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Disease Introduction
More than 17 million people died from cardiovascular disease (CVD) in 2008. CVD is responsible for almost half of all deaths in the western world. Therefore the need for effective methods of determining risk as well as diagnosis is increasingly important. The sooner lifestyle and medical interventions are initiated, the better the survival prognosis.
CVD covers all diseases related to the heart and blood vessels and can be roughly divided in two groups: CVD due to atherosclerosis (heart attack, stroke, hypertension and peripheral vascular disease), and other CVDs (congenital and rheumatic heart diseases, cardiomyopathies and arrhythmias). The risk of atherosclerosis is significantly increased by behavioural risk factors, e.g. tobacco use, physical inactivity, unhealthy diet and alcohol abuse. From a monetary point-of-view CVD is extremely expensive. The annual direct medical cost of cardiovascular disease has been reported to be as high as $403.1 billion, where the cost for coronary heart disease is estimated to $120.6 billion, and for stroke, $48.9 billion. However, by also adding the indirect costs for CVD the economic burden is considerably higher.
Current diagnostics and treatments
Unless specifically detected through medical examination, symptoms of potential upcoming disease are usually passed unnoticed making the first warning of underlying disease the actual heart attack or the stroke. However, a high number of CVDs, especially heart attack and stroke are preventable by smoking cessation, changing diet and increasing exercise. Prevention programmes and early detection of risk groups are warranted, especially in developing countries where the prevalence is higher.
Also, through early detection using available and simple diagnostic tools many people at high risk can be identified, and thereby prevent a significant number of CVD conditions. There are several treatment options available, from simple lifestyle changes to complicated invasive surgical interventions. However, if diagnosed early, most CVDs may be treated with lifestyle changes and inexpensive medications.
Latest and future development
CVD prevalence and its associated costs are projected to increase substantially in the future.
Isolating the genetic, cellular, and molecular factors that contribute in identifying risks and developing new diagnostic tools, will enable a faster and better diagnosis of people with CVD.
No matter what advances there are in upcoming high-technology drugs, the major reduction of deaths and disability from CVD will come from prevention in the future, not cure. Therefore, since it is largely preventable, there is great need for diagnostic and prognostic tools for early detection.
Some biomarkers suggest a more specific risk of CVD but their clinical value need to be further investigated. Such CVD biomarkers include: Higher fibrinogen and PAI-1 blood concentrations, elevated homocysteine, or even upper half of normal, elevated blood levels of asymmetric dimethylarginine, inflammation as measured by C-reactive protein (CRP), and elevated blood levels of brain natriuretic peptide (also known as B-type or BNP).
