An Overview of Cardiovascular Disease

By Brianna Koenick MPH (c) MMS (c) and Dr. Heather F. McClintock PhD MSPH MSW

Technology and medical advances in society have reduced the burden of communicable diseases in many countries. Preventative measures like vaccination and improved sanitation contributed to a 6-year increase in life expectancy from 2000 to 2019, but noncommunicable diseases, like cardiovascular diseases (CVDs), are on the rise. Across the globe, CVDs are the leading cause of death. The World Health Organization (WHO) estimates that 17.9 million lives are lost every year. The WHO has implemented several recent projects, such as the Signature Initiative and the Global Report on Hypertension, which aim to reduce the global burden of CVD.

In the United States (U.S.), one person dies every 33 seconds from CVD. U.S.-based initiatives like Million Hearts and WISEWOMAN are taking action to improve cardiovascular health outcomes by educating vulnerable populations about heart-healthy behaviors and preventative screenings. For some individuals though, cardiovascular disease remains a scary phrase surrounded by mystery. A recent survey (2023) conducted on behalf of the American Heart Association found that more than half of adults in the United States did not know that heart disease was a leading cause of death. Whether CVD enters one’s life through a personal potential risk, diagnosis, or through a loved one, it may leave them with questions. The uncertainty may be related to the fact that CVD refers to a number of disorders that impact the heart or blood vessels. Coronary heart disease, heart attack, and stroke are the main players when one thinks of CVD, but there are many other conditions that fall under the CVD umbrella.

A combination of genetics, lifestyle factors and the social determinants of health play a role in the development of CVDs. There are factors that we cannot control like age, sex, and family history. There are factors that we can control like dietary choices, tobacco use, exercise, and alcohol consumption. But then, there are factors that disproportionately impact vulnerable populations like air pollution and access to healthcare. CVD prevention is not only essential for the beating hearts in each and every one of us, but it needs to be at the forefront of public health to promote overall health and well-being.

The size of a fist, the heart is the hardest working muscle in our bodies. Every day the heart beats around 100,000 times to carry oxygen and nutrients throughout the body so we can enjoy all that life has to offer. When the heart is not working properly, our general health and well-being can be impacted as well as an increased risk of premature death. Cardiac events like a heart attack or stroke may be the first sign of CVD, but long term physical symptoms like fatigue and sleeping difficulties may contribute to or result from a history of CVD. Both shorter and longer sleep duration is associated with increased risk for poor cardiovascular health outcomes. Evidence shows that depression, anxiety, and Post-Traumatic Stress Disorder (PTSD) can also develop after a cardiac event linked to CVD. With the range of physical and emotional symptoms that one can experience, quality of life for those diagnosed with CVD can be poor. Furthermore, mental health conditions are linked to CVD through a combination of behavioral and biological mechanisms.

CVD and general well-being outcomes are influenced by where people are born, age, live, learn, work and play (also called social determinants). Low- and middle-income countries are burdened with over three-quarters of CVD deaths. In the United States, CVD outcomes highlight the underlying disparities and inequalities in health and healthcare systems. Specifically, racial and ethnic minorities are at greater risk due to the structural racism and other factors that are embedded in our policies and fueling the disparities in housing, education, employment, and healthcare access. For instance, if you were to take a look at the neighborhoods throughout the United States, you can still see the impacts of district redlining that was outlawed in the 1960s. The current state of residential segregation limits the educational and economic opportunities within Black communities.

Other social determinants of health, like access to healthy food and quality healthcare, are influenced by the built environment of one’s neighborhood. Independent of individual factors, incident CVD risk was 12% higher in Black populations living in areas with higher Black segregation. Additionally, other groups experience a disproportionate burden of CVD. In some research, persons with disability have a higher mortality rate from coronary heart disease than persons without disability. Findings indicate that women are at increased risk for late diagnosis, less intensive treatment and worse health outcomes for CVD. To achieve health equity, with regards to CVD incidence, we must change the systems and policies that have contributed to the generational injustices that put vulnerable populations at greater risk. 

About Authors

Brianna Koenick MPH (c) MMS (c) 

Brianna Koenick is a current student in Arcadia University’s Dual Master of Public Health/Master of Medical Science in Physician Assistant Program. As an MPH student, her capstone research explored the relationship between lifestyle factors and cognitive health outcomes related to dementia. She completed an internship at the Jewish Relief Agency, a hunger-relief organization working to inspire volunteerism across the greater Philadelphia region, where she assisted the client services team with community outreach and developed communication materials for both clients and volunteers. Her public health interests include preventative health, environmental health, and health equity. After graduating, she plans to continue practicing evidence-based public health and advocating for the communities she will serve as a Physician Assistant.

Dr. Heather F. McClintock PhD MSPH MSW
Dr. McClintock is an IH Section Member and Associate Professor in the Department of Public Health, College of Health Sciences at Arcadia University. She earned her Master of Science in Public Health from the Department of Global Health and Population at the Harvard School of Public Health. Dr. McClintock received her PhD in Epidemiology from the University of Pennsylvania with a focus on health behavior and promotion. Her research broadly focuses on the prevention, treatment, and management of chronic disease and disability globally. Recent research aims to understand and reduce the burden of intimate partner violence in Sub-Saharan Africa. Prior to completing her doctorate she served as a Program Officer at the United States Committee for Refugees and Immigrants and a Senior Project Manager in the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania. At the University of Pennsylvania she led several research initiatives that involved improving patient compliance and access to quality healthcare services including the Spectrum of Depression in Later Life Study and Integrating Management for Depression and Type 2 Diabetes Mellitus Study.