Three most common causes of cardioavascular disease are tobbaco use, Physical inactivity,

Cholesterol/lipids.

1. tobbaco use

 Smoking is estimated to cause nearly 10 per cent of all CVD.

 The risk of developing CVD is higher in female smokers, young men, and heavy smokers.
 There are currently about 1 billion smokers in the world today.
 Within two years of quitting, the risk of coronary heart disease is substantially
reduced, and within 15 years the risk of CVD returns to that of a non-smoker.

2. Physical inactivity

 Insufficient physical activity can be defined as less than five times 30 minutes of moderate
activity per week, or less than three times 20 minutes of vigorous activity per week, or
equivalent.
 Insufficient physical activity is the fourth leading risk factor for mortality.
 Approximately 3.2 million deaths and 32.1 million DALYs – representing about 2.1 per cent
of global DALYs* – each year are attributable to insufficient physical activity.
 People who are insufficiently physically active have a 20 to 30 per cent increased risk of all-
cause mortality compared to those who engage in at least 30 minutes of moderate intensity
physical activity most days of the week.
 In 2008, 31.3 per cent of adults aged 15 or older (28.2 per cent men and 34.4 per cent
women) were insufficiently physically active.
 The prevalence of insufficient physical activity is higher in high-income countries compared
to low-income countries due to increased automation of work and use of vehicles for
transport in high-income countries.
 High-income countries have more than double the prevalence of insufficient physical activity
compared to low-income countries for both men and women, with 41 per cent of men and
48 per cent of women being insufficiently physically active in high-income countries
compared to 18 per cent of men and 21 per cent of women in low-income countries.

3. cholesterol/lipid

 Raised blood cholesterol increases the risk of heart disease and stroke.
 Globally, one third of ischaemic heart disease is attributable to high cholesterol.
 Overall, raised cholesterol is estimated to cause 2.6 million deaths (4.5 per cent of total) and
29.7 million DALYS*, or 2 per cent of total DALYS globally.
 In 2008, the prevalence of raised total cholesterol among adults – defined as total
cholesterol of 6.2 mmol/l (240 mg/dl) or higher – was 9.7 per cent (8.5 per cent for males
and 10.7 per cent for females).
 Lowering raised blood cholesterol reduces the risk of heart disease.
 In 2008, the global prevalence of raised total cholesterol among adults was 39 per cent (37
per cent for males and 40 per cent for females).
 The prevalence of raised total cholesterol noticeably increases according to the income level
of the country. In low-income countries, around 25 per cent of adults have raised total
 cholesterol, while in high-income countries, over 50 per cent of adults have raised total
cholesterol.

To patient who has yet to develop heart disease, we should do assesment fisrst. Risk assessment
should include ethnicity, smoking habit history, family history of CVD and measurements of weight,
waist circumference, blood pressure, lipids (total cholesterol and high-density lipoprotein (HDL)
cholesterol) and glucose. The American Heart Association (AHA) guidelines also recommend
recording the pulse rate and rhythm to screen for atrial fibrillation.

More recently the European Society of Cardiology (ESC) recommends a total CVD risk assessment
using the SCORE (= Systemic Coronary Risk Evaluation) project approach. This consists of charts
which provide a risk assessment over a patient's lifetime, with different charts for high- and low-risk
countries. This replaces the notion of primary and secondary CVD prevention. For example, patients
with CKD and no other cardiac risk factors should be treated as very high-risk.

To prevent cardiovascular disesae tell the patient what to be The healthy individual

The European Health Charter in 2007 made a public health announcement describing the healthy to
have the following characteristics:

1.No use of tobacco.

2. Physical activity - at least 30 minutes, five times a week.

3. Healthy eating.

4. Not overweight.

5. BP <140/90 mm Hg.

6. Total cholesterol <5 mmol/L.

7. Normal glucose metabolism.

7. Avoidance of stress.