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Car­dio­vas­cu­lar dis­ease (CVD) is a class of dis­eases that involve the heart or blood ves­sels. Com­mon CVDs include: ischemic heart dis­ease (IHD), stroke, hyper­ten­sive heart dis­ease, rheumat­ic heart dis­ease (RHD), aor­tic aneurysms, car­diomy­opa­thy, atri­al fib­ril­la­tion, con­gen­i­tal heart dis­ease, endo­cardi­tis, and periph­er­al artery dis­ease (PAD), among oth­ers. The under­ly­ing mech­a­nisms varies depend­ing on the dis­ease in ques­tion. IHD, stroke, and PAD involve ath­er­o­scle­ro­sis. This may be caused by high blood pres­sure, smok­ing, dia­betes, lack of exer­cise, obe­si­ty, high blood cho­les­terol, poor diet, and exces­sive alco­hol, among oth­ers. High blood pres­sure results in 13% of CVD deaths, while tobac­co results in 9%, dia­betes 6%, lack of exer­cise 6% and obe­si­ty 5%. Oth­ers such as RHD may fol­low untreat­ed strep­to­coc­cal infec­tions of the throat. It is esti­mat­ed that 90% of CVD is pre­ventable. Pre­ven­tion of ath­er­o­scle­ro­sis is by decreas­ing risk fac­tors through: healthy eat­ing, exer­cise, avoid­ance of tobac­co smoke and lim­it­ing alco­hol intake. Treat­ing high blood pres­sure and dia­betes is also ben­e­fi­cial. Treat­ing peo­ple who have strep throat with antibi­otics can decrease the risk of RHD. The effect of the use of aspirin in peo­ple who are oth­er­wise healthy is of unclear ben­e­fit. The USPSTF rec­om­mends against its use for pre­ven­tion in women less than 55 and men less than 45 years old; how­ev­er, in those who are old­er it is rec­om­mends in some indi­vid­u­als. Treat­ment of those who have CVD improves out­comes. Car­dio­vas­cu­lar dis­eases are the lead­ing cause of death glob­al­ly. This is true in all areas of the world except Africa. Togeth­er they result­ed in 17.3 mil­lion deaths (31.5%) in 2013 up from 12.3 mil­lion (25.8%) in 1990. Deaths, at a giv­en age, from CVD are more com­mon and have been increas­ing in much of the devel­op­ing world, while rates have declined in most of the devel­oped world since the 1970s. IHD and stroke account for 80% of CVD deaths in males and 75% of CVD deaths in females. Most car­dio­vas­cu­lar dis­ease affects old­er adults. In the Unit­ed States 11% of peo­ple between 20 and 40 have CVD, while 37% between 40 and 60, 71% of peo­ple between 60 and 80, and 85% of peo­ple over 80 have CVD. The aver­age age of death from IHD in the devel­oped world is around 80 while it is around 68 in the devel­op­ing world. Dis­ease onset is typ­i­cal­ly sev­en to ten years ear­li­er in men as com­pared to women.