Common Heart Diseases
- Heart disease is the number one killer of Americans. Heart disease is a blanket term for any and all health conditions affecting the heart. This article discusses five types of heart diseases: coronary, hypertensive, heart failure, inflammatory, and valvular. Use this article as a way to become familiar with the different types of heart disease and what they affect, not as a replacement for the necessary visits to a doctor.
Heart Disease Related Events and Factors Contributing to Heart Disease
Diagnosing heart disease can be a complex process, and the causes and consequences of the disease are equally complex. There are several factors that contribute to the development and severity of the disease. Furthermore, heart disease can culminate in serious, even traumatic medical events like heart attack. Understanding what causes heart disease and how it affects the heart''s function is the key to preventing, managing or reversing the disease.
The Road Back: How to Heal Your Heart
- There a personal road map to fit your unique journey toward a healthier heart. Use this article as a guide to initiate a discussion with your physician about the ways you can improve your heart health. If you have recently had a heart attack, heart failure, or been diagnosed with a heart condition, this article can help you understand some strategies for rehabilitating your heart.
How How the Heart Works
- This document explains how the heart works to an audience that is not very familiar with medical terms and health care lingo. This document should help you arrive at the doctors office with enough knowledge to make the visit very helpful. If you understand the basics of how your heart works, you can use the doctor''s time to tailor a very specific and personal strategy to optimize your heart''s health. It is compiled by Matt Nilsen, and the main source is information from the National Heart Lung and Blood Institute, an institute within the National Institutes of Health. (Note: This is a PDF file. You must have Adobe Reader to open this file.)
CHICAGO — People living with diabetes face double the risk of cardiovascular disease, a study reported in the June 11 issue of Archives of Internal Medicine.
The study concluded that men and women with diabetes at age 50 and older appear not to live as long overall. Furthermore, statistics suggest they do not live as many years without cardiovascular disease, than individuals without diabetes. In fact, the face double the risk of the disease.
"Having diabetes at age 50 years and older represents not only a significant increase in the risk of developing cardiovascular disease and mortality but also an important decrease in life expectancy and life expectancy free of cardiovascular disease," the authors write. "Prevention of diabetes is a fundamental task facing today''s society, with the aim to achieve populations living longer and healthier lives," they conclude.
Oscar H. Franco, M.D., D.Sc., Ph.D., of University Medical Center Rotterdam, the Netherlands, and Unilever Corporate Research, Sharnbrook, England, and colleagues used data from the Framingham Heart Study, a group of 5,209 men and women age 28 to 62 years recruited between 1948 and 1951 and followed for more than 46 years. The researchers selected three follow-up periods of 12 years each that began in 1956 to 1958, 1969 to 1973, and 1985 to 1989. Participants were followed during each of the three periods until they developed cardiovascular disease or died, and their diabetes status was measured again at the beginning of each interval.
Source: Arch Intern Med. 2007;167:1145-1151.
The presence of cardiovascular disease should now be recognized as a risk factor for the development of kidney disease, and patients with both should be screened and treated accordingly, write Barry I. Freedman, M.D., and Thomas D. DuBose Jr., M.D., of the Wake Forest University School of Medicine, Winston-Salem, N.C., in an accompanying editorial to the recent heart disease and kidney disease study published in the June 11 issue of Archives of Internal Medicine.
These two reports "address the interactive effects of kidney disease and cardiovascular disease risk in more than 50,000 subjects," they write. "These studies provide novel insights into the relationship between kidney disease and the vasculature."
"The chances for reducing the current high rates of chronic kidney disease and cardiovascular disease will be maximized when primary care physicians, nephrologists and cardiologists work in partnership to reduce and treat modifiable vascular disease risk factors, including those that are a consequence of kidney disease," Drs. Freedman and DuBose conclude. "In addition, the potential for achieving current treatment goals in individuals at risk for nephropathy and cardiovascular disease using a more focused approach promises greater reductions in future cardiovascular disease and end-stage renal disease events."
Most patients with chronic kidney disease die of complications from heart disease rather than of kidney failure, according to two reports in the June 11 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
The reports found that anemia and other conditions related to chronic kidney disease are independently associated with the risk of cardiovascular disease; conversely, heart disease is associated with a decline in kidney function and the development of kidney disease.
Chronic kidney disease is becoming increasingly prevalent in the United States and worldwide, according to background information in the articles. Chronic kidney disease is associated with a wide variety of complications, including anemia (low red blood cell count, or red blood cells that are deficient in oxygen-transporting hemoglobin), nerve pain, bone disease, death, and cardiovascular disease.
In one study, Peter A. McCullough, M.D., M.P.H., of William Beaumont Hospital, Royal Oak, Mich., and colleagues assessed a group of 37,153 individuals who were screened for kidney disease through a community-based program between 2000 and 2003. The participants (average age of 52.9 years) all reported a personal or family history of diabetes, hypertension, or kidney disease on a screening survey. Patients had their blood pressure measured and provided blood and urine samples, which were processed to assess three markers of chronic kidney disease:
- estimated glomerular filtration rates (eGFR), or the rate at which kidneys filter blood, calculated based on levels of the waste product creatinine in the blood
- anemia, determined by blood hemoglobin levels
- and microalbuminuria, or slightly high levels (20 milligrams per liter or more) of the protein albumin in the urine
Of the participants who were followed for a maximum of 47.5 months, 5,504 (14.8 percent) had abnormal eGFR values, and signs of declining kidney function. In addition, 4,588 (13.1 percent) had anemia; and 15,959 (49.5 percent) had microalbuminuria. A total of 1,835 (4.9 percent) had a history of heart attack, 1,336 (3.6 percent) had a history of stroke and 2,897 (7.8 percent) had a self-reported history of heart attack or stroke.
