Lifestyle Disorders: Cardiovascular Diseases

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About Cardiovascular Diseases

Cardiovascular diseases are a group of diseases that affect the heart and blood vessels. Cardiovascular diseases that involve blood vessels are termed as vascular diseases. In general, heart diseases can be of the following types; coronary heart disease (CHD), heart attack (myocardial infarction), chronic hypertension and congenital heart diseases. Among them, CHD and myocardial infarction (MI) are the most frequently talked about and commonly occurring cardiovascular diseases. Coronary heart disease (CHD) is a condition where the blood vessels (coronary arteries) are narrowed due to the lack of proper supply of oxygen. CHD is also known as congestive heart failure (CHF). This happens due to a waxy substance called plaque which gets accumulated inside the arteries of the heart. The most frequently observed symptoms of CHD are shortness of breath, chest pain, increased heart rate and unpleasant dizziness. Myocardial infarction (MI), on the other end, is a deadly situation which happens due to the stoppage of blood flow to the heart. The most frequently observed symptoms of MI are chest pain, dyspnea (shortness of breath), dizziness, nausea and perspiration (sweating). MI may often lead to congestive heart failure, arrhythmia (irregular heartbeat) and cardiac arrest. 

How Common are they?

Cardiovascular diseases are serious public health concerns across the world and more in particular in growing economies like India. CVDs influence the important productive years of an individual’s life. It is expected that more than 90% of CVDs are avoidable by adapting to a healthy lifestyle. In the year 2015 alone, CVDs constituted to nearly 17 million global deaths. CHD and stroke constitute nearly 80% of the total male deaths and 75% of female deaths. Majority of these diseases affect men than women. In Indian population, more than 25% of the deaths occur due to cardiovascular diseases. The Global Burden of Disease Study by the Institute for Health Metrics and Evaluation reported that the rate of deaths by CVDs in Indian population is way higher than the worldwide average. Despite its diversity, CVDs have turned into a major cause of death across the length and breadth of India. The advancement of this epidemic is largely due to socioeconomic factors like usage of tobacco, alcoholism, very minimal intake of fruits and vegetables. Globally, the majority of the deaths due to CVDs occur in low-income and middle-income countries. It is expected that an approximate of over 23million individuals will lose their lives from heart diseases alone. In the near future, close to 60% of the global CVD burden will happen in South-Asian countries.

Clinical Features:

• Pain in chest, chest discomfort (angina), fluttering in chest
• Shortness of breath (dyspnea)
• Numbness and pain in legs and arms
• Pain in abdomen, throat, jaw and throat
• Racing heartbeat (tachycardia)
• Slow heartbeat (bradycardia)
• Fainting (syncope)
• Chronic sweating

Cardiovascular Diseases – Risk Factors and Complications:

Majorly CVD risk factors fall into two categories: Modifiable (can be modified with treatment), Non-Modifiable (cannot be modified with treatment). They are,

• Lack of physical exercise, tobacco usage, untimely diet, obesity, (modifiable)
• Family history, Diabetes (non-modifiable risk factors)
• Age, gender, ethnicity, social status (other non-modifiable risk factors)

Do Genes Have Anything To Do With It?

Myocardial Infarction:

Different types of genes and variants related to CHD and MI were surveyed in the most recent times. Genetic approaches like linkage analysis and candidate-gene association analysis give us a direct link between the pathogenesis of CAD/MI and candidate genes. Only one in three of the total 45 CAD loci in the biggest CAD and MI genome-wide association study (GWAS) showed the presence of a known gene.  (Dai, Xuming et al, 2016). The most powerful genetic effect on myocardial infarction is a variant present on chromosome 9p21. Among them, very less are known to have been related with classic risk factors like old-age, gender, smoking, physical inactivity etc. Majority of these risk-presenting types are quite common (nearly 84% for the allele at risk when compared with the 16% for the allele that is protecting) and have a minimal risk increase between 10 to 30%. The genetic susceptibility addressed by the risk alleles is found in persons with a positive family history and negative family history.

