Heart and vascular (blood vessel) diseases are the leading causes of disability and death for adults in the US. It’s important to understand what you can do to reduce your risk of developing these conditions, or to help stay as healthy as possible if you already have a cardiovascular condition.
Below you’ll find information about common diseases of the heart and vascular system, including overviews, risk factors, management, and commonly prescribed medications.
Cholesterol is a kind of fat that you need to perform many bodily functions, like building cells. Your body makes cholesterol, and it also comes from certain foods, like meat and dairy products. When the total level of cholesterol in your blood is too high—200mg/dl or greater—your risk of cardiovascular diseases like heart attacks and strokes increases. In the US, 2 in 5 adults have high cholesterol. Many may not know they have this problem because high cholesterol, itself, doesn’t have any symptoms.
There are several types of fats, including HDL (good) and LDL (bad) cholesterol and triglycerides. High LDL or triglyceride levels and low HDL levels can create thick deposits (plaque) on the walls of your arteries, making them stiff and narrow (atherosclerosis). When plaque breaks off from the artery wall, a clot forms around it that can completely block or reduce blood and oxygen flow to the heart (heart attack) or brain (stroke).
Lifestyle changes are always the first step in preventing or managing high cholesterol. These include:
Make sure to take any medications as your doctor has prescribed to get the most benefit from them. Create a follow-up plan so your doctor can determine if the medication is working. Below is information on some commonly prescribed cholesterol-lowering medication classes.
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Hypertension is when the force of blood pushing against the blood vessel walls is consistently too high. Nearly half of US adults have high blood pressure (above 130/80 ) with nearly half of these adults having uncontrolled high blood pressure (above 140/90). It is considered a silent killer as often high blood pressure, itself, will often lack any symptoms, but it can significantly raise the risk for heart attacks, strokes, and many other conditions.
There are many things you can do to help manage your blood pressure. Making changes to your lifestyle is the first step and include:
Please note: Sodium restriction not only encompasses table salt but also the salt that is a part of your food. It’s important to read nutritional labels to help you make informed decisions about what you are putting your body. Not all foods are equal, and moderation is key!
A blood pressure should be taken with:
Make sure to take any medications as your doctor has prescribed to get the most benefit from them. Create a follow-up plan so your doctor can determine if the medication is working. Let your doctor know if you experience any new symptoms.
Below is information on some commonly prescribed blood pressure lowering medication classes.
Heart disease is the leading cause of deaths in the US, and coronary artery disease (CAD)—a narrowing of the major blood vessels in the heart—is the most common form of heart disease. CAD includes conditions like angina and heart attacks (myocardial infarctions).
A heart attack happens when plaque—a buildup of fat and cholesterol on the artery walls— breaks off and a clot forms around it. This causes severe narrowing or complete blockage of blood flow/oxygen to a portion of the heart, causing tissue in that area to be damaged or die.
Risk factors for coronary artery disease vary, including:
Symptoms of a heart attack include:
**After having a heart attack, some people report they thought their increased fatigue or shortness of breath with doing their normal activities was just them ‘getting older.’
If you are experiencing heart attack symptoms, seek help immediately. Call 911; an emergency medical services team can begin treatment on route and are trained to perform cardiopulmonary resuscitation if your heart stops. Never drive yourself to the hospital if you are experiencing symptoms of a heart attack for the safety of yourself and others on the road.
These are common tests/procedures used to determine if a heart attack has taken place:
Your test results will determine your treatment plan. Here are some of the most common procedures performed:
These lifestyle modifications can help reduce the risk of coronary artery:
Make sure to take any medications as your doctor has prescribed to get the most benefit from them. Create a follow-up plan so your doctor can determine if the medication is working. Let your doctor know if you experience any new symptoms.
Below is information on some commonly prescribed medication classes to help reduce the risk of heart attack.
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Atrial fibrillation (AFib) is a type of irregular heartbeat (arrhythmia) where the upper chambers of the heart (atrials) quiver instead of beating effectively. This can cause blood clots, stroke, and heart conditions. The irregularity can be constant or intermittent in nature.
Approximately 12.1 million people in the United States have AFib; this diagnosis comes with a five-fold increase of having a stroke.
Risk factors for AFib include:
Some people experience no symptoms when their heart is in an AFib rhythm, and it will only be detected through a physical examination or an electrocardiogram (EKG). For those who do experience symptoms, they can be:
These lifestyle modifications can help reduce the risk of complications from AFib like strokes and cardiac complications:
The goal of managing AFib is to prevent blood clots and have the heart rate stay in a normal range. This is often achieved through medication management.
