Cardiovascular Diseases and treatments in Iran

Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. More than four out of five Cardiovascular Diseases deaths are due to heart attacks and strokes, and one third of these deaths occur prematurely in people under 70 years of age.
The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. Amongst environmental risk factors, air pollution is an important factor. The effects of behavioral risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of heart attack, stroke, heart failure and other complications.
Cessation of tobacco use, reduction of salt in the diet, eating more fruit and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. Health policies that create conducive environments for making healthy choices affordable and available, as well as improving air quality and reducing pollution, are essential for motivating people to adopt and sustain healthy behaviors.
Identifying those at highest risk of Cardiovascular Diseases and ensuring they receive appropriate treatment can prevent premature deaths. Access to noncommunicable disease medicines and basic health technologies in all primary health care facilities is essential to ensure that those in need receive treatment and counselling.
Cardiovascular Diseases – Heart attack and stroke
Often, there are no symptoms of the underlying disease of the blood vessels. A heart attack or stroke may be the first sign of underlying Cardiovascular Diseases. Symptoms of a heart attack include:
- pain or discomfort in the centre of the chest; and/or
- pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.
In addition 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.
People experiencing these symptoms should seek medical care immediately.
Rheumatic heart disease – Cardiovascular Diseases
Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heartbeats, chest pain and fainting. Symptoms of rheumatic fever (which can cause rheumatic heart disease if not treated) include: fever, pain and swelling of the joints, nausea, stomach cramps and vomiting.
Cardiovascular Diseases – Coronary heart disease
Coronary heart disease occurs when the flow of oxygen-rich blood to the heart muscle is blocked or reduced.
This puts an increased strain on the heart, and can lead to:
- angina – chest pain caused by restricted blood flow to the heart muscle
- heart attacks – where the blood flow to the heart muscle is suddenly blocked
- heart failure – where the heart is unable to pump blood around the body properly
Strokes and TIAs – Cardiovascular Diseases
A stroke is where the blood supply to part of the brain is cut off, which can cause brain damage and possibly death.
A transient ischaemic attack (also called a TIA or “mini-stroke”) is similar, but the blood flow to the brain is only temporarily disrupted.
The main symptoms of a stroke or TIA can be remembered with the word FAST, which stands for:
- Face – the face may have drooped on one side, the person may be unable to smile, or their mouth or eye may have dropped.
- Arms – the person may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
- Speech – their speech may be slurred or garbled, they may not be able to talk at all or they may not be able to understand what you are saying to them.
- Time – it’s time to dial 999 immediately if you see any of these signs or symptoms.
Peripheral arterial disease – Cardiovascular Diseases
Peripheral arterial disease occurs when there’s a blockage in the arteries to the limbs, usually the legs.
This can cause:
- dull or cramping leg pain, which is worse when walking and gets better with rest
- hair loss on the legs and feet
- numbness or weakness in the legs
- persistent ulcers (open sores) on the feet and legs
Aortic disease as Cardiovascular Diseases
Aortic diseases are a group of conditions affecting the aorta. This is the largest blood vessel in the body, which carries blood from the heart to the rest of the body.
One of most common aortic diseases is an aortic aneurysm, where the aorta becomes weakened and bulges outwards.
This doesn’t usually have any symptoms, but there’s a chance it could burst and cause life-threatening bleeding.
Causes of CVD
The exact cause of CVD isn’t clear, but there are lots of things that can increase your risk of getting it. These are called “risk factors”.
The more risk factors you have, the greater your chances of developing CVD.
If you’re over 40, you’ll be recommended by your GP for an health check every 5 years.
Part of this check involves assessing your individual CVD risk and advising you how to reduce it if necessary.
Cardiovascular Diseases: High blood pressure
High blood pressure (hypertension) is one of the most important risk factors for CVD. If your blood pressure is too high, it can damage your blood vessels.
Hypertension can lead to serious problems like heart attacks or strokes. But lifestyle changes and blood pressure medicines can help you stay healthy.
Check if you’re at risk of high blood pressure
High blood pressure is very common, especially in older adults. There are usually no symptoms, so you may not realise you have it.
Things that increase your chances of having high blood pressure include:
- your age – you’re more likely to get high blood pressure as you get older
- having close relatives with high blood pressure
- your ethnicity – you’re at higher risk if you have a Black African, Black Caribbean or South Asian ethnic background
- having an unhealthy diet – especially a diet that’s high in salt
- being overweight
- smoking
- drinking too much alcohol
- feeling stressed over a long period
Smoking
Smoking and other tobacco use is also a significant risk factor for Cardiovascular Diseases. The harmful substances in tobacco can damage and narrow your blood vessels.
High cholesterol
Cholesterol is a fatty substance found in the blood. If you have high cholesterol, it can cause your blood vessels to narrow and increase your risk of developing a blood clot.
Diabetes
Diabetes is a lifelong condition that causes your blood sugar level to become too high.
High blood sugar levels can damage the blood vessels, making them more likely to become narrowed.
Many people with type 2 diabetes are also overweight or obese, which is also a risk factor for Cardiovascular Diseases.
Inactivity
If you don’t exercise regularly, it’s more likely that you’ll have high blood pressure, high cholesterol levels and be overweight. All of these are risk factors for CVD.
Exercising regularly will help keep your heart healthy. When combined with a healthy diet, exercise can also help you maintain a healthy weight.
Being overweight or obese
Being overweight or obese increases your risk of developing diabetes and high blood pressure, both of which are risk factors for CVD.
You’re at an increased risk of CVD if:
- your body mass index (BMI) is 25 or above – use an accurate BMI healthy weight calculator to work out your BMI
- you’re a man with a waist measurement of 94cm (about 37 inches) or more, or a woman with a waist measurement of 80cm (about 31.5 inches) or more
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