Cardiovascular disease statistics

According to the American Heart Association, 79 million Americans have some form of cardiovascular disease and hypertension is the leading cardiovascular disease. Coronary heart disease affects 15.8 million Americans and is the nation’s number one killer.  

Approximately 72 million Americans have been diagnosed as suffering from hypertension, typically defined as a blood pressure greater than 140 millimeters of mercury ("mmHg") systolic pressure and/or greater than 90 mmHg diastolic pressure. Nearly 75% of those (37.5 million) not properly treated for the condition and thus face significantly increased risk for heart and kidney disease and strokes. 

According to the Johns Hopkins White Papers on Hypertension (2007), one in five Americans are estimated to have prehypertension, defined as a blood pressure reading 120-139 mmHg. These individuals have increased risk of developing hypertension and they have a greater risk of cardiovascular events than people with lower blood pressure.

What is hypertension?

Hypertension can easily go undetected and has been called the "silent killer" because it usually produces no symptoms until after it seriously damages the heart, kidneys, brain or some other organ. Elevated blood pressure indicates that the heart is working harder than normal, putting both the heart and the arteries under greater strain. 

Over time, these arteries become scarred, hardened and less elastic, accelerating the process of atherosclerosis and leaving one susceptible to heart attacks, strokes, kidney failure, and eye damage. According to the Archives of Internal Medicine (March 24, 1997), high blood pressure is of particular concern to older adults, as levels increase with age, and is present in more than half of Americans age 60 or older. 

The seriousness of this problem increases as the population grows older because individuals with sustained high blood pressure have an increased overall death rate from stroke, heart attack and kidney disease.

Damage caused by hypertension

Hypertension is a deadly disease that damages both large and small arteries, leading to pathological changes in the tissues or organs supplied by the damaged arteries, and accelerating the development of atherosclerosis (the formation of plaque and the accumulation of fatty deposits lining the walls of the artery which affect blood flow) in large blood vessels, and the arteries supplying blood to the brain, heart, kidneys and legs. 

Atherosclerotic plaques can cause mini-strokes (transient ischemic attacks) due to diminished blood flow (ischemia) to parts of the brain; angina from partly obstructed coronary arteries; or pain in the leg muscles when walking, a result of poor blood supply to the legs (peripheral arterial disease). Blood clots, which tend to occur at the sites of atherosclerotic narrowing, can totally block a vessel and cause a stroke or heart attack.

Atherosclerosis

Atherosclerosis begins in the wall of the artery with an early abnormality in the lining of the arterial wall called the endothelium. The endothelium helps to maintain the flexibility or elasticity of the artery and normally inhibits the accumulation of lipid and cellular deposits into the arterial wall of the artery. 

Abnormal function of the endothelium and the associated structural changes in the wall result in a loss of elasticity of the small arteries. Detection of this loss in elasticity can identify individuals with abnormal arterial structure and function long before plaque formation can cause morbid cardiovascular events. Furthermore, demonstration of normal arterial structure and function might suggest that the individual does not have early atherosclerosis and may not need aggressive risk factor management.

Understanding the risk factors

A number of risk factors for atherosclerosis have been identified, including elevated blood pressure, elevated cholesterol level, smoking, diabetes and a family history of atherosclerosis. Clinical events associated with atherosclerosis, including heart attacks (myocardial infarction), strokes, angina (myocardial ischemia), peripheral vascular ischemia (claudication) and renal failure are late manifestations of the disease as a result of plaque formation that impinges on blood flow. 

The absence of a clinically applicable method to detect the presence of atherosclerosis prior to plaque obstruction of the lumen (the inner space in the blood vessel through which blood passes) has led to widespread efforts to identify the risk factors in the entire population and to intervene on those who harbor such risk factors. 

The problem with this approach is two-fold: (a) patients without these risk factors will not be identified even though up to half of the atherosclerotic clinical events occur in individuals without any of the traditional risk factors; and (b) patients who have one or more risk factors may be subjected to therapy even though they do not have the atherosclerotic process the therapy is designed to inhibit.

   

Papers on Early Detection of Vascular Disease through Arterial Waveform Analysis

   "It Starts In The Wall"

   "Clinical Application of the CVProfilor^®"

   "Beyond the Cuff"

American Association of Clinical Endocrinologists

American College of Cardiology

American College of Phys./Am. Society of Internal Medicine

American Diabetes Association

American Heart Association

American Society of Hypertension

Association of Black Cardiologists

International Society of Hypertension

International Society on Hypertension in Blacks