All you want to know about Cardiovascular diseases

What are cardiovascular diseases or CVDs?

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and they include:

Coronary heart disease – disease of the blood vessels supplying the heart muscle;

Cerebrovascular disease – disease of the blood vessels supplying the brain;

Peripheral arterial disease – disease of blood vessels supplying the arms and legs;

Hypertension- also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure.

Atherosclerosis- a process of progressive thickening and hardening of the walls of medium-sized and large arteries as a result of fat deposits on their inner lining

Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;

Congenital heart disease – malformations of heart structure existing at birth;

Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs,

Heart attack- blockage due to build-up of fatty deposits that prevents blood from flowing to the heart,

Stroke- bleeding from a blood vessel in the brain or from blood clots.

Heart failure- happens when the heart isn’t pumping well enough, either because the walls of the ventricles are enlarged, weakened, damaged or too stiff, or the heart’s valves don’t work properly.

The top symptoms of cardiovascular health problems

Often, there are no symptoms of the underlying disease of the blood vessels and that’s why they are often silent killers. A heart attack or stroke may be the first and often final warning of an underlying disease.

Symptoms of a heart attack include:

pain or discomfort in the centre of the chest;

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; feeling sick or vomiting; feeling light-headed or faint; breaking into a cold sweat; and becoming pale. Women are more likely 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, loss of balance or coordination;

severe headache with no known cause; and

fainting or unconsciousness.

Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heart beats, chest pain and fainting.

Symptoms of rheumatic fever include: fever, pain and swelling of the joints, nausea, stomach cramps and vomiting.

The 7 most significant risk factors of cardiovascular diseases. 

There are numerous risk factors associated with Cardiovascular diseases. Some of them, such as family history, cannot be modified while other risk factors like high blood pressure can be mitigated with the right nutrition

1. High dietary fat intake

A high intake of dietary fats strongly influences the risk of developing cardiovascular diseases.

Saturated fatty acids commonly found in dairy products and meat raise cholesterol levels. Moreover, studies have also shown trans fatty acids, found in industrially hardened oils, increase the risk of coronary heart disease. While they have been eliminated from many parts of the world, trans fatty acids are still found in deep-fried fast foods, processed food and baked goods.

2. Behavioral factors

The most important behavioural risk factors of heart disease and stroke are unhealthy eating patterns, physical inactivity, tobacco use and alcohol consumption. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risk factors” can be measured via simple blood tests and are helping in indicating an increased risk of developing a heart attack, stroke, heart failure and other complications.

3. Stress

Studies suggest that the high levels of cortisol from long-term stress can increase blood cholesterol, triglycerides, blood sugar, and blood pressure. Cortisol is the body’s main stress hormone. It works in this way- more the stress, more is the Cortisol level. This stress can also cause changes that promote the buildup of plaque deposits in the arteries. 

4. Hereditary

Approximately 40% of the risk for cardiovascular disease lies in hereditary factors and remains a non-modifiable risk factor.

5. High Homocysteine and CRP levels

High levels of Homocysteine can lead to hardening of the arteries and can also result in blood clot formation. In addition to being clinically useful as a measure of systemic inflammation, high CRP levels are indicative of CVDs risk as they are prominent markers of inflammation.

6. Hemochromatosis

Haemochromatosis is an inherited condition where excessive levels of iron in the body gets absorbed, leading to iron overload. Over time, this overload leads to a build up of iron in different parts of the body, including the heart. Cardiomyopathy caused by haemochromatosis usually causes symptoms of heart failure.

7. Toxin overload on the Liver

“The connection between fatty liver and early signs of plaque in the coronary arteries is increasingly compelling,” says Dr. Tracey Simon, a hepatologist at Harvard-affiliated Massachusetts General Hospital (MGH) because of dangerous accumulation of fat in the liver. This overload can be due to chronic alcoholism or heavy metal ingestion. 

