Features August 2017 Issue

What Is Cardiovascular Disease? It’s Actually Dozens of Disorders

Cardiovascular disease covers circulation problems that can affect you from head to toe. Learn the common prevention strategies they all share.

You may hear the term “cardiovascular disease” used interchangeably with “heart disease” or any of several other terms to describe problems with your heart or blood vessels. But what is cardiovascular disease (CVD) exactly, and why does it seem to be applied so broadly to conditions related to circulation?†

Coronary artery disease (CAD), peripheral artery disease (PAD), and carotid artery disease are among the conditions that fall under the heading of cardiovascular disease. What they all share is atherosclerosis—the buildup of cholesterol plaque in the arteries. Atherosclerosis can restrict blood flow by narrowing the arteries. Atherosclerosis can also make the arteries less flexible. Plaque can also rupture, leading to the formation of a blood clot and the complete blockage of blood flow in the affected blood†vessel.

“Any atherosclerosis of a heart, brain and peripheral artery is in the umbrella of cardiovascular disease,” says Leslie Cho, MD, section head of Preventive Cardiology and Rehabilitation at Cleveland Clinic. “In general, it refers to blocked arteries. Arrhythmias and valve disease are heart disease, but we do not consider them cardiovascular disease.”

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Cardiovascular disease can affect blood vessels in the heart, neck, limbs and the rest of your body. All arteries are vulnerable to the buildup of plaque.

About Atherosclerosis

Over the course of your lifetime, plaque builds up in various arteries throughout your body. Plaque is made up of cholesterol, fat, calcium, and other substances found in the blood. Plaque may never be enough to affect your circulation, but for some people plaque accumulation can reduce blood flow.

In the coronary arteries—the arteries that supply blood to your heart muscle—restricted blood flow can cause chest pain. This is called angina. Blockage in your coronary arteries is CAD. In your peripheral arteries—those in your arms, legs, hands, and feet—blockage is PAD. A major symptom of PAD is leg pain when walking that subsides at rest. Blockage in the arteries that carry blood to your brain is called carotid artery disease, a major risk factor for stroke. And blockage in your kidney’s arteries is called renal artery stenosis.

Diagnosing CVD

Reviewing your symptoms and your medical history will help your doctor determine what is cardiovascular disease and what might be another cause of your symptoms. But there are other tests and screenings that are necessary to make a final diagnosis.

For example, your doctor will listen to your arteries with a stethoscope. A bruit is a whooshing sound that indicates poor blood flow, possibly caused by plaque buildup. Your pulse will be checked at various points, such as the leg or foot, to see if it’s weak. This could also indicate blockage.

Screenings such as an echocardiogram can help detect blood flow problems in the heart. This test may be combined with stress testing, in which you walk briskly on a treadmill or ride a stationary bicycle to get your heart pumping harder. Seeing how your heart responds to exertion can be very helpful in diagnosing CVD. A computed tomography (CT) scan can reveal blockage in your large arteries.Blood tests that reveal levels of cholesterol and other markers can also help gauge your risk of atherosclerosis.†

Risk Factors

The buildup of cholesterol plaque isn’t the only problem that can affect arterial health. Smoking, for example, can damage your endothelium≠—the thin, inner lining of your arteries. Diabetes, obesity, and high blood pressure can also take a toll on the health of your artery walls. Dr. Cho adds that a family history of cardiovascular disease also raises your risk of developing the same condition. “All of it leads to endothelial dysfunction, which leads to atherosclerosis,” Dr. Cho says. “The biggest misconception about CVD is family history. Patients think it is anyone in their family at any age. This is not true.”

Family history is considered to be having a close male relative who was age 55 or younger or a close female relative who was 65 or younger when he or she experienced CVD, heart attack, coronary artery bypass grafting, stenting, or stroke, Dr.†Cho†explains.

Another misconception about CVD is that exercise helps only the younger patient. “It does not matter how old you are, exercise helps,” Dr. Cho says. “Also, quitting smoking, no matter how long you smoked, dramatically reduces your risk. It is never too late. Along with quitting smoking, you may need to take medications to control other risk factors.”

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