Table II.
Description of adulthood clinical and subclinical CVD outcomes included in the literature review
| Characteristics | Description | Common clinical presentation |
|---|---|---|
|
| ||
| Types of clinical CVD | ||
| CHD also known as ischemic heart disease, coronary artery disease | Reduced blood flow to the heart due to narrowing or obstruction of the coronary arteries (atherothrombosis) | Myocardial infarction, angina, sudden cardiac death |
| Stroke | Reduced blood flow to the brain due to a blockage or rupture of the arteries supplying the brain | Ischemic stroke, hemorrhagic stroke, transient ischemic attack |
| Heart failure | Inability of the heart to supply body’s circulatory needs, commonly due to heart muscle pump dysfunction or inadequate relaxation | Congestive heart failure - syndrome manifested by shortness of breath, decreased exertional tolerance, and/or peripheral edema |
| Measurement methods | ||
| Arterial stiffness | Reduced elasticity of the large arteries | Pulse wave velocity - speed that systolic BP wave travels through the vascular system body. Distensibility and compliance - measures of volume and pressure in an artery during heart muscle contraction |
| Arterial wall thickness | Thickening of the large arterial walls, tracks the presence and progression of atherosclerosis | cIMT, the thickness of innermost 2 layers of the wall of the artery, where atherosclerosis develops |
| Arterial calcification | Build-up of calcium in the large arteries, marker of atherosclerosis | Coronary artery calcium scan determines the area and density of calcium deposits, which correlates with overall coronary plaque burden |
| Endothelial dysfunction | Ability of the small arteries to dilate and constrict properly | Flow mediated dilation - measures the ability of the artery to dilate as blood flow increases after ischemia |
| LV structure and function | Enlarged mass and thickness of the walls of the left ventricle (hypertrophy) and reduced volume of blood pumped from the left ventricle (ejection fraction) are subclinical signs of heart failure | Echocardiography - produces images of the left ventricle to measure: LV mass, LV hypertrophy, Relative wall thickness, LV ejection fraction |