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Cardiovascular disease (CVD) encompasses different blood and heart diseases, for instance, coronary heart diseases, hypertension, rheumatic heart diseases and stroke. These diseases lead to deaths and hospitalization of patients.
CVD occurs as a result of clogged arteries due to blood clotting, atherosclerotic plague and wandering clot or rupture of a brain artery. Coronary Artery Disease (CAD), on the other hand, is a disease that results from disorders that lead to a reduction of blood supply to heart muscles (Fawcett, et al 2004).
Cardiovascular disease occurs when inner layers of the artery walls grow thick and irregular due to the deposition of fat cholesterol among other substances. The thickening in the artery walls could cause chest pains or breathlessness (Michimi 2008). In most cases, the middle-aged individuals and the old are the ones prone to CVD. CVD could be accelerated by diabetes, obesity, high blood pressure, smoking and physical dormancy. Some of these causes are, however, preventable (Wang 2006).
Atherosclerosis is the pathological process during which atheroma, also known as lipid-filled plague, develops within the intima of large and medium sized arteries, including the coronary vessels. Macrophages and vascular smooth muscle cells that accumulate these plagues making them rupture hence triggering platelet activation and thrombus formation. This further causes luminal obstruction and reduction in the blood flow leading to Coronary Artery disease, a composite of cardiovascular disease.
Public Health Surveillance and Monitoring
A research carried out by P.G Surtees and co-authors sought to determine the relationship between limited mastery (stressful experiences and negative emotions) to cardiovascular diseases. The research focused on 19,067 men and women aged 41-80 years, who had no previous heart disease or stroke cases during assessment according to scientists in Cambridge and the UK report (Acton 2011).
The research revealed that a total of 791 CVD deaths were recorded up to June during media 11.3 person-years of follow up. In this case, limited mastery of life was linked with the increase in the risk of CVD independent of biological, lifestyle and socioeconomic risk factors (Acton 2011).
Coronary Heart Disease (CHD) is said to be the most common cause of deaths in the UK causing around 94,000 deaths every year (Preedy 2011). One in five men and one in seven women will die from CHD in the UK each year according to British Heart Foundation report of 2008. Around 19 per cent of male and 10 per cent of female die prematurely due to the disease totaling the number of premature deaths in the UK to 31,000 as of 2006 according to the report (Preedy 2011).
The report further showed a high rate of CHD in men than women. 4 per cent of men and 0.5 per cent of women have had a heart attack with over 60 per cent of all cardiovascular deaths in men and 80 per cent in women occurring after the age of 75 according to Stanner (Preedy 2011).
Data from the UK shows that CVD is the leading cause of mortality. For instance, in 2003, more than one in three people (38%) died of CVD accounting for about 233,000 deaths (Waring 2006). Heart diseases accounted for the most number 147,500 deaths with 114,000 deaths related to CAD.
According to World Health Organization report of 2004, CVD accounts for 1.95 million deaths in the UK every year. Approximately 30% of these deaths occur in patients under 65 years. Coronary Artery Diseases account for half of these deaths while stroke covers just a quarter. With regard to gender, 23% of these deaths in the UK occur in women while men stand at 21 % of the deaths caused by cardiovascular diseases. Independently, stroke accounts for 1.28 million deaths yearly.
This makes it the second highest cause of death. The report further states that everyone in ten men (11%) dies of stroke complications while over one in six women, translating to 18%, die of the same cause. Most women get anxious and depressed easily hence making them at risk of CDV (Weidner et al 2002). The total number of deaths is, however, in the decrease for both men and women (Michimi 2008).
The burdens that CVD causes in the UK
Societal effects: The first resultant effect of CVD is death. This brings about premature changes in the family roles with the remaining family members being under pressure to take charge, for instance, when a sole bread winner dies. The sadness that comes with these deaths is also traumatizing especially to the young members of the family (Alexander et al 2000).
Population effect: CVD also has an effect on the personal life of the patient and procreation. This is because; most patients with CVD do not indulge in sexual intercourse and hence affecting the population growth (Waring 2006).
Economic effect: The death of people in the middle-age or advanced age bracket has dangerous implications on the economy. Usually, these people, especially the middle-aged are the driving force of the economy since they have the experience and skills needed for efficiency in work. Those in the advanced age also possess rich skills in the market and some of them are founders of various companies or highly ranked personnel in several business entities (Waring 2006).
