GLOBAL HEALTH | Addressing the world’s health challenges
24 July 2008
Heart Disease a Leading Cause of Death Worldwide
Global research projects seek to end preventable heart attacks, strokes
Washington -- Despite dramatic medical advances over the past 50 years, heart disease remains a leading cause of death globally and the Number 1 cause of death in the United States.
Heart disease, or cardiovascular disease, accounts for 30 percent of deaths worldwide, according to the World Health Organization (WHO). In the United States, almost 700,000 people die from heart disease each year. In 2006, the American Heart Association estimated heart disease would cost Americans more than $258 billion.
Heart disease encompasses several specific heart ailments. One of the most common is coronary heart disease, which accounted for 71 percent of U.S. heart disease fatalities in 2002 according to the Centers for Disease Control and Prevention (CDC). Other common cardiovascular diseases are congenital heart disease, congestive heart failure, pulmonary heart disease and rheumatic heart disease.
Coronary heart disease is caused by a narrowing of the blood vessels that lead to the heart. This occurs when fatty deposits, called atherosclerosis, form along the vessel walls. If these fatty deposits become thick enough to stop blood flow, a heart attack or myocardial infarction results, which can lead to disability or death.
The risk of heart disease can be reduced through lifestyle changes -- a healthy diet, physical activity and elimination of tobacco use. Risk indicators like cholesterol levels and blood pressure can be monitored to assess the effectiveness of drug treatments and lifestyle changes in reducing the chances of heart disease. Diabetes and obesity are also heart disease risks. (See “Diabetes Threatens Lives Worldwide” and “Obesity Becoming Worldwide Health Threat.”)
INTERNATIONAL COOPERATION ON RESEARCH
WHO and the Global Forum for Health Research began a cardiovascular disease research initiative in November 1998. The initiative has six research projects, including community-based interventions and clinical management programs. Researchers from Switzerland, Australia, Finland and the United States are cooperating in this effort.
WHO also sponsors a project called INTER-HEART, a global study that seeks to identify traditional and emerging heart attack risk factors, and to use that information to help develop more effective health policies.
The National Heart, Lung and Blood Institute (NHLBI), a division of the National Institutes of Health, is conducting clinical and basic research programs. Basic research is exploratory and involves experiments and studies in a laboratory setting. Clinical trials involve volunteers on whom experimental drugs and devices are tested to ascertain their efficacy and safety.
One research project involves improving the use of magnetic resonance imaging to observe the heart. NHLBI researcher Elliott McVeigh is developing strategies to overcome the two major obstacles to obtaining a good image. One problem is that the heart moves; the other is that the need for imaging often coincides with a health emergency, McVeigh told America.gov.
Imaging helps heart disease patients because it allows doctors to “to better determine which treatment is the best for each patient,” McVeigh said. “Sometimes, the treatment itself can be delivered more precisely and more effectively under direct image guidance.”
One of McVeigh’s research projects involves trying to see the shape of the scar, or “myocardial infarct,” that develops after a person has a heart attack. “The relationship of the shape of that scar to the propensity for a fatal arrhythmia at a later time is unknown. We would like to discover that relationship so that we can determine which patients need defibrillators.”
An arrhythmia, or erratic heart beat, can be treated with a defibrillator, a device that uses electrical signals to help the heart regain a healthy rhythm.
PREVENTING HEART DISEASE
Treatment and management can help address the heart disease problem, but another effective strategy for curbing this chronic illness is prevention.
In the United States, the CDC operates programs to prevent heart disease in 33 states. The programs promote heart health by educating the public, monitoring risk factors and identifying promising strategies for promoting heart-healthy interventions.
“Our research is about heart disease and stroke prevention. It begins with prevention of the risk factors themselves,” Dr. Darwin Labarthe, director of the CDC Division for Heart Disease and Stroke Prevention, told America.gov. “We are working with the World Health Organization in efforts to reduce the intake of salt to prevent high blood pressure or reduce high blood pressure.”
Prevention strategies and treatment options for heart disease are having positive effects. In the United States, the overall death rate from heart disease has decreased since the 1960s but the gains have not been consistent across demographic groups.
For instance, “[t]he gap between blacks and whites has widened in the United States,” Labarthe said. According to the CDC, in 2002, the death rate for heart disease was 30 percent higher among blacks than among whites in the United States.
“The challenges that we face today,” he said, “are to eliminate all preventable heart attacks and strokes beginning with the risk factors themselves and achieving that for all members of the population.”
