Heart disease cvd
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Cardiovascular Disease (CVD): A Global Health Challenge
Prevalence of Cardiovascular Disease in Type 2 Diabetes
Cardiovascular disease (CVD) is a prevalent comorbidity in individuals with type 2 diabetes (T2DM). A comprehensive review of literature from 2007 to 2017 revealed that approximately 32.2% of adults with T2DM are affected by CVD. The study, which analyzed data from 57 articles encompassing 4,549,481 individuals, highlighted that coronary heart disease and stroke are the major contributors to CVD in this population. Notably, CVD accounts for nearly half of all deaths among people with T2DM, underscoring the critical need for effective management and prevention strategies in this group.
Epidemiology of Cardiovascular Disease in China
In China, CVD is the leading cause of death, driven by a complex interplay of demographic, environmental, lifestyle, and healthcare factors. The burden of atherosclerotic CVD, including ischemic heart disease and ischemic stroke, is rising, while mortality from hemorrhagic stroke is declining. Regional variations in CVD trends and the increasing age of patients present new challenges for prevention and treatment. Additionally, a significant proportion of out-of-hospital deaths due to ischemic heart disease and gaps in prehospital care highlight areas needing urgent attention. The high prevalence of undiagnosed, untreated, or uncontrolled hypertension, hypercholesterolemia, and diabetes mellitus further complicates the CVD landscape in China.
Cardiovascular Disease Risk in Young Adults
Assessing CVD risk in underserved young adult populations (18-34 years) is crucial for early intervention. A systematic review identified 21 distinct CVD risk assessment tools, with six not requiring clinical or laboratory data. These non-clinical tools, such as the Heart Disease Fact Questionnaire and the WHO STEPwise approach, are valuable for evaluating CVD risk factors in young adults, particularly in resource-limited settings.
Global Burden and Secondary Prevention of Cardiovascular Disease
CVD remains the leading cause of global mortality, with ischemic heart disease, stroke, and heart failure being the primary contributors. Despite advances in prevention and treatment, the incidence of CVD continues to rise, especially in low and middle-income countries. Secondary prevention through pharmacologic interventions like aspirin, statins, and blood pressure-lowering agents has proven effective in reducing CVD events and mortality. However, adherence to these therapies is often poor, particularly in chronic patients, leading to higher rates of recurrent CVD events and increased healthcare costs.
Cardiovascular Disease in Dialysis Patients
Patients with end-stage renal disease (ESRD) on hemodialysis (HD) face a significantly higher risk of CVD, with mortality rates 20 times higher than the general population. This elevated risk is attributed to factors such as ventricular hypertrophy, chronic volume overload, anemia, inflammation, oxidative stress, and chronic kidney disease-mineral bone disorder. Understanding these non-traditional risk factors is essential for developing targeted prevention and treatment strategies for CVD in dialysis patients.
Conclusion
Cardiovascular disease remains a major global health challenge, affecting diverse populations from those with diabetes to young adults and dialysis patients. Effective management and prevention strategies, including early risk assessment and adherence to secondary prevention therapies, are critical in reducing the burden of CVD worldwide. Addressing the unique epidemiological features and risk factors in different populations will be key to mitigating the impact of this pervasive disease.
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