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Financial burden: CDV also causes a burden to the National Health Service, commonly known as NHS. It is expensive to treat CVD (£ 6.2 billion by 2003). This, therefore, weighs heavily on NHS. The cost of informal care, for instance outpatient treatment, was over £ 4800 in the same year (2003) according to World Health Organization.
In total, CVD costs the UK economy over £ 26 billion a year as the cost of treating the CVD patients (Waring 2006). The economic troubles are also caused by the fact that most of these patients cannot work hence crippling the economy. These patients also require a prolonged medical attention hence leading to increased medical expenses (Waring 2006).
Control measures and effectiveness
It has been difficult to control the causes of cardiovascular diseases in the UK due to the vested interest in both the political and economical circles. The government, has, however, tried to influence the pattern of consumption mainly through persuading smokers to change their behavior (Calnan 1991).
Cigarette is a leading cause of cardiovascular disease. The UK government has taken some measures, due to pressure from the anti-smoking lobby, to help reduce the rate of smoking. Activities of individuals and government-funded lobby groups such as ASH can also be stated as a force that helped the government bow to pressure to enforce some of these policies (Calnan 1991).
These efforts have led to tobacco industries accepting government policies and adopting self-regulation and control measures to prevent excessive smoking. Wilkinson states that, in 1984, the British Medical Association initiated an anti-smoking campaign directed at stopping cigarette advertising.
The government intended to reduce the rate of cigarette consumption in the UK by enforcing anti-smoking policies. In 1972, for instance, 52 per cent of men and 41 per cent of women in Great Britain were smokers. This percentage fell by 1986, where 35% of men and 31% of women were smokers.
According to Townsend, the British government also increased the tax on cigarette in a bid to reduce cigarette consumption. This measure was effective in some sense, in that it led to the increase in the price of cigarette hence making many smokers reduce smoking. According to Townsend, this move led to about half of the total 20 per cent reduction in cigarette smoking.
Health education and publicity of a series of reports on smoking and health prepared by the Royal College of Physicians also helped in the reduction of cigarette consumption. This is said to contribute to the other half of the 20 per cent reduction in smoking.
The government’s safer cigarette policy is also quoted as a resultant factor in the reduction of CVD. According to Calnan, many cigarette companies have reduced the amount of tar content in cigarette as a result of the UK government’s restrictions on the level of tar that was to be moved from high to low (Calnan 1991).
Reduction in smoking, therefore, helped to reduce cases of CVD (Courtenay et al 2010) hence reducing ill health and prolonging the life of an individual. The Food Standard Agency in the UK set target levels that food industries should adhere to for each food category. This policy was aimed at reducing the amount of salt intake in people (Mancini et al 2011).
Campaigns have also been rolled out on TVs, billboards, buses and magazines to advise people on the need to limit salt consumption in order to avoid ill health.
This strategy, that began in 2003 has proven effective, such that much food bought in supermarkets contain 20 to 30 per cent less salt by 2008. Companies such as Unilever, Kellogg’s and Heinz have also reduced salt concentration in their food. The minimal consumption of salt helps in prevention of hypertension which is a cardiovascular disease.
People in the UK have also been advised to avoid fatty and sugary foods in order to minimize the rate of diabetes. The organization Diabetes UK recommends that a meal should have vegetables, salad, fruits, one sixth of the plate should contain meat, fish and beans while two sixth of it should have potatoes, pasta and rice. Sucrose can provide 10 per cent of daily energy requirement hence it is not necessary to do away with sugar intake.
This control measure has helped people to be wary of their diet hence minimizing the rate of diabetes and heart diseases (Mittal 2005).
It is, therefore, evidence that increase in cigarette prices, health education and legislative controls over tobacco advertising can lead to reduced in cigarette consumption.
The UK should put more emphasis on banning advertisements that are meant to reduce tobacco and alcohol consumption. This measure has led to a reduction in cigarette smoking hence reducing cases of CVD (Calnan 1991). The government has focused on fiscal policy rather than control because it of easier to pursue bureaucratic procedures for tobacco regulation than complex control programs.
The UK government has adopted for persuasion and self-regulation as a move to control smoking rather than direct intervention. The effectiveness of the policies that the UK government has adopted is difficult to access. However, there has been a significant reduction over the last ten years in the number of smokers among the population (Calnan 1991).
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