Fight to Avoid the Fate of Millions of People Who Succumb to Death Annually Due to Cardiovascular Diseases

Introduction

Cardiovascular Diseases (CVDs) are disorders of the heart and blood vessels. These diseases include:

• Coronary heart disease – a disease of the blood vessels supplying the heart muscle;
• Cerebrovascular disease – a disease of the blood vessels supplying the brain;
• Peripheral arterial disease – a disease of blood vessels supplying the arms and legs;
• Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
• Congenital heart disease – birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth; and
• Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.

Over the years CVDs have gained the reputation of being the leading cause of death in the world. According to the World Heart Federation report released in 2023, cardiovascular diseases killed around 20.1 million people in 2021; with coronary heart disease (ischemic heart disease) being the leading cause of premature death in 146 countries for men and 98 countries for women. The report further asserts that these diseases afflict more than half a billion people globally, with low- and middle-income countries carrying most of the burden. According to the report, 4 out of 5 deaths due to CVDs occur in low- and middle-income countries.

Cardiovascular Heart Diseases Risk Factors 

There are many risk factors for CVDs. These factors singularly or combined can cause one or more of the CVDs. These factors are aggregated into three groups which are:

• Behavioral factors;
• Metabolic factors; and
• Environmental factors

Behavioral factors: These refer to the actions, habits, and choices that individuals engage in, which can have a significant impact on their health, well-being, and overall quality of life. Behavioral factors that may contribute to initiation and continuation of CVDs include smoking, alcohol consumption, sodium intake, a wrong diet, working long hours and insufficient physical activity.

Metabolic factors: These refer to various processes and components involved in metabolism, which is the set of chemical reactions that occur within living organisms to maintain life. Metabolism involves the creation and breakdown of chemicals in the body. Metabolic factors that may contribute to initiation and continuation of CVDs include high blood pressure, high fasting blood glucose, high body mass index, high levels of low-density lipoprotein (LDL) cholesterol, metabolic acid ash (from metabolized proteins and carbohydrates), glycation (the process of dietary sugar binding to the proteins that have been used to build up blood cells), damaged cell membranes due to the consumption of trans fats, and diabetes.

Environmental factors: These refer to the external conditions and influences in the surrounding environment that can impact individuals, communities, and ecosystems. These factors can have both direct and indirect effects on various aspects of human life, including physical health, mental well-being, social interactions, and overall quality of life. Environmental factors that can contribute to the initiation and continuation of CVDs include air pollution, noise pollution, built environment, workplace factors, social economic factors, climate change and access to healthy food. 

How Do You Know that You May Have One or More CVDs?

Of course, the best way to know is do a medical check. However, not many people, especially those residing in low-income countries can afford the luxury of frequent medical checkups. In part the high CVDs mortality rate in these countries can be attributed to this. People never visit the doctor unless they have already fallen ill. So, what can people do if they can’t do medical checkups? The best alternative is to educate themselves on the symptoms of CVDs, in order to take appropriate action as early as possible, in the event of suspecting the presence of CVDs. Common symptoms for CVDs include:

• Pain or discomfort in the center of the chest; and/or
• Pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.

Additionally, the person may experience difficulty in breathing or shortness of breath; nausea or vomiting; light-headedness or faintness; a cold sweat; and turning pale. Women are more likely than men to have shortness of breath, nausea, vomiting, and back or jaw pain.

The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one side of the body. Other symptoms include sudden onset of:

• numbness of the face, arm, or leg, especially on one side of the body;
• confusion, difficulty speaking or understanding speech;
• difficulty seeing with one or both eyes;
• difficulty walking, dizziness and/or loss of balance or coordination;
• severe headache with no known cause; and/or
• fainting or unconsciousness.

Dealing With CVDs

WHO Initiatives

According to the World Health Organization (WHO) the key to cardiovascular disease reduction lies in the inclusion of cardiovascular disease management interventions in universal health coverage packages. To this end WHO has developed two technical packages providing in depth guidelines to stakeholders. The first package is a risk-based CVD management tool for use in primary health care. This technical package provides a strategic approach to improving cardiovascular health in countries. It comprises six modules and an implementation guide. This package supports ministries of health to strengthen CVD management in primary health care settings. You can down load it here:  https://www.who.int/publications/i/item/9789240001367. The second package is a tool for the development of a consensus protocol for treatment of hypertension. You can download it here: https://www.who.int/publications/i/item/WHO-NMH-NVI-19-8.  

According to WHO high blood pressure kills more people than any other condition – approximately 10 million people each year. It kills more people than all infectious diseases combined. Reducing blood pressure prevents stroke, heart attack, kidney damage, and other health problems.

WHO believes that the creation and endorsement of a detailed and standardized treatment protocol is a critical first step in developing a successful large-scale hypertension program.

WHO contends that evidence from 18 countries has shown that hypertension programs can be implemented efficiently and cost-effectively at the primary care level which ultimately result in reduced coronary heart disease and stroke.

