7 Immediate treatment of cardiovascular diseases
Treatment obviously depends on the severity of cardiovascular diseases at presentation and any safety considerations. Medications (pharmaceutical drugs) are available to treat many of the symptoms and slow the progression of cardiovascular diseases. Some are used for specific purposes, whereas others are useful for a range of cardiovascular diseases. In certain circumstances, individuals may not be able to take one type of medication and will be prescribed something else to serve the same function. The type of treatment will certainly depend on where in the world the patient is taken ill, due to availability and costs (see Figure 12).
Figure 12: The availability and/or affordability of antihypertensive medications in different regions of the world (WHO data; Mackay and Mensah, 2004)
Immediate treatment following an MI is required to minimise further damage to the heart cells and restore blood circulation. As soon as possible, drugs to prevent blood clotting are administered, as long as there are no medical reasons contravening this. After further assessment, other treatments may be required. Many effective surgical devices have been developed to treat cardiovascular disease complications and are now in routine use, including:
- pacemakers (to artificially maintain the heart's rhythm)
- implantable defibrillators (to restart the heart)
- coronary angioplasty followed by placement of stents (to widen blocked vessels)
- prosthetic heart valves (to replace faulty or diseased valves)
- patches to mend holes or tears in the heart muscle.
Technological advances also mean that many of these procedures are being used and further developed so that they involve only minor surgery, leading to safer outcomes for patients. More invasive but often life-saving and life-enhancing operations that are also carried out include coronary artery bypass and – as a last resort – artificial hearts and heart transplantation. The development and use of such impressive surgical advances reduce disability and death from cardiovascular disease complications and improve the quality of life for patients, but they do incur higher health care costs.
Despite such encouraging advances in cardiovascular disease treatment options, there are still substantial numbers of people worldwide who would benefit from treatment but are not receiving it. Whereas 1 in 2 people with high blood pressure in the USA are receiving treatment, only a quarter of those over 20 years old with blood cholesterol levels of more than 6.2 mmol/l are on cholesterol-lowering drugs (Mackay and Mensah, 2004). As you started to discover in Section 3, the quality of treatment received by people of different ethnicities, socioeconomic backgrounds and even gender show marked disparity. Research in these areas is ongoing, so if you are interested you can keep your knowledge current with developments via the internet or publications.