Some other interventions for atrial fibrillation if medications are not reducing symptoms or risk are:
Make sure to take any medications as your doctor has prescribed to get the most benefit from them. Create a follow-up plan so your doctor can determine if the medication is working. Let your doctor know if you experience any new symptoms.
Below is information on some commonly prescribed medication classes for aFib.
– Beta-blockers: Generic beta blockers usually end in -olol (e.g., atenolol, metoprolol tartrate, metoprolol succinate extended-release, and propranolol).
– Calcium channel blockers: Some examples of calcium channel blockers include amlodipine, felodipine, and diltiazem.
– Digitalis preparations: Digoxin is in this class of medications.
– Sodium channel blockers: Some examples include flecainide and quinidine which slow the heart’s ability to conduct electricity which helps the heart's rhythm.
– Potassium channel blockers: Some examples include amiodarone, dofetilide, and sotalol. These medications slow down the electrical signals to help the heart’s rhythm.
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A stroke is when a part of the brain becomes damaged or dies as a result of a blood clot blocking the blood supply to the brain(ischemic stroke) or a blood vessel in the brain bursting (hemorrhagic stroke). Strokes are the fifth-leading cause of death in the United States and the leading cause of disability.
Risk factors for a stroke include:
Time is brain! If you are experiencing symptoms of a stroke you need to get help immediately; your treatment options decrease the longer you wait.
Use the acronym FAST to help you detect a stroke.
F=Face drooping: If asked to smile, is the smile uneven?
A=Arm weakness: Does one arm drift downward if both arms are raised?
S=Speech difficulty: Is speech slurred or garbled?
T=Time to call 911 if symptoms are present!
Sudden onset of numbness, confusion, trouble with vision or hearing, dizziness, loss of balance, or a severe headache may also be signs of a stroke.
A stroke is diagnosed through a combination of physical examination, medical history, and imaging. Often people will have an MRI (magnetic resonance imaging) or a CAT/CT scan as part of their work up. The type of stroke identified will determine the course of treatment.
Most strokes (87%) are ischemic (caused by blockage of blood flow). Patients with ischemic strokes will have a combination of lifestyle modifications suggested and medication management. At times, people qualify for treatment with tissue plasminogen activator (TPA); this medication is given intravenous(iv) and can dissolve the clot. Another procedure sometimes used when a large vessel is blocked is mechanical removal of the clot. In this procedure, a catheter (a hollow tube) is inserted into a large blood vessel, often in the groin, going to the site of the clot and removing it.
Both TPA administration and mechanical removal of the clot can only occur within a specific timeframe from the onset of symptoms, so make sure you seek care immediately!
After a stroke, some patients will require rehabilitation. Depending on severity, rehabilitation may consist of staying at a facility, home health care, or going to an outpatient office. Rehabilitation can help with such things as balance, coordination, strengthening, memory, and speech. It can take time to see results, so be patient.
Lifestyle changes that can help prevent further events are:
Make sure to take any medications as prescribed by your doctor to get the most benefit from them. Create a follow-up plan so your doctor can determine if the medication is working. Let your doctor know if you experience any new symptoms.
Below is information on some commonly prescribed medication classes.
– Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II receptor blockers (ARBs): ACE inhibitors and ARBs work similarly to widen the blood vessels and decrease the work the heart has to do. They can also help prevent and slow progression of kidney disease. Generic ACE inhibitors names usually end in -pril (e.g., enalapril, captopril, and lisinopril) while generic ARBs usually end in -sartan (e.g., candesartan, losartan, and valsartan).
– Diuretics: Also known as “water pills”, diuretics help lower blood pressure by increasing urination to get rid of excess water and salt (sodium). Some examples of diuretics include chlorthalidone, hydrochlorothiazide, furosemide (Lasix®), and spironolactone.
– Calcium channel blockers: Calcium channel blockers work on the smooth muscle of the heart and arteries to widen blood vessels which reduces heart rate and lowers blood pressure. Some examples of calcium channel blockers include amlodipine, felodipine, and diltiazem.
– Statins: The most common cholesterol-lowering medications are HMG CoA reductase inhibitors, also known as “statins.” Statins decrease the body’s production of cholesterol and increase the removal of cholesterol by the liver. They’re most effective at lowering LDL and can also help lower triglycerides and increase HDL. Generic statin names end in -vastatin, including atorvastatin (Lipitor®), pravastatin (Pravachol®), rosuvastatin (Crestor®) and simvastatin (Zocor®).
– Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors: Alirocumab (Praluent®) and evolocumab (Repatha®) are injectable cholesterol-lowering agents that bind to and inactivate a protein on cells found in the liver to lower LDL (bad) cholesterol. They have been shown to reduce cardiovascular events such as heart attack or stroke.
