CHAPTER ONE
Introduction
1.1 Cardiovascular disease
1.1.1Aortic aneurysm / Abdominal aortic aneurysm
1.1.2 Acute coronary syndrome
1.1.3 Angina pectoris
1.1.4 Atherosclerosis
1.1.5 Coronary heart disease (CHD)/ Coronary artery disease
1.1.6 Heart attack / Acute myocardial infarction (AMI)
1.1.7 Heart failure / Congestive heart failure
1.1.8 Ischemic heart disease (IHD)
1.1.9 Ischemic stroke
1.1.10 Peripheral arterial disease (PAD)
1.1.11 Stroke
1.1.12 Sudden cardiac death
CHAPTER TWO
2.0 Tobacco smoking and cardiovascular diseases
2.1 Cigarette Smoking and Inflammation
2.2 Smoking in relation to Coronary Heart Disease
2.3 Smoking in relation to Sudden Cardiac Death
CHAPTER ONE
1.0 INTRODUCTION
1.1 CARDIOVASCULAR DISEASE
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. Common CVDs include: ischemic heart disease (IHD), stroke, hypertensive heart disease, rheumatic heart disease (RHD), aortic aneurysms, cardiomyopathy, atrial fibrillation, congenital heart disease, endocarditis, and peripheral artery disease (PAD), among others (McGill et al., 2008; Mendis et al., 2011). The underlying mechanisms varies depending on the disease in question. IHD, stroke, and PAD involve atherosclerosis. This may be caused by high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol, among others. High blood pressure results in 13% of CVD deaths, while tobacco results in 9%, diabetes 6%, lack of exercise 6% and obesity 5%. Others such as RHD may follow untreated streptococcal infections of the throat (Mendis et al., 2011). It is estimated that 90% of CVD is preventable (McGill et al., 2008). Prevention of atherosclerosis is by decreasing risk factors through: healthy eating, exercise, avoidance of tobacco smoke and limiting alcohol intake. Treating high blood pressure and diabetes is also beneficial (Mendis et al., 2011). Treating people who have strep throat with antibiotics can decrease the risk of RHD (Spinks et al., 2013). The effect of the use of aspirin in people who are otherwise healthy is of unclear benefit (Sutcliffe et al., 2013). The USPSTF recommends against its use for prevention in women less than 55 and men less than 45 years old; however, in those who are older it is recommends in some individuals. Treatment of those who have CVD improves outcomes. Cardiovascular diseases are the leading cause of death globally. This is true in all areas of the world except Africa (Mendis et al., 2011). Together they resulted in 17.3 million deaths (31.5%) in 2013 up from 12.3 million (25.8%) in 1990. Deaths, at a given age, from CVD are more common and have been increasing in much of the developing world, while rates have declined in most of the developed world since the 1970s (Moran et al., 2014). IHD and stroke account for 80% of CVD deaths in males and 75% of CVD deaths in females (Mendis et al., 2011). Most cardiovascular disease affects older adults. In the United States 11% of people between 20 and 40 have CVD, while 37% between 40 and 60, 71% of people between 60 and 80, and 85% of people over 80 have CVD (Moran et al., 2014). The average age of death from IHD in the developed world is around 80 while it is around 68 in the developing world. Disease onset is typically seven to ten years earlier in men as compared to women (Go et al., 2013).