Analysis of Cardiovascular Disease as a Global Health Problem: Report

This report addresses cardiovascular disease (CVD) as a leading global health issue, emphasizing its impact on sustainable development. It covers the collection of CVD data, its complex nature, and various causes, including ischemic heart disease and other related conditions. The report highlights the higher prevalence in males and presents global mortality data from 2015. It also examines health frameworks, focusing on social, political, and economic determinants, including the Sociodemographic Index (SDI). The economic and social costs of CVD are discussed, projecting significant financial burdens and productivity losses, especially in developing countries. Finally, the report provides three key recommendations: improving data collection, implementing individual and population-based prevention strategies, and promoting healthy lifestyles, including nutritional adjustments and regular physical activity. The report references several studies and provides a comprehensive overview of CVD's global impact and management strategies.

Foundations of Public Health
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Cardiovascular disease as global problem :
Cardiovascular diseases is one of the leading causes of death throughout the world and it is
prominent hurdle for the sustainable development of human being. In 2011, United Nations
officially identified it as global health issue and proposed plan to reduce effect of this global
health issue in all regions. Third Sustainable Global Development (SGD) identified
importance to implement control measures of CVD and targeted to reduce it to one-third of
the total affected population.
Data for the CVDs used to be collected through death certificates, verbal autopsy, health
surveys, prospective cohort studies, health system administrative data and health registers.
Global burden of CVDs is more and it is being increasing because of its complex nature and
multiple causes. Its causes include ischemic heart disease, ischemic stroke, atrial fibrillation,
peripheral arterial disease, aortic aneurysm, cardiomyopathy and myocarditis, hypertensive
heart disease, endocarditis and rheumatic heart disease. Other cause of CVDs includes
maternal, neonatal and nutritional disorders. It has been observed that prevalence of CVDs is
more in male as compared to the female. In 2015, global death due to CVDs estimated to be
17921047, 9419637 and 8501409 for total population, males and females respectively in all
the age group people. Age standardised deaths due to CVDs were found to be 286, 242 and
335 per 100000 population in total population, female and male population respectively.
Following are the representative countries with lower level prevalence – Singapore, Japan,
South Korea; middle level prevalence – United states and United Arab Emirates; and highest-
level prevalence – West Africa, Iran, Oman. From 1990 – 2015, it has been estimated that
there was no significant change in the prevalence of CVDs. This might be due to the
unavailability of the data (Roth et al., 2017).
Health framework:
Determinants of health framework can be identified by application of different strategies like
literature mining strategy, qualitative analysis of discourse, data visualisation of historical
trends and computational methods for network-based discovery. Literature mining strategy
used PubMed / MEDLINE database which are the most widely used database for biomedical
literature. Qualitative analysis of discourse includes data-retrieval processes and natural
language processing for collecting data from the large databases. Data visualization of
historical trends include collection of data from the historical documents related to the social
determinants of cardiovascular disease. This data should be from the pervious thirty years. In
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computational methods for network-based discovery, network analysis need to be done to
unveil hidden interactions between various social determinants of cardiovascular disease.
Health framework analysis revealed that social, political, economic, and organisational
factors are responsible for the occurrence of CVDs. Sociodemographic index (SDI) is very
useful tool for the assessment of CVDs prevalence. SDI include factors like per capita
income, educational level and total fertility rate. These factors can be helpful in determining
target population, health professionals, and organizations for implementing health policy
related to the CVDs. Most vulnerable group for the occurrence of CVDs are people below 70
years of age in low and middle economic countries which are called as developing countries.
