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Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels (arteries

and veins).

CVD is a family of diseases that includes


hypertension atherosclerosis coronary heart disease stroke.

Smoking: Smokers' risk of heart attack is more than twice that of nonsmokers', and smokers' risk of sudden cardiac death is two to four times that of nonsmokers'. Unhealthy Diet: An unhealthy diet is a major risk factor for chronic cardiac diseases. It is not difficult to figure out the diets that are unhealthy. Fast food and beverages containing colorants and preservatives are harmful for the heart. Fast foods are responsible for obesity of the millions of people.

Family history: Family history is an important cardiovascular disease (CVD) risk factor. Preventive behaviors, including lifestyle modifications, can attenuate CVD risk.If you have a family history of CVD, that is your father or brother was diagnosed when they were under 55, or your mother or sister when they were under 65, you also have an increased risk of developing the condition.

Alcohol and Drugs: Alcohol addiction can lead to high blood pressure, heart failure, alcoholic cardiomyopathy and strokes. Narcotics such as heroin, cocaine and other similar hard drugs cause contraction in the heart valve and weakens the circulatory system. Age The older you are the more likely you are to develop CVD Ethnicity.

Is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. Disease of the vascular regulation in which the mechanism that control arterial pressure within the normal range are altered.

(Secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart or endocrine system. Stage 2 hypertension. The most severe hypertension, stage 2 hypertension is a systolic pressure of 160 or higher or a diastolic pressure of 100 or higher.

Pathophysiology and Etiology Primary and Essential HPN


1. When the diastolic pressure is 90mmHg or

higher and other causes of HPN are absent. Diagnostics: Average of three or more blood pressure readings taken at rest several days apart exceeds the upper limit.

2. Cause is idiopathic. 3. Systolic BP elevation in the absence of

elevated diastolic BP is termed isolated systolic HPN.

Management Lifestyle Modification 1. Weight loss 2. Limit alcohol intake 3. Regular aerobic exercise - 30 mins

4. Cut Na intake

2.4g or less/day 5. DASH (Dietary Approaches to Stop Hypertension) High magnesium and K Fruits and Vegetables 6. Stop smoking 7. Reduce dietary saturated fat and cholesterol

8. Reducing coffee intake (5 cups/day

HPN)

9. Despite lifestyle changes, the BP remains

at or above 140/90 mmHg over 3 6 months drug therapy should be initiated.

Urinary Tract Infection

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it does not usually have bacteria in it, but when bacteria get into the bladder or kidney and multiply in the urine, they may cause a UTI.

There are several risk factors for UTI. These factors make a person more likely to develop a UTI and we will explain some of them below:

Young sexually active women have a higher risk because sexual activity aids in pushing bacteria into the urethra. Infections are more common if spermicidal creams and diaphragms are used as contraceptives.

Pregnancy predisposes to UTI. The interesting fact is that there may be no symptoms and yet the infection is present. It is a cause of pre term labour. An enlarged prostate gland in a man can cause urinary retention and increase the risk of urinary tract infections due to bacterial colonization. Kidney stones can also cause UTIs because the bacteria grow and multiply on the stones.

Post menopausal women - Due to loss of estrogen the vagina, urethra & bladder base become thinner, more fragile and more susceptible to bacterial infection. Unprotected sex with someone who has a sexually transmitted disease like Gonorrhea. Previous episodes of urinary tract infection increase the risk of getting it again.

HIV Infection because it lowers the immunity. Any medication that can lower immunity e.g. cancer chemotherapy, chronic steroid therapy. Chronic illness that impair immunity e.g. diabetes mellitus. Not drinking enough fluids - Drinking more fluids makes you pass more urine and this reduces the number of bacteria in the urinary tract.

Any structural problem involving the urinary tract. It may be present at birth or be a result of treatment e.g. Improperly treated UTI with scarring. Prolonged use of urethral catheters (artificial tubes for draining urine). On the average, women tend to have more episodes of urinary tract infections than men because the female urethra is shorter than the male urethra and germs don't have to travel far to get to the bladder.

Urinary tract infections: Diagnostic Tests:


Urine tests Urinalysis Intravenous pyelogram (IVP) Cystoscopy

Drug Study

Aspirin- is also used to prevent ischemic strokes (strokes that occur when a blood clot blocks the flow of blood to the brain) or ministrokes (strokes that occur when the flow of blood to the brain is blocked for a short time) in people who have had this type of stroke or mini-stroke in the past.

Atorvastatin- is used along with diet, exercise, and weight-loss to reduce the risk of heart attack and stroke and to decrease the chance that heart surgery will be needed in people who have heart disease or who are at risk of developing heart disease. Atorvastatin is also used to decrease the amount of cholesterol (a fat-like substance) and other fatty substances in the blood. This will decrease the risk of stroke, heart attack, and other heart diseases because when there are high levels of cholesterol and other fats in the blood, these substances may build up along the walls of the blood vessels and decrease or block blood flow to the heart.

Telmisartan- Treatment of essential hypertension. Catapres- Management of hypertension. Prophylactic treatment of migraine or recurrent vascular treatment of migraine. Amlopidine- For chronic stable angina pectoris, hypertension.

Lactulose- Habitual constipation, diseases or conditions in which easier bowel movements with soft stools are desirable e.g. anal fissures, hemorrhoids, following rectal or anal surgery. Dulcolax- Habitual constipation, diseases or conditions in which easier bowel movements with soft stools are desirable e.g. anal fissures, hemorrhoids, following rectal or anal surgery.

For LRTI, pneumonia, otitis media, skin structure, UTI, uncomplicated gonorrhea, PID, bacteria septicimia, bone and joint infections, meningitis.

Citicoline- For mild to moderately severe dementia of the Alzheimer type, and symptomatic treatment of mild to moderately severe dementia of the Alzheimer type with relevant cardiovascular and cerebrovascular disease.

Norgesic- Spastic paralysis in cerebrovascular diseases, control of primary, uncomplicated hyperuricemia, prophylaxis against uric acid nephropathy in secondary hyperurecimia.

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