There are numerous risk factors associated with Cardiovascular diseases. Some of them, such as family history, cannot be modified while other risk factors like high blood pressure can be mitigated with the right nutrition

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The Inflammatory process

We always hear that inflammation is the root cause of development of X disease. But ever wondered what this inflammation actually is and how does this inflammatory process affect your health? Here’s how:

When  tissues are injured by bacteria, trauma, toxins, heat, or any other cause like poor dietary habits or inactivity, there occurs inflammation. This inflammatory response is made evident by something known as Pro-inflammatory markers. As the name suggests, these are substances capable of producing inflammation and it is no good. Some of the pro-inflammatory markers are IL-1 beta, TNF-alpha and Interferon- gamma.

This inflammatory process contributes to all stages of CVDs, from the development of atherosclerosis to end stage complications. It all starts from poor dietary habits like increased consumption of foods rich in saturated fats (meat and dairy products mainly) which leads to high levels of LDL-C. Low density lipoprotein cholesterol (LDL-C) is  also known as ‘bad’ cholesterol. It contributes to fatty buildups in arteries (atherosclerosis), thus narrowing them and increasing your risk for heart attack and other conditions.

Accumulation of LDL-C in the arteries has shown to trigger the inflammatory response by activating the pro-inflammatory markers, CRP and finally resulting in a heart attack or stroke. There are anti-inflammatory nutrients which aid in avoiding this process.

Nutrients that are of help

When we expose it to alcohol, tobacco smoke, radiation, pesticides or unhealthy foods, certain particles are formed called as- Free Radicals. These are highly reactive and damage our healthy cells. Antioxidants are substances that may protect your cells against free radicals. The benefitting nutrients that we are going to talk about, have protective effects for precisely this reason. The antioxidant and antiinflammatory properties of these nutrients make their consumption on a daily basis, much more important.

Following is a list of certain nutrients which are important for protection from CVDs-

1. Vitamin E

Studies have suggested that supplementation with vitamin E might reduce serum CRP levels.

2. Vitamin C

Vitamin C is also known to exert potential antioxidant and anti-inflammatory effects, increasing the levels of HDL-C and decreasing CRP levels. 

3. Vitamin D

Researchers have  shown that vitamin D-supplemented groups had lower levels of TNF-α, one of the proinflammatory markers.

4. Folic Acid, Vitamin B6 and B12

An adequate  intake of folic acid, Vitamin B6 and Vitamin B12 could possibly reduce the risk of coronary heart disease by significant reduction in Homocysteine concentrations. High levels of Homocysteine can contribute to blood vessel damage and blood clots in your blood vessels. 

5. Magnesium

Several studies have suggested that Magnesium supplementation helps with cardiovascular health

6. Co-enzyme Q10

CoQ10 has shown potent antioxidant properties in numerous studies. 

However, when it comes to supplementing with nutrients, please consult a functional medicine/ functional nutrition specialist as you could easily overdose on some of these. 

Bioactive compounds from food that are of help

Multiple bioactive compounds (omega-3 fatty acids, carotenoids, polyphenols or flavonoids) present in our food have beneficial effects on atherosclerosis development. All of them act to reduce levels of LDL-C and inflammatory biomarkers. 

1. Omega-3 fatty acids-

Polyunsaturated fatty acids (PUFAs) are a class that includes many important compounds, such as essential fatty acids (EFAs). EFAs are fats  that humans must ingest for good health because our bodies cannot make them. EFAs include- alpha-linolenic acid (ALA)/ omega-3 fatty acid, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) and have been reported as potential agents for prevention from formation of blood clots. 

2. Carotenoids

Carotenoids are a family of fat-dissolvable shades found chiefly in plants. Humans cannot produce them too, so they are important in their eating routine.  They are known to help in battling Atherosclerosis with their antioxidant and antiinflammatory properties. Following are some of the potent Carotenoids-

-Lycopene: This is present in red-colored fruits and vegetables, such as tomatoes, papaya, or watermelons among others. Studies suggest that lycopene might reduce CVD risk, particularly in early stages of atherosclerosis, preventing endothelial dysfunction and LDL accumulation.

-Lutein: It’s found in oranges, honeydew melon, and higher concentrations in dim green vegetables, for example, turnip greens, kale, parsley, spinach, and broccoli. Lutein prevents advancement of atherosclerosis.

