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The UK has one of the highest death rates from heart disease in the world, with around one British adult dying from the disease every three minutes. Many of these deaths could be prevented by addressing lifestyle issues. Benenden Hospital’s Mahmoud Ahmed explains coronary heart disease, its symptoms and treatment and also suggests ways of preventing it.
One of the commonest conditions to affect the heart is coronary heart disease (CHD). It is usually caused by a build up of fatty materials within the walls of the arteries that supply the heart with oxygen and nutrients (atherosclerosis). The arteries become narrow, restricting the supply of blood and oxygen to the heart, especially during exertion.
The main symptom is angina, a feeling of heaviness, tightness or pain in the middle of the chest that may extend to the arms, neck, jaw, face, back and abdomen. There are other symptoms to be aware of, including inappropriate breathlessness, palpitations, fainting, fluid retention and puffiness, bluish-tinged fingernails and fatigue, though these could well be harmless or caused by another condition.
In CHD, the arteries become congested with raised patches (plaques) which can eventually totally block the coronary arteries, leading to a heart attack which is often, unfortunately, the first indication the patient has that something is wrong.
The risk of developing coronary heart disease increases with age with four out of five people who die from heart disease aged 65 or over. Men are more at risk than women in earlier life but this changes as women reach the menopause, after which heart disease kills more women than any other condition, including cancer.
If your parents or close relatives have suffered from heart disease, you are more likely to be pre-disposed, and some races, such as Afro-Caribbeans are more prone to it than others.
But by far the biggest contributor is lifestyle and even small changes can make a difference.
Even being moderately overweight can increase your risk of coronary heart disease and ‘apple’ shaped people who carry excess fat around their middle have been found to be more at risk than other body shapes. Body shape is largely inherited, so if your parents are ‘apples’ it is a good idea to try to avoid this by taking care of your diet and exercising regularly.
High cholesterol and high blood pressure are two major factors in coronary heart disease and as they often don’t have any obvious symptoms, it is important to get both checked by your GP.
Cholesterol is a fatty substance that circulates around the body in the bloodstream in proteins called lipoproteins. There are two types: low-density (also know an bad cholesterol) which carries cholesterol to the body’s cells and high-density (good cholesterol) which helps clear excess cholesterol from the arteries and take it back to the liver to be destroyed.
The body needs some cholesterol to produce hormones and the bile needed to digest fat, but if you have high levels of bad cholesterol and low levels of good, you are more at risk of heart disease. This can be caused by eating a diet high in saturated fat and processed foods, being overweight, drinking too much alcohol and not doing enough exercise.
Blood pressure is a measure of the force that the blood applies to the walls of the arteries as it flows through them. It's normal for blood pressure to increase when you exert yourself, or when you feel stressed or anxious. But if your blood pressure is consistently higher than normal at rest, this is high blood pressure, also known as hypertension. High blood pressure can be caused by smoking, obesity, poor diet and lack of exercise but can also be the result, or the symptom of, another cause, such as kidney disease.
Smokers are twice as likely to suffer a heart attack as non-smokers and they are more likely to die as a result. The nicotine and carbon monoxide in tobacco smoke damages the cardiovascular system and passive smoking may also be a danger. Women who smoke and take the contraceptive pill are at a higher risk of heart disease.
Alcohol is also a danger as it can affect blood pressure, increase weight and the amount of fat carried in the blood. Binge drinking is particularly dangerous.
By adopting a healthy lifestyle with plenty of exercise, eating a diet rich in fresh fruit, vegetable and wholegrains, reducing your intake of animal fat, processed food and salt, limiting alcohol and stopping smoking can make a difference to your chances of developing coronary heart disease and improve your survival chances should you develop it.
Ways to a healthy heart
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Eat five portions of fruit and vegetables a day. They can be fresh, frozen, tinned or dried and can be raw or cooked.
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Reduce the amount of fat in your diet.
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Eat two portions of fish a week, one of them oily fish such as mackerel, trout or salmon.
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Reduce the amount of salt in your diet.
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Don’t drink too much alcohol and observe government guidelines of no more than two to three units a day for women and three to four for men.
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Maintain a healthy weight – if you carry excess weight around your middle you are more at risk of developing coronary heart disease.
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Take regular exercise.
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Get your blood pressure and cholesterol checked by your GP.
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