CVD stands for cardiovascular disease, an umbrella term for a group of disorders affecting the heart and blood vessels. It is the leading cause of death worldwide, and it includes conditions ranging from heart attacks and strokes to blood clots and birth defects of the heart. Some forms develop slowly over decades, while others are present from birth or triggered by infection.
Conditions That Fall Under CVD
Cardiovascular disease isn’t a single illness. It covers several distinct conditions:
- Coronary heart disease: narrowing of the blood vessels that supply the heart muscle, which can lead to heart attacks.
- Cerebrovascular disease: problems with blood vessels supplying the brain, including stroke.
- Peripheral artery disease: reduced blood flow to the arms and legs.
- Rheumatic heart disease: damage to heart valves caused by rheumatic fever, itself a complication of untreated strep throat.
- Congenital heart disease: structural heart defects present at birth.
- Deep vein thrombosis and pulmonary embolism: blood clots that form in the leg veins and can travel to the lungs.
Most conversations about CVD focus on coronary heart disease and stroke because they account for the vast majority of cardiovascular deaths. But the term is deliberately broad, covering anything that disrupts the heart or the network of vessels that carry blood throughout the body.
How Atherosclerosis Drives Most CVD
The biological engine behind coronary heart disease, stroke, and peripheral artery disease is usually the same process: atherosclerosis. It starts when fat, cholesterol, calcium, and other substances collect inside artery walls, forming a sticky deposit called plaque. Over years, this plaque thickens and hardens the artery wall, gradually narrowing the opening that blood flows through.
A narrowed artery means less blood, and less oxygen, reaches whatever organ sits downstream. When it happens in arteries feeding the heart, the result can be chest pain or a heart attack. When it happens in arteries feeding the brain, the result is a stroke. When it happens in the legs or arms, it causes peripheral artery disease. The location differs, but the underlying process is remarkably similar.
Plaque can also rupture suddenly. When it does, a blood clot forms at the site and can block the artery entirely, cutting off blood flow in minutes rather than years. This is the mechanism behind most heart attacks and many strokes.
Coronary Heart Disease
Coronary heart disease is the most common form of CVD. Plaque builds up in the coronary arteries, the vessels responsible for feeding blood to the heart muscle itself. The hallmark symptom is angina, a feeling of chest pain, pressure, or tightness that often worsens with physical activity.
For many people, though, the first sign of coronary heart disease is a heart attack. Symptoms include chest pain, shortness of breath, pain radiating into the arms or shoulder, lightheadedness, nausea, or a cold sweat. These symptoms can appear suddenly and require emergency care. Doctors can detect coronary heart disease before a heart attack using tools like stress tests, echocardiograms (ultrasound images of the heart), and CT scans that look for calcium deposits in the coronary arteries.
Stroke and Cerebrovascular Disease
Strokes happen in two main ways. About 87% are ischemic strokes, caused by a blood clot or piece of plaque blocking blood flow to the brain. The remaining cases are hemorrhagic strokes, where an artery in or around the brain ruptures and causes bleeding. Of those, most involve bleeding within the skull, while roughly 3% of all strokes involve bleeding between the brain and the membrane surrounding it.
Both types share key risk factors with other forms of CVD: high blood pressure, diabetes, and high cholesterol. High blood pressure is especially dangerous because it stresses artery walls throughout the body, accelerating both plaque buildup and the risk of a vessel rupturing in the brain.
Peripheral Artery Disease
Peripheral artery disease (PAD) affects blood flow to the limbs, most often the legs. Plaque narrows the arteries in the same way it does in the heart, but the symptoms show up differently. The classic sign is leg pain or cramping that starts during walking or climbing stairs and stops with rest. This pattern, called claudication, happens because working muscles need more blood than narrowed arteries can deliver.
PAD can also be surprisingly subtle. Many people have mild symptoms or none at all. As the condition progresses, you might notice coldness in one foot compared to the other, slow-growing toenails, shiny skin on the legs, or sores on the feet that heal poorly. Severe PAD can cause pain even at rest or during sleep. Erectile dysfunction is another potential sign, since the same type of plaque buildup can affect blood flow to the pelvis.
Rheumatic and Congenital Heart Disease
Not all cardiovascular disease comes from plaque. Rheumatic heart disease starts with something as ordinary as a sore throat. When a strep throat infection goes untreated, the immune system can overreact, attacking the body’s own tissues, including the heart valves. Repeated episodes of this inflammatory reaction, called rheumatic fever, scar and stiffen the valves so they no longer open and close properly. An estimated 55 million people worldwide live with rheumatic heart disease, and it remains the most commonly acquired heart condition in people under 25. The burden falls overwhelmingly on low- and middle-income countries where access to antibiotics for strep throat is limited.
Congenital heart disease, by contrast, is structural. The heart forms abnormally during fetal development, producing defects that range from small holes between chambers to major malformations that affect how blood circulates. These conditions are present at birth, and while many can be repaired surgically, they still fall within the broader CVD category.
Major Risk Factors You Can Control
Five modifiable factors drive most cardiovascular disease risk: unhealthy diet, physical inactivity, excess body weight, smoking, and poorly managed medical conditions like high blood pressure, high cholesterol, and diabetes. Of these, smoking is one of the most potent. Quitting reduces your cardiovascular risk, and the benefits begin within weeks as blood pressure and circulation start to improve.
Blood pressure deserves particular attention because it is both a risk factor and often symptom-free. Normal blood pressure is below 120/80 mm Hg. Readings of 120 to 129 systolic (the top number) are considered elevated. Once you reach 130/80 or above, you are in stage 1 hypertension. Stage 2 begins at 140/90, and readings above 180/120 represent a hypertensive emergency requiring immediate attention. Because high blood pressure rarely causes noticeable symptoms, many people have it for years without knowing.
Screening and Early Detection
Catching CVD risk factors early makes a significant difference, and most screening happens during routine checkups. Blood pressure should be checked at least once a year if your readings are normal. Cholesterol screening is recommended starting at age 20, repeated every four to six years for people at normal risk and more often if your risk is elevated. Blood glucose testing is recommended starting at age 45, or earlier if you are overweight and have at least one additional cardiovascular risk factor. If results are normal, retesting every three years is reasonable.
These screenings are simple, but they catch the conditions that feed atherosclerosis long before symptoms appear. High cholesterol and high blood sugar both accelerate plaque formation inside arteries, and both can be managed effectively once identified.