Introduction: Minerals

Abstract

Cardiovascular diseases (CVD) are a group of disorders of the heart and blood vessels and include coronary heart disease (CHD), cerebrovascular disease, raised blood pressure (hypertension), rheumatic heart disease, angina, peripheral arterial disease, atherosclerosis, congenital heart disease, heart failure, and deep vein thrombosis (WHO 2009). Cardiovascular disease is the leading cause of death worldwide accounting for about 40 % of global mortality and 10.3 % of the global burden of disease. The incidence of CVD has risen greatly in low- and middle-income countries (Yusuf et al. 2001). Among cardiovascular disease, CHD is the most common heart disease, responsible for 40–60 % of all deaths and is invariably associated with atherosclerosis (thickening of the arteries). Atherosclerosis is a major cause of CVD that develops slowly over decades. In atherosclerosis, narrowing of the vessel’s lumen may lead to obstruction and to its clinical manifestations, such as myocardial infarction (MI) (Lefant and Savage 1995). Although women do not suffer from this problem as frequently as men, but it is numerically more significant in the case of older women. It has been reported that the risk of CHD is more in postmenopausal women (Miller 1990). Angina pectoris is one of the several expressions and one of possible manifestations of coronary heart disease. It is precipitated when the oxygen demands of the myocardium exceeds the available arterial oxygen supply. The major modifiable risk factors for CVD include high blood pressure (hypertension), high total cholesterol, obesity, physical inactivity, unhealthy diet, diabetes mellitus (DM), and homocysteine levels (Mackay and Mensah 2004). The more risk factors a person has, the greater the likelihood of developing CVD. Risk of CHD is two- to threefold higher in persons having type II diabetes as compared to general population (Fox et al. 2004). In diabetes, cardiovascular disease affects both men and women to the same extent (Uusitupa et al. 1993). It has been observed that women with diabetes, regardless of menopausal status, have a four- to sixfold higher risk of developing CVD, whereas men with diabetes have a two- to threefold increased risk of CVD compared to women and men without diabetes (Legato et al. 2006). Individuals having DM also face the risk of developing atherosclerosis due to the disturbances in the lipid metabolism (Adlerberth et al. 1998). Furthermore, high-density lipoprotein cholesterol (HDL cholesterol) that is commonly regarded as protective is decreased in diabetic patients. Diabetes mellitus acts as an independent risk factor for several forms of CVD, and it has been estimated that approximately 65 % of CVD-caused deaths are of the persons with DM (Geiss et al. 1995). Diabetes accounts for 6 % of total global mortality, with 50 % of diabetes-associated deaths being attributed to CVD (International Diabetes Federation 2008).