-Beta-carotene: Beta-carotene is a standout amongst the most generally examined carotenoids. It is also known as Pro-Vitamin A. It’s found in carrot, orange, kale, spinach, turnip greens, apricot, and tomato, low serum carotenoid levels may reflect  high LDL-C levels which may further increase the risk of developing CVDs.

3. Polyphenols-

Polyphenols are a large class of organic compounds of plant origin, tend to be colourful and possess a wide range of health effects in the prevention of CVD.

Many studies have been focused on the antioxidant power of these polyphenols from most commonly consumed plant-derived foods, with very high values found for spices, herbs, berries, fruits, nuts, and vegetables. 

Highest antioxidant value is reported for cranberries, blueberries, and blackberries among fruits and for celery, Ginkgo biloba, onions beans, artichokes, and russet potatoes among vegetables. 

Moreover, nuts (pecans, walnuts, almonds, pistachios and hazelnuts) and spices (turmeric, ground cloves, ground cinnamon, and oregano) have also been reported as good sources of antioxidants.

4. Flavonoids-

Flavonoid compounds that occur in a variety of foods such as citrus fruits, berries, onions, apples and legumes could also possibly reduce the risk of coronary heart disease. Flavonoids show high antioxidant, anti-inflammatory and antiallergic properties.

Cardioprotective foods and herbs

The role of certain nutrients is quite clear in CVDs. But the question is where do we get these nutrients from? The answer is right around the corner. Yes, foods and herbs.

When it comes to food, there is only one true saying- The whole, the healthier!

Some good plant based sources of all the important nutrients are:

Vitamin C: Guava, Amla (Indian Gooseberry), Capsicum, Oranges

Vitamin E: Sunflower seeds, Almonds, Hazelnuts, Avocados

Folic Acid: Legumes- beans, peas, lentils sesame seeds, green leafy vegetables- spinach and kale, Asparagus

Vitamin B6: Chickpeas, Carrots, Sweet potatoes, Bananas, Green peas

Magnesium: Brazil nuts, almonds, pecans, walnuts, pumpkin seeds, flaxseeds, sunflower seeds, sesame seeds,cumin seeds, peach apricots, avocado, banana, blackberries, spinach, okra, broccoli, beetroot,  buckwheat.

However, for nutrients like Vitamin B12, Vitamin D and Co-enzyme Q10 there is need for supplementation because of scarcity of natural sources from food.

Herbs that help with heart health include the following

• Caraway oil and seed, 
• Cardamom seed, 
• Cinnamon bark, 
• Cloves, 
• Coriander seed, 
• Dill seed, 
• Fennel oil and seed, 
• Garlic, 
• Ginger root, 
• Licorice root, 
• Mint oil, 
• Paprika, 
• Parsley herb and root, 
• Peppermint leaf and oil, 
• Rosemary, 
• Sage, 
• Thyme, 
• Turmeric root, 
• White mustard seed,
• Ginseng 

Sprinkle these on your salads and soups or use them during your cooking process itself and reap the benefits of these healing powerhouses 

Did you know? 

CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause.

An estimated 17.9 million people died from CVDs in 2016, representing 31% of all global deaths. Of these deaths, 85% are due to heart attack and stroke.

Over three quarters of CVD deaths take place in low- and middle-income countries.

Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2015, 82% are in low- and middle-income countries, and 37% are caused by CVDs.

Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies.

People with cardiovascular disease or who are at high cardiovascular risk (due to the presence of one or more risk factors such as hypertension, diabetes, hyperlipidaemia or already established disease) need early detection and management using counselling and medicines, as appropriate.

References:

• https://www.who.int/cardiovascular_diseases/about_cvd/en/
• https://sci-hub.tw/10.3390/ijms19123988
• https://medcraveonline.com/PPIJ/natural-foods-and-indian-herbs-of-cardiovascular-interestnbsp.html
• https://www.mdpi.com/1422-0067/21/4/1250
• https://sci-hub.tw/10.1007/978-981-13-1745-3_3-1
• https://www.cardiosecur.com/magazine/specialist-articles-on-the-heart/heart-attack-genetic-risk
• https://www.health.harvard.edu/heart-health/fatty-liver-disease-an-often-silent-condition-linked-to-heart-disease

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