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Peripheral artery disease is narrowing of the peripheral arteries caused by atherosclerosis. Atherosclerosis (sometimes called “hardening of the arteries”) is when cholesterol buildup (plaque) on the walls of the arteries cause narrowing or a total blockage of the blood flow. Peripheral artery disease most commonly affects the legs and feet. If left untreated, poor blood/oxygen flow can result in tissue getting infected or dying which can lead to disability—due to the need for amputation—or even death. Additionally, a diagnosis of PAD is a risk factor for a stroke or coronary artery disease.
Risk factors for PAD include:
The most common symptom of PAD is “claudication”—pain in one or both legs with physical activity that resolves with rest. This cramping or aching pain can range from buttocks to calf.
Unfortunately, 40% of people don’t experience this pain with PAD and it can go undetected until it’s in a more severe state.
Other symptoms that could be present below the narrowed artery are:
Here are some of the lifestyle modifications to help manage and prevent PAD:
Depending on severity, you may require a procedure in addition to lifestyle modifications and medication management.
Some of those procedures are:
Make sure to take any medications as prescribed by your doctor to get the most benefit from them. Create a follow-up plan so your doctor can determine if the medication is working. Let your doctor know if you experience any new symptoms. Below is information on some commonly prescribed medication classes.
– Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II receptor blockers (ARBs): ACE inhibitors and ARBs work similarly to widen the blood vessels and decrease the work the heart has to do. They can also help prevent and slow progression of kidney disease. Generic ACE inhibitors names usually end in -pril (e.g., enalapril, captopril, and lisinopril) while generic ARBs usually end in -sartan (e.g., candesartan, losartan, and valsartan).
– Statins: The most common cholesterol-lowering medications are HMG CoA reductase inhibitors, also known as “statins.” Statins decrease the body’s production of cholesterol and increase the removal of cholesterol by the liver. They’re most effective at lowering LDL and can also help lower triglycerides and increase HDL. Generic statin names end in -vastatin, including atorvastatin (Lipitor®), pravastatin (Pravachol®), rosuvastatin (Crestor®) and simvastatin (Zocor®).
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Heart failure is a chronic progressive disease where the muscles in the heart can’t keep up with the workload of pumping enough oxygen- and nutrient-rich blood to the rest of the body. For a period of time, the heart will enlarge or beat faster to try to make up for this but, eventually, these mechanisms fall short. It is estimated that 6.2 million adults in the United States have heart failure.
A common measurement associated with heart failure is an ejection fraction (EF). The EF reports what percentage of blood is being pumped out of the left ventricle to the rest of the body with each heartbeat. A normal EF is 60% —reflecting that 60% of the total amount of blood in the left ventricle is being pushed out of the heart with each beat. An EF under 40% may indicate heart failure or cardiomyopathy (a disease of the heart muscle making it hard to pump blood, sometimes a precursor to heart failure).
Think of the heart in terms of plumbing—when the heart pumps less blood out to the body, it causes blood (fluid) to back up, first into the lungs and eventually into the rest of your body. This can be seen as swelling in your feet, legs, and stomach.
Risk factors for heart failure include:
Symptoms of heart failure include:
Some of the more common tests used to diagnose heart failure are as follows:
These lifestyle modifications can help reduce the risk of complications from heart failure:
Make sure to take any medications as your doctor has prescribed to get the most benefit from them. Create a follow up plan so your doctor can determine if the medication is working. B
Below is information on some commonly prescribed medication classes used to treat heart failure.
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If you’d like to learn more about a newly diagnosed heart condition or a chronic condition that you’ve had for a while, Martin’s Point has a team of nurse care managers here to help. This service is offered at no cost to you. A nurse care manager helps you learn about your chronic conditions and build skills to proactively manage your health. They review medications, help coordinate your care, and find helpful community resources.
If you would like to speak with a care manager, please call us at 1-877-659-2403.
Coronary artery disease, peripheral artery disease, atrial fibrillation, cerebrovascular disease, and diabetes are just some examples of chronic diseases.
For many, having a chronic disease can cause major upheaval in one’s previous routine. Some people are prescribed new medications, need to eat differently and/or perform routine monitoring at home. Some may have more medical appointments or expenses. Some may worry about experiencing another heart attack, stroke, or return of symptoms. Due to the nature of chronic diseases, mental health issues like anxiety or depression can occur.
If you are experiencing symptoms of depression or anxiety, please speak to your health care provider. These conditions are common, and your doctor will know how to best support you. Untreated, conditions like anxiety and depression can worsen and can also become a barrier to managing your chronic disease.