Coronary Heart Disease:

One of the most important and powerful genetic associations with atherosclerosis, stroke, coronary heart calcifications and aneurysms is stationed near the cyclin-dependant kinase inhibitor (CDKN2A/2B) – 9p21 region. Genetic markers for CHD are also present in MTHFD1L (Methylenetetrahydrofolate Dehydrogenase (NADP+ Dependent) 1 Like) gene, LPA (lipoprotein A) gene, CDH13 (T-cadherin) gene and in the PSRC1 (Proline/serine-rich coiled-coil protein 1) gene. 

Managing Cardiovascular Diseases: Risk- Diet and Lifestyle:

Like most lifestyle diseases, cardiovascular disease are curable should the individual give preference to healthy diet and lifestyle interventions. Procedures like vaccination are influential in treating influenza which often leads to heart attacks and strokes and also reduce the rate of mortality. Timely management of cardiovascular diseases calls for focusing on MI and stroke with a special focus on low and middle-income countries. With regards to MI, drugs like aspirin, atenolol is cost-effective than streptokinase and are also used for secondary and tertiary prevention of the disease in the regions. The incidence and rate of increase of cardiovascular diseases can be prevented by the following measures.

• Adopt a healthy diet, avoid skipping meals, and include foods like whole grains, fruits, vegetables, high-fibre foods, and vitamin-rich foods.
• Consume fewer amounts of processed foods and sugar, hydrogenated fats and oils.
• Exercise regularly and maintain a healthy weight.
• Keep yourselves physically active lifestyle throughout the day for better metabolism.
• Stay away from smoking and alcoholism.
• Reduce the intake of beverages and foods containing added sugars.

An interesting fact about all these lifestyle disorders is that they are reversible and if identified early, can be treated well. To overcome the impending burden of epidemic-turning diseases like cardiovascular diseases,, one should adapt themselves to a positive lifestyle with a clear balanced diet, giving up on alcohol and smoking, including fruits and vegetables, whole grains, lean meats in your daily diet, regular physical activity and more importantly, monitor your blood glucose levels on a frequent basis. On the top of it, understanding your genetic predisposition to specific health conditions helps you plan for better treatment procedures and aid in the speedy recovery. 

How Can Mapmygenome Help you: 

At Mapmygenome, our focus is mainly on predictive risk assessment, maintaining a proper diet, adapting to a healthier lifestyle. A comprehensive wellness assessment like Genomepatri will give an insight into the weaknesses of your immunity, genetic predisposition to specific health conditions, drug efficiency and helps in pre-empting most of these risks. Genetic counselling is therefore recommended to obtain authenticated reviewing and recommending testing/screening options, diet/lifestyle interventions and as educational and emotional support.

Tapping into your genes will assist you to know the real ‘YOU’. Genomepatri helps you find the best-suited route for yourself, and reiterates the importance of not following the crowd but forging a unique way of leading quality life. It is personalized, predictive, participatory, preventive, and POWERFUL!!!

References:

1. American Diabetes Association. “8. Cardiovascular disease and risk management.” Diabetes care 39.Supplement 1 (2016): S60-S71.
2. Dai, Xuming et al. “Genetics of coronary artery disease and myocardial infarction.” World journal of cardiology vol. 8,1 (2016): 1-23. doi:10.4330/wjc.v8.i1.1
3. Erdmann, Jeanette et al. “Genetic causes of myocardial infarction: new insights from genome-wide association studies.” Deutsches Arzteblatt international vol. 107,40 (2010): 694-9. doi:10.3238/arztebl.2010.0694
4. Gupta, Sushil et al. “Emerging risk factors for cardiovascular diseases: Indian context.” Indian journal of endocrinology and metabolism vol. 17,5 (2013): 806-14. doi:10.4103/2230-8210.117212
5. Prabhakaran, Dorairaj, Panniyammakal Jeemon, and Ambuj Roy. “Cardiovascular diseases in India: current epidemiology and future directions.” Circulation 133.16 (2016): 1605-1620.