Cardiovaskular Disease 3

The effect of a low salt diet is unclear. A Cochrane review concluded that any benefit in either
hypertensive or normal tensive people is small if present.
[61]
Additionally, the review suggested a
low salt diet may be harmful in those with congestive heart failure.
[61]
owever, the review was
critici!ed particularly for not e"cluding a trial in heart failure where people had low salt and water
levels due to diuretics.
[6#]
$hen this study is left out the rest of the trials show a trend to benefit.
[6#][6%]
Another review of dietary salt
[6&]
concluded that there is strong evidence that high dietary salt
inta'e increases blood pressure and worsens hypertension, and that it increases the number of
cardiovascular disease events( the latter happens both through the increased blood pressure
and, )uite li'ely, through other mechanisms.
[6&][6*]
+oderate evidence was found that high salt
inta'e increased cardiovascular mortality( and some evidence was found for an increase in
overall mortality, stro'es and left,ventricular hypertrophy.
[6&]
Supplements
$hile a healthy diet is beneficial, the effect of antio"idant supplementation -vitamin ., vitamin C,
etc./ or vitamins generally has not been shown to improve protection against cardiovascular
disease and in some cases may possibly result in harm.
[66][60]
1iacin, a type of vitamin 2%, may
be an e"ception with a modest decrease in the ris' of cardiovascular events in those at high
ris'.
[63][64]
+agnesium supplementation lowers high blood pressure in a dose dependent manner.
[05]
+agnesium therapy is recommended for patients with ventricular arrhythmia associated with
torsade de pointes who present with long 6T syndrome as well as for the treatment of patients
with digo"in into"ication,induced arrhythmias.
[01]
7esults from an observational study conducted
in the general 8apanese population demonstrated that lower serum magnesium levels were
associated with a greater average intima,media thic'ness and the ris' of at least two carotid
pla)ues.
[0#]
.vidence to support omega,% fatty acid supplementation is lac'ing.
[0%]
Medication
Aspirin has not been found to be of benefit overall in those at low ris' of heart disease as the
ris' of serious bleeding is e)ual to the benefit with respect to cardiovascular problems.
[0&]
9tatins are effective in preventing further cardiovascular disease in those with a history of
cardiovascular disease.
[0*]
As the event rate is higher in men than in women, the decrease in
events is more easily seen in men than women.
[0*]
:n those without cardiovascular disease but
ris' factors statins appear to also be beneficial with a decrease in mortality and further heart
disease.
[06]
The time course over which statins provide preventation against death appears to be
long, of the order of one year, which is much longer than the duration of their effect on lipids.
[00]
Management
Cardiovascular disease is treatable with initial treatment primarily focused on diet and lifestyle
interventions.
[03][04][35]
Epidemiology
Cardiovascular diseases are the leading cause of death. :n #553, %5; of all global death is
attributed to cardiovascular diseases. <eath caused by cardiovascular diseases are also higher
in low and middle,income countries as over 35; of all global death caused by cardiovascular
diseases occurred in those countries. :t is also estimated that by #5%5, over #% million people
will die from cardiovascular diseases annually.
Research
The first studies on cardiovascular health were performed in 14&4 by 8erry +orris using
occupational health data and were published in 14*3.
[3#]
The causes, prevention, and=or
treatment of all forms of cardiovascular disease remain active fields of biomedical research, with
hundreds of scientific studies being published on a wee'ly basis.
A fairly recent emphasis is on the lin' between low,grade inflammation that hallmar's
atherosclerosis and its possible interventions. C,reactive protein -C7>/ is a common
inflammatory mar'er that has been found to be present in increased levels in patients at ris' for
cardiovascular disease.
[3%]
Also osteoprotegerin which involved with regulation of a 'ey
inflammatory transcription factor called 1?,@2 has been found to be a ris' factor of
cardiovascular disease and mortality.
[3&][3*]
9ome areas currently being researched include possible lin's between infection with
Chlamydophila pneumoniae -a maAor cause of pneumonia/ and coronary artery disease. The
Chlamydia lin' has become less plausible with the absence of improvement after antibiotic use.
[36]
9everal research also investigated the benefits of melatonin on cardiovascular diseases
prevention and cure. +elatonin is a pineal gland secretion and it is shown to be able to lower
total cholesterol, very low density and low density lipoprotein cholesterol levels in the blood
plasma of rats. 7eduction of blood pressure is also observed when pharmacological doses are
applied. Thus, it is deemed to be a plausible treatment for hypertension. owever, further
research needs to be conducted to investigate the side effects, optimal dosage and etc. before it
can be licensed for use.
[30]