Introduction

Vascular diseases—coronary artery disease, peripheral vascular disease, and cerebrovascular disease—are extremely debilitating, and are by far the most common causes of stroke, myocardial infarction, and heart failure in the United States (2002). The vast majority of vascular disease occurs due to atherosclerosis of the affected vessels, yet our understanding of the mechanisms by which atherosclerosis develops is limited. Clinicians therefore have few tools at their disposal to prevent or reverse the atherosclerotic process in patients at risk for the consequences of atherosclerosis.

Blood vessels invade and nourish every organ in the body, so the consequences of vascular disease are diverse and reflect dysfunction of the organ system(s) targeted by the affected vessels. Atherosclerotic disease of coronary vessels threatens myocardial viability and can lead to myocardial infarction and its sequelae, and disease of the medium and small vessels of the cerebral vessels can lead to stroke. Although these are the most common manifestations of vascular disease, other vessels are also frequently affected. Abdominal aortic aneurysms are a relatively common affliction in elderly populations; the vascular disease leading to these aneurysms bears both similarities and differences with typical atheromatous disease typically seen in coronary and other vascular beds. These aneurysms may rupture catastrophically or cause thrombotic occlusions of the distal extremities. Vascular disease also affects the renal and mesenteric vasculature, and contributes to the complications of diabetes.

According to the most recent statistics reported by the National Center for Health Statistics, cardiovascular diseases remain the leading cause of death in the United States (2002). In 2001, 41% of all deaths were due to cardiovascular disease, and of these, nearly three quarters were atherosclerosis-related. The good news is that death rates due to cardiovascular diseases declined 36% over the preceding 20 years. The bad news is that the burden of cardiovascular diseases falls disproportionately among the elderly, who are the fastest growing segment of our population. Adults over age 70 are almost four times more likely to suffer cardiovascular diseases than are those in the 40- to 49-year age group. In fact, some cardiovascular diseases, such as abdominal aortic aneur-ysms, are almost unknown in individuals under age 65, yet may be found in up to 5% of males over age 65 (Salo et al., 1999). Unless reductions occur in the incidence of cardiovascular diseases in the elderly, it is probable that the increasing numbers of older individuals will provide resistance against the long-term trends toward decreasing overall cardiovascular mortality.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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