It is evident that approximately 75 % of the worldwide deaths due to CVDs occur in these
developing countries. Different social determinants like social gradient or SES,
unemployment, stress, social support, conditions in early life, addiction, food, work, transport
and social exclusion are mainly responsible for the occurrence of CVDs in population of
these developing countries (Martínez-García et al., 2018). Most of the low and middle
economic countries implemented health examination surveys which helped in identification
of CVDs population and its associated risks
Economic and social cost :
According to World Economic Forum, CVDs are the second largest economic burden
throughout the world. Economic burden of CVDs is expected to grow up to US$ 13 trillion
by 2030. With every 10 % increase in the mortality due to CVDs, there is reduction in the
economic growth by 0.5 %. It has been projected that approximately US$ 56.7 trillion loss
due to CVDs can occur in next 20 years. Approximately 50 % of this loss is expected to
occur in developing countries. Mortality due to CVDs mostly occur in the population of
productive age (Ebrahim et al., 2013). Hence, there can be significant productivity burden
due CVDs. It is more staggering in developing countries because productivity loss can
impose more social and economic burden on developing countries as compared to the high
economic countries. It is evident that younger population are more affected in developing
countries as compared to the developed countries. It can lead to further increase in poverty,
unemployment, consumption of less nutritional food, unhealthy lifestyle and addiction
behaviour in these developing countries (Yeates et al., 2015).
Three recommendations :
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Major hurdle for implementation of the control measures for CVD in most of the countries is
due to unavailability of sufficient data of CVDs population. For the prevention of CVDs both
individual and population based approaches need to implemented to achieve targeted
eradication of the CVDS. Health promotion and protection of CVDs can be achieved by
providing nutritional food, promoting exercise and physical activity and healthy lifestyle
(Cohn, 2015). Nutrition play important role in the aetiology of the cardiovascular disease.
Dietary patterns, individual food items, and nutritional supplements need to be considered for
reducing risk of CVDs. Dietary patterns like low carbohydrate diet, low-fat diet,
Mediterranean diet, and the DASH diet need to be considered. Individual food items like
whole grains and dietary fiber, vegetables and fruits need to be considered for the prevention
of CVDs. Supplements like omega-3 and fish oil, phytosterols, antioxidants need to be
considered for prevention of CVDs (Sigal et al., 2013). Regular physical activity like
walking, running, or swimming which can be helpful in improving exercise capacity,
endurance, and skeletal muscle strength. Habitual physical activity can be helpful in reducing
development of CVDs and also it can be helpful in relieving from symptoms of CVDs
(Murlasits, 2015). Healthy lifestyle devoid of alcohol and smoking addiction can reduce
CVDs risks effectively. It is evident that combined effect of alcohol and smoking can exhibit
more deleterious effect on CVDs as compared to the individual effect of alcohol and smoking
(Adjemian et al., 2015).
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References:
Adjemian MK, Volpe RJ & Adjemian J. (2015). Relationships between Diet, Alcohol
Preference, and Heart Disease and Type 2 Diabetes among Americans. PLoS One,
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Cohn JN. (2015). Prevention of cardiovascular disease. Trends Cardiovasc Med, 25(5), pp.
436-42.
Ebrahim S, Pearce N, Smeeth L, Casas JP, Jaffar S, et al. (2013). Tackling Non-
Communicable Diseases In Low- and Middle-Income Countries: Is the Evidence from High-
Income Countries All We Need? PLoS Med, 10(1):e1001377. doi:
10.1371/journal.pmed.1001377.
Martínez-García M, Salinas-Ortega M, Estrada-Arriaga I, Hernández-Lemus E , García-
Herrera R, & Vallejo M1. (2018). A systematic approach to analyze the social determinants
of cardiovascular disease. PLoS One, 13(1):e0190960. doi: 10.1371/journal.pone.0190960.
Murlasits Z. (2015). A call for the better utilization of physical activity and exercise training
in the defense against cardiovascular disease. Phys Sportsmed, 43(4), pp. 329-32.
Roth GA, Johnson C, Abajobir A & Abd-Allah F. (2017). Global, Regional, and National
Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol, 70(1),
pp. 1-25.
Sigal, EA, Tali, S, Chaim, Y & Yaakov H. (2013). Nutritional Recommendations for
Cardiovascular Disease Prevention. Nutrients, 5(9), pp. 3646–3683. doi:
10.1016/j.cjca.2015.06.035. Epub 2015 Jul 13.
Yeates K, Lohfeld L, Sleeth J, Morales F, Rajkotia Y & Ogedegbe O. (2015). A Global
Perspective on Cardiovascular Disease in Vulnerable Populations. Can J Cardiol, 31(9), pp.
1081-93.
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