher risks

  2. Controllable risk factors

    • Unregulated diabetes

    • A diet high in fat, low in fiber, and whole grains, and fewer than five portions of fruits and vegetables daily

    • Elevated levels of stress, anger, and anxiety

    • LDL or “bad” cholesterol levels exceeding 160 mg/dL

    • Hypertension (high blood pressure) exceeding 139/89 mmHg

    • Low HDL or “good” cholesterol levels less than 40 mg/dL for men or 50 mg/dL for women

    • Obesity: body mass index (BMI) exceeding 30.0

    • Physical Inactivity: less than 30 minutes of vigorous activity most days of the week

    • Smoking

Morbidity and Mortality

Cardiovascular disease is the leading cause of death in the United States. Over 80,000,000 adults in the United States have some form of cardiovascular disease. One in every three deaths is from heart disease and stroke, which equals approximately 2,200 deaths per day. Problems relating to cardiovascular disease are also the leading cause of disability, preventing people from working and enjoying family and recreational activities. According to the American Heart Association, some progress is being made on reducing death rates from cardiovascular disease: the death rate from heart diseases declined 27.8 percent from 1997 to 2007, while the death rate from stroke rate fell 44.8 percent. However, in the same time period, the total number of inpatient cardiovascular operations and procedures increased 27 percent. These procedures have helped extend the average age of death from cardiovascular disease to 75 years, but this is still well below the 2010 average life expectancy of 78.3 years in the United States. In 2010, heart disease and stroke hospitalizations cost the United States more than $444 billion in health care expenses and lost productivity, far exceeding any other condition (including cancer), according to the Centers for Disease Control and Prevention. These problems are not unique to the United States; cardiovascular disease is the leading cause of death and disability in the world. Although a large proportion of cardiovascular disease is preventable, it continues to increase because preventative measures are inadequate.

Treatment Options

By the time heart problems and the symptoms of cardiovascular disease are identified, the underlying cause (atherosclerosis) is often quite advanced, having progressed undetected for considerable time. Thus, there is an increased emphasis on preventing atherosclerosis by modifying controllable risk factors, such as diet, physical activity level, and avoidance of smoking. Cardiovascular disease, unlike many other chronic medical conditions, is treatable and sometimes reversible, even after a prolonged period of disease. Treatment for cardiovascular disease involves an emphasis on diet, exercise, and reducing stress. The key focus in recent years has been largely on prevention, promotion of health education, and raising of awareness so that people can make better lifestyle choices.

See also: Alcohol; Cancer; Disease; Epidemiology; Health Promotion; Tobacco.

Tim Thornton
Copyright 2014 by Michael Brennan

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