Each of the three variables-anemia, microalbuminuria and low eGFR-was associated with cardiovascular disease. More than one-fourth of the patients who had all three kidney disease measures had cardiovascular disease, and their survival rates over the course of the study were lower by approximately 93 percent than those of any other group.
"These data suggest that screening for cardiovascular disease would be of high yield among patients with these risk markers but who do not report any history of cardiovascular disease symptoms," the authors conclude.
In a related study, Essam F. Elsayed, M.D., of Tufts-New England Medical Center, Boston, and colleagues evaluated a total of 13,826 individuals (average age 57.6) who had participated in one of two large cardiovascular health studies. Participants were recruited to the studies between 1987 and 1990 and followed up at approximately three-year intervals for an average of 9.3 years. At the beginning of the study and at each subsequent visit, blood creatinine levels were measured and used to track the decline in kidney function and the development of kidney disease both directly and by calculating eGFR. History of cardiovascular disease, as well as medication use, lifestyle characteristics, and other variables also were collected at the initial assessment.
At the beginning of the studies, 1,787 (12.9 percent) of the participants had cardiovascular disease. As measured by creatinine levels, 520 individuals (3.8 percent) experienced a decline in kidney function-including 128 (7.2 percent) of those with cardiovascular disease and 392 (3.3 percent) of those without cardiovascular disease-and 314 (2.3 percent) developed kidney disease. The presence of cardiovascular disease at the beginning of the study was associated with a decline in kidney function and the development of kidney disease as measured by both creatinine levels and eGFR.
"Our study demonstrates that cardiovascular disease is associated with subsequent kidney function decline and development of kidney disease," the authors conclude. "Because these patients are mainly under the care of primary care physicians and cardiologists, it is important to draw attention to the increased risk of kidney disease in this population, with goals of preventing further progression, managing sequelae of kidney disease as they arise and adequately preparing individuals for kidney failure with timely nephrology referrals. Only with recognition of risk factors for kidney disease can this happen."
PASADENA, Calif., June 6 /PRNewswire-USNewswire/ -- NASA space technology is helping doctors diagnose and monitor treatments for hardening of the arteries in its early stages, before it causes heart attacks and strokes.
Hospitals and doctors around the country are using ArterioVision software initially developed at NASA''s Jet Propulsion Laboratory (JPL), Pasadena, Calif., along with a standardized, painless, non-invasive ultrasound examination of the carotid artery, which carries blood from the heart to the brain.
A standard carotid ultrasound measures plaque and blood flow within the artery. When an ultrasound is used with the software, the test measures the thickness of the inner two layers of the carotid artery -- the intima and media. Medical Technologies International, Inc. (MTI) of Palm Desert, Calif., patented the ArterioVision software.
Arterial thickening provides the earliest evidence of atherosclerosis, or hardening of the arteries, the beginning stage of a disease process that leads to heart disease and stroke. Doctors can use this carotid intima media thickness (CIMT) measurement to calculate the age of the patient''s arteries, which does not always match the patient''s calendar age.
"You may look and feel one way on the outside, but your arteries actually could be much older than one realizes," said Dr. Howard N. Hodis of the Keck School of Medicine at the University of Southern California, Los Angeles. "Once patients see how thick their arteries are, there is much more incentive for them to change their lifestyle with dietary modification and exercise," he said. "Physicians also can use the test to monitor and change current medications."
The U.S. Food and Drug Administration has approved the new diagnostic tool, called the ArterioVision CIMT procedure. Robert Selzer, MTI chief engineer, worked in JPL''s Image Processing Laboratory for 15 years, where the technology was developed that ultimately led to the software used in ArterioVision.
"This is such a precise method of examining the carotid artery. It can distinguish between 256 shades of gray at a subpixel level," Selzer said. "You need that kind of detail to help catch heart disease as early as you can, often before there are any outward symptoms."
During the test, a patient lies on an examination table while a technician applies gel to the neck to image the carotid arteries, located on both sides of the neck near the skin''s surface. The technician uses an ultrasound machine while following a patented protocol to capture specific images of the carotid artery wall. Using the ArterioVision software, the physician generates a CIMT measurement and a report that identifies the patient''s risk profile when compared to people of the same gender and age.
"It is exciting to see this NASA-funded technology grow in sophistication over the years and help in the battle against one of the nation''s leading health issues," said Ken Wolfenbarger, Innovative Partnerships Program manager at JPL. The American Heart Association says heart disease is the leading cause of death in the United States, while strokes are third, behind all forms of cancer.
Gary F. Thompson, chairman and chief executive officer of MTI, says the test is near and dear to his heart -- literally and figuratively. "I was the first male in my family to reach 50, so I decided to celebrate by running the Los Angeles marathon, but I had a heart attack halfway through it and couldn''t finish," Thompson said. "None of the non-invasive tests that I had prior to the marathon detected my silent heart disease, and I knew there had to be something better out there."
The California Institute of Technology, Pasadena, which manages JPL for NASA, licensed the ArterioVision device to MTI. For more information about ArterioVision, visit: http://www.i-mti.com.