Cardiovascular Disease: Epidemiology

Abstract

Coronary heart disease (CHD) is the commonest form of degenerative arterial disease, which also includes stroke and lower‐extremity arterial disease. High levels of cholesterol and fibrinogen, raised blood pressure and cigarette smoking are the main risk factors for CHD, and can be avoided to a large extent (entirely in the case of smoking) by lifestyle modifications or pharmacological methods.

Keywords: heart attack; stroke; intermittent claudication; risk factors; prevention

Figure 1.

Number of people in the population with different levels of blood pressure, and the relative risk of coronary heart disease (CHD) due to raised blood pressure. Those with high blood pressure are at greatest relative risk, but there are many more people with only moderately raised blood pressure levels, among whom the largest absolute numbers of blood pressure‐related cases occur.

Figure 2.

Steps towards clinical events: causes → pathways → pathology → disease.

Figure 3.

Cholesterol levels and CHD in an overview of a 16‐year cohort study of men aged 35–57 years with and without diabetes (Armitage and Collins, ).

Figure 4.

(a) Diastolic blood pressure (DBP) and CVA in an overview of 45 cohort studies; (b) cholesterol level and CVA in the same studies. The vertical black line shows no effect (relative risk 1.0); squares to the left of this line indicate a lower risk, and those to the right a higher risk. The dotted line shows the overall effect: (a) relative risk 1.87; (b) relative risk 0.98. For individual studies 99% confidence intervals are shown; for the overview result 95% confidence intervals are given (Prospective Studies Collaboration, ).

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References

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Further Reading

Fowkes FGR (ed.) (1991) Epidemiology of Peripheral Vascular Disease. London: Springer.

Gotto AM, Lenfant C, Catapano AL and Paoletti R (eds) (1995) Multiple Risk Factors in Cardiovascular Disease: Vascular and Organ Protection. Dordrecht, The Netherlands: Kluwer Academic.

MacCallum PK and Meade TW (eds) (1999) Baillière's Best Practice and Research: Clinical Haematology – Thrombophilia, vol. 12, no. 3. London: Baillière Tindall.

Marmot M and Elliott P (1992) Coronary Heart Disease Epidemiology: From Aetiology to Public Health. Oxford: Oxford Medical Publications.

Swales J and de Bono D (1993) Cardiovascular Risk Factors. London: Gower Medical.

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Meade, TW(Jun 2001) Cardiovascular Disease: Epidemiology. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0002263]