Cardiovascular disease (Heart and blood vessel disease) includes multiple problems like heart attack, stroke, abnormal heart rhythm, heart failure, heart valve problems, and peripheral arterial disease. Most of these conditions are related to a process called atherosclerosis, that develops when cholesterol plaques build up in the arteries, including the ones supplying the heart and brain. This causes heart attack and stroke, respectively.
Chronic kidney disease (CKD) mainly comprises persistent reduction of kidney’s blood-filtering ability, expressed as glomerular filtration rate (GFR) below 60 ml/min/1.73 m2 for more than 3 months. It is also diagnosed if certain markers of kidney damage are identified in blood or urine tests, or imaging studies.
It is understood that the underlying pathology and manifestation of CVD differ in the presence of CKD. CKD is a known important and independent risk factor for CVD. CKD can lead to many cardiovascular issues such as coronary artery disease, heart attack and congestive heart failure. A common complication in CKD patients, which can lead to cardiovascular problems, is anemia. In a CKD patient with anemia, damaged kidneys are not able to produce adequate amounts of a hormone called erythropoietin, which stimulates bone marrow to produce red blood cells. Since red blood cells carry oxygen to the entire body, a lack of oxygen to the bodies tissues and organs can make a person susceptible to organ failure or a heart attack. Furthermore, high blood pressure, another common complication in patients with CKD, can increase the risk of heart attack and congestive heart failure.
CKD patients have higher incidence of heart attack, stroke, heart failure, heart valve disorders, peripheral arterial disease, and abnormal heart rhythm, the most common being atrial fibrillation. Furthermore, CKD patients are also at increased risk of sudden death due to heart related problems.
There are many risk factors associated with CVD. Some risk factors cannot be changed, such as family history, ethnicity (African or Asian ancestry), male gender and age. Some of the risk factors that can be treated or changed include smoking, high blood pressure, high cholesterol, obesity, physical inactivity, diabetes, and unhealthy diets.
Lifestyle changes have remarkable benefit to slow progression, and have the potential to prevent cardiovascular events. Smoking cessation, regular exercise, healthy diet and weight reduction to optimal targets are useful interventions. You should discuss these with your physician, who can recommend an ideal regimen for you. In addition, optimal control of blood pressure, diabetes, and blood cholesterol should be targeted by you and your physician. Aspirin has been found to be beneficial, and you should discuss with your physician if you should take it.
You should maintain frequent follow up visits with your physician, and get the recommended blood work and other tests done in a timely manner. Make sure to take all your medications as prescribed. If you experience any of the symptoms mentioned below, call 911 or see your physician immediately.
Symptoms of CVD can be variable in different people. Typically, heart attack can present as chest pain, loss of consciousness or shortness of breath. Stroke usually presents as sudden loss of strength or sensation, usually on one side of the body, or loss of speech. Heart failure, heart valve problems, and abnormal heart rhythms mostly present as shortness of breath, swelling in the feet, dizziness, loss of consciousness, or chest pain. Peripheral arterial disease commonly manifests as pain in the legs, worsened on walking.
There are multiple tests that may be done to diagnose a suspected CVD. These tests are aimed at determining the cause of symptoms and how much damage was done. Some tests monitor progress to see if treatment is working. The tests may include blood test, stress test, echocardiography, cardiac monitoring, and a heart catheterization, if needed. For stroke, CT scan or MRI of the head may also be done. Ultrasound of legs may be done to diagnose peripheral arterial disease. Some other tests may be needed, depending on clinical suspicion for different problems.
Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.