WHO asserts that patients with cardiovascular disease should have access to appropriate technology and medication. Basic medicines that should be available include:

• aspirin;
• beta-blockers;
• angiotensin-converting enzyme inhibitors; and
• statins.

Other Diet Driven Initiatives

 At       At the end of the day, diet is probably the most important variable in the war against CVDs. A lot of metabolic factors that contribute to CVDs are influenced by diet. A proper diet should be one that does not cause cellular inflammation, does not cause cellular damage, and does not produce acidic ash in the body. To know what a proper diet constitutes let us take a look at common individuals food components that we use most of the time to formulate our diets.

• Sugar and processed carbohydrates: These are known to cause glycation; they are highly inflammatory; and leave an acidic ash after metabolism
  
  
  
  
  
  
  
• Vegetable cooking oils: These are known to transform into trans fats during the cooking process which attacks the electron cloud on cell membranes. In addition, they are also highly inflammatory.
  
  
  
  
  
  
  
• Proteins: These leave an acidic ash after metabolism.
  
  
  
  
  
  
• Vegetables and fruits: These are loaded with vitamins, antioxidants and with the exception of cranberry, leave an alkaline ash after metabolism. 
  
  
  
  
  
  

By analyzing the food components listed above, it is obvious that a protective diet is one loaded with fruits and vegetables.  A diet that does not contain enough vegetables and fruits does not have sufficient quantities of vitamins and antioxidants needed to protect healthy conditions in the body. In addition, it won’t have sufficient quantities of alkaline minerals needed to neutralize the huge acid load generated by the protein and carbohydrates parts of the diet. When such a diet is sustained for long periods, the body compensates by causing the bones to release calcium to deal with the acid. The released calcium ends up combining with other metabolic byproducts in the blood stream to create arterial plaque which cause clogging. Clogging narrows down the blood vessels causing blood pressure to rise and also blocks blood flow to the heart. So, to prevent damage to blood vessels and the heart eating copious quantities of vegetables and fruit is absolutely essential.

In addition, we need to increase consumption of food items known for their benefits to the circulatory system. These include:

• .     Food items containing a lot of polyphenolic compounds: One such food item is juice made from pomegranates. In pomegranates most of the polyphenolic compounds are concentrated on the skin. Because of this the whole fruit must be crashed and made into a pulp for these phenolic compounds to be available. After adding water, the resulting mixture should be filtered to obtain the solution. The solution can be blended with other fruits of choice to make the juice. One medium sized pomegranate will need one litter of water to make the required solution. Another food item with plenty of polyphenols is dark honey. The darker the honey, the more polyphenols are there
  
  
  
  
  
  
  
  
• .       Garlic: Garlic is known for its extensive health benefits including as a blood thinner and a vasodilator.
  
  
  
  
  
  
  
• .       Beetroots: Beetroots contain a lot of nitrates. Upon consumption these are converted into nitric oxide which blood vessels need to maintain their ability to expand and constrict. Probably the best way to take beetroot is to make a smoothie.
  
  
  
  
  
  
  
• .        Ginger: Ginger is a root that is commonly used as a spice and suppression of nausea, inflammation, indigestion, and morning sickness. Several studies suggest that ginger could help lower blood pressure levels.
  
  
  
  
  
  
  
• .       Turmeric: Turmeric, a spice derived from the Curcuma longa plant, has been studied for its potential to lower blood pressure. Several studies have shown that curcumin, the active ingredient in turmeric, may help to reduce blood pressure by inhibiting the production of angiotensin-converting enzyme (ACE), which in turn can lead to a decrease in blood pressure. Additionally, curcumin may have other effects on the cardiovascular system, such as reducing inflammation and improving blood flow.
  
  
  
  
  
  
  
• Cinnamon: Several studies have suggested that cinnamon may help lower blood pressure. Cinnamon is a spice that is commonly used in baking and cooking. It contains several antioxidants and anti-inflammatory compounds that may contribute to its potential blood pressure-lowering effects
  
  
  
  
  
  

Conclusion

In conclusion, cardiovascular diseases (CVDs) remain a significant global health challenge, responsible for millions of deaths each year. The burden of CVDs is particularly high in low- and middle-income countries. However, there are strategies and initiatives that can make a substantial impact in reducing the prevalence and mortality rates associated with CVDs. The World Health Organization (WHO) emphasizes the importance of implementing comprehensive cardiovascular disease management interventions as part of universal health coverage.

 Additionally, adopting a diet driven approach that includes ample amounts of vegetables, fruits, and food items known for their circulatory system benefits can contribute to the prevention and management of CVDs.

By implementing these evidence-based approaches, enhancing access to appropriate medications, and promoting healthy lifestyle choices, it is possible to make significant strides in reducing the global burden of cardiovascular diseases and improving the overall cardiovascular health of populations worldwide.