le malattie cardiovascolari(cvd) .1 le malattie cardiovascolari(cvd) • le malattie cardiovascolari

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Le Malattie Cardiovascolari(CVD)

Le malattie cardiovascolari sono la principale causa di mortalit e morbilit nei Paesi industrializzati. Pi di tutte le forme di tumore. Acquistano sempre maggior peso anche nei Paesi emergenti. Possiamo distinguere:

Cardiopatia ischemica(CHD):Infarto miocardico, Angina pectoris, morte cardiaca improvvisa.

Ictus cerebrale, aneurismi aortici, malattia vascolare periferica.

www.cardiovascularprevention.com

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Age-standardised death rates, per 100.000, from CHD, 1968-2002, selected countries, the world (1)

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From: Steven Allender, Viv Peto, Peter Scarborough, Asha Kaur and Mike Rayner (2008) Coronary heart disease statistics. British Heart Foundation: London.

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Age-standardised death rates, per 100.000, from CHD, 1968-2002, selected countries, the world (2)

www.cardiovascularprevention.com

From: Steven Allender, Viv Peto, Peter Scarborough, Asha Kaur and Mike Rayner (2008) Coronary heart disease statistics. British Heart Foundation: London.

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La Malattia Cardiovascolare in Europa

E la principale causa di morte contando per il 41% di tutti i decessi (Eurostat 2003)

1.2 milioni di decessi in Europa / anno

1/3 degli anni di vita perduti per morte precoce secondaria a CVD

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Maggiori cause di morte in EU anno 2003 per gruppi di 5 anni di et

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EUROPE 1995-2006

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Incidenza in Italia per anno

Sindromi coronariche acute 280.000 M 78.000 F + 50.000 morti improvvise Solo il 30% dei soggetti con fattori di

rischio tradizionali manifesta segni di CAD Pz giovani 50 aa. senza FRC: nel

50% M, 25% F , IMA o Morte come prima manifestazione di CAD, di questiIl 68% ha stenosi coronariche subcritiche, < 50%

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Mortalit Per Grandi Gruppianno 2002- ISTAT (Italy)

Malattie Cardiovascolari 237.198

Tumori 163.070

Morte improvvisa 54.000www.cardiovascularprevention.com

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Numero dimessi 2004 - Ricoveri per acuti. ISTAT (Italy)

Tumori 761.582

Malattie cardiovascolari 1.413.082

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Particolari condizioni patologiche associate ad elevata mortalit

cardiovascolare

Diabete mellito Scompenso cardiaco Ictus ischemico/emorragico

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Cardiovascular Disease in United Kingdom - 2006

Diseases of the heart and circulatory system (cardiovascular disease or CVD) are the main cause of death in the UK and account for almost 198,000 deaths each year. More than one in three deaths (35%) are from CVD each year. The main forms of CVD are coronary heart disease (CHD: Acute myocardial infarction, Angina pectoris, sudden cardiac death) and stroke. About half (48%) of all deaths from CVD are from CHD and more than a quarter (28%) are from stroke.

CHD by itself is the most common cause of death in the UK. Around one in five men and one in seven women die from the disease. CHD causes around 94,000 deaths in the UK each year.

Other forms of heart disease cause over 31,000 deaths in the UK each year so in total there were just under 126,000 deaths from heart disease in the UK in 2006.

Premature mortality(death before the age of 75). CVD is one of the main causes of premature death in the UK 30% of premature deaths in men

and 22% of premature deaths in women were from CVD in 2006. CVD caused just over 53,000premature deaths in the UK in 2006.

CHD, by itself, is the most common cause of premature death in the UK About one fifth (19%) of premature deaths in men and one in ten (10%) premature deaths in women were from CHD.

CHD caused almost 31,000 premature deaths in the UK in 2006. Other forms of heart disease cause more than 7,500 premature deaths in the UK each year. In

total there were over 38,000 premature deaths from heart disease in the UK in 2006 - around one fifth of all premature deaths.

From: Steven Allender, Viv Peto, Peter Scarborough, Asha Kaur and Mike Rayner (2008) Coronary heart disease statistics. British Heart Foundation: London.

www.cardiovascularprevention.com

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DEATHS BY SEX, AGE, UNITED KINGDOM - 2006

From: Steven Allender, Viv Peto, Peter Scarborough, Asha Kaur and Mike Rayner (2008) Coronary heart disease statistics. British Heart Foundation: London.

