Determinants and Interventions for Cardiovascular Disease (CVD)

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Published: 23 June 2018

Cardiovascular disease (CVD) is one of the 10 major chronic conditions in Australia (AIHW 2021).

The other main chronic diseases are asthma, diabetes, chronic obstructive pulmonary disease (COPD), arthritis, back pain, cancer, chronic kidney disease, osteoporosis and mental health conditions (AIHW 2021).

Chronic diseases are on the rise and are a priority area for the health system. Unfortunately, at present, chronic diseases affect half of the Australian population, with 47% of people having at least one of the 10 major chronic conditions (AIHW 2021).

What is Cardiovascular Disease?

Cardiovascular disease (CVD) is an umbrella term describing disorders of the heart and blood vessels, including:

  • Coronary heart disease (alternatively referred to as ischaemic heart disease and includes heart attack/acute myocardial infarction, and angina)
  • Stroke
  • Heart failure
  • Rheumatic heart disease
  • Congenital heart disease
  • Peripheral vascular disease
  • Deep vein thrombosis and pulmonary embolism.

(DoH 2020; WHO 2021)

Man holding his chest due to a heart attack or stroke

Determinants of a Healthy Cardiovascular System

  • Environment
  • Location (e.g. remote, urban, etc.)
  • Socioeconomic status
  • Knowledge (e.g. health literacy)
  • Beliefs
  • Health behaviours
  • Psychology
  • Safety
  • Genetics
  • Biomedical factors

(AIHW 2016a)

Evidently, not all of these determinants can be changed, but it is the aim of evidence-based interventions to reduce risk factors for disease and prevent complications or deaths from chronic disease (Kumar 2017).

CVD is the leading cause of death on a global scale (WHO 2021). Kumar (2017) states that better access to healthcare could help to prevent CVD.

Determinants of CVD

Determinants of CVD (with stronger evidence links) generally fall under one of the following:

  1. Behaviours - including tobacco smoking, lack of physical activity and diet (i.e. high intake of saturated fat is linked to coronary heart disease)
  2. Biomedical – including obesity, hypertension, and abnormal blood lipids.

(AIHW 2016b)

Determinants may include:

  • Excessive alcohol intake
  • Older age
  • Ethnicity
  • Gender
  • Being an Aboriginal or Torres Strait Islander person
  • Diabetes
  • Smoking
  • Diet
  • High cholesterol
  • Hypertension
  • Physical activity
  • Weight
  • Depression
  • Social isolation.

(Better Health Channel 2020)

General Interventions for Determinants of CVD

  • Improved policies
  • Lifestyle behaviour modification programs
  • Improved access to programs and healthcare
  • Allocating resources to CVD prevention and management
  • Improving the environment,
  • CVD-specific interventions with effective monitoring and planning systems,/li>
  • Promoting CVD education across the community (e.g. not just in medical clinics), and targetting CVD risk factors.

(Kumar 2017)

Australia-specific interventions for CVD include:

  • Subsidised healthcare by the Medicare Benefits Schedule (MBS)
  • Subsidised medicines used to treat CVD under the Pharmaceutical Benefits Scheme
  • Research into CVD funded by the Medical Research Future Fund and the National Health and Medical Research Council
  • The Australian Institute of Health and Welfare's National Centre for Monitoring Chronic Conditions.

(DoH 2020)


References

Author

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Madeline Gilkes View profile
Madeline Gilkes, CDE, RN, is a Fellow of the Australasian Society of Lifestyle Medicine. She focused her Master of Healthcare Leadership research project on health coaching for long-term weight loss in obese adults. Madeline has found a passion for preventative nursing. She has transitioned from leadership roles (CNS Gerontology & Education, Clinical Facilitator) in the acute/hospital setting to education management and primary healthcare. Madeline’s vision is to implement lifestyle medicine to prevent and treat chronic conditions. Her research proposal for her PhD involves Lifestyle Medicine for Type 2 Diabetes Mellitus. Madeline is a Credentialled Diabetes Educator (CDE) and primarily works in the academic role of Head of Nursing. Madeline’s philosophy focuses on using humanistic management, adult learning theories/evidence and self-efficacy theories and interventions to promote positive learning environments. In addition to her Master of Healthcare Leadership, Madeline has a Graduate Certificate in Diabetes Education & Management, Graduate Certificate in Adult & Vocational Education, Graduate Certificate of Aged Care Nursing, and a Bachelor of Nursing. She is working towards her PhD.