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USA Death rate in 2003 The 2003 preliminary CVD death rates were 364.2 for males

and 262.5 for females. Cancer death rates were 232.3 for males and 160.2 for

females. Breast cancer claimed the lives of 41 566 females in 2003. Lung cancer claimed 67 894. Death rates for females were 25.2 for breast cancer and 41.1

for lung cancer. One in 30 female deaths are from breast cancer, while 1 in

2.6 are from CVD. Based on preliminary 2003 mortality, CVD caused about a

death a minute among females over 480 000 female lives every year.

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Other causes of death in 2003 in USA (preliminary data)

Cancer 554 643 Accidents 105 695 Alzheimers disease 63 343 HIV (AIDS) 13 544.

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U.S.A. Data 1999-2002 Of the 71 300 000 American adults with 1 or more types

of cardiovascular disease (CVD), 27 400 000are estimated to be age 65 or older

High blood pressure 65 000 000. Coronary heart disease 13 200 000.

Myocardial infarction (MI, or heart attack)7 200 000.

Angina pectoris (AP, or chest pain) 6 500 000. Heart failure 5 000 000. Stroke 5 500 000. Congenital cardiovascular defects 1 000 000.

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U.S.A. Data 2003 & cost 2006

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CARDIOVASCULAR DISEASE IN CANADA (1)These statistics are based on 2004 data (from Statistics Canada)

Cardiovascular disease (heart disease, diseases of the blood vessels and stroke) accounts for the death of more Canadians than any other disease. Every 7 minutes in Canada, someone dies from heart disease or stroke.

Cardiovascular disease accounted for 72,338 deaths:32% of all deaths in Canada 31% of all male deaths 33% of all female deaths In 2004, of all cardiovascular deaths:54% were due to ischemic heart disease20% to stroke25% to heart attack

Cost of cardiovascular diseasesHeart disease and stroke costs the Canadian economy more than $18 billion every year in physician services, hospital costs, lost wages and

decreased productivity. www.cardiovascularprevention.com

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CARDIOVASCULAR DISEASE IN CANADA (2)These statistics are based on 2004 data (from Statistics Canada)

Cardiac arrest

About 40,000 Canadians experience cardiac arrest every year.Less than 5% of those who have a cardiac arrest outside of a hospital

survive.

Congestive heart failure

It is estimated that there are 400,000 Canadians living with congestive heart failure (CHF).

Stroke

More than 50,000 strokes occur in Canada each year. Thats one stroke every 10 minutes.

Stroke is the third leading cause of death in Canada. Each year, more than 14,000 Canadians die from stroke.

Each year, more women than men die from stroke.

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ACUTE CORONARY SINDROME IN INDIA India has the largest percentage of heart disease in the world Xavier et al's, examined the incidence of STEMI and non-STEMI among

almost 21 000 patients from 89 centers in 50 Indian cities. They found that more than 60% of these patients were diagnosed with STEMI, mean age was 57.5 years (although STEMI patients tended to be even younger), and the vast majority were from lower-middle-income or poor families.

The Indians were, on average, 57,5 years of age compared with 70.7 yearsfor the European whites.

Reinfarction, and stroke rates and 30-day death, were higher for STEMI patients than non-STEMI, and mortality, notably, was significantly higher in poor patients than in rich patients.

They also had significantly increased prevalence of diabetes, hypertension, history of CAD compared with European whites.

And triple-vessel disease was more common in the Indian Asians than in the whites.

Almost all STEMI and non-STEMI patients were treated with antiplatelet drugs (primarily aspirin), but use of thrombolytics, ACE inhibitors or Angiotensin-Receptor Blockers, beta blockers, statins, omega 3 fatty-acids and PCI/CABG were all far lower than rates seen in the West.

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India: Mortality rates and socioeconomic status

Mortality Rich (%)

Lower middle class (%)

Poor (%) p

Unadjusted mortality 5.5 6.5 8.2

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Ten-year risk of CHD event (%) in 60-year-olds British minority Ethnic groups

From: P Brindle, M May, et Al: Heart 2006;92:15951602. doi: 10.1136/hrt.2006.092346

Ethnic group Male nonsmoker

Male smoker

Female nonsmoker

Female smoker

Indian 18.5 27.9 6.4 10.0Pakistani 21.3 31.8 9.8 15.3Bangladeshi 21.2 31.7 5.3 8.3All South

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