Heart Disease - How to keep your heart healthy

Heart disease is the second most common cause of death in the UK and is something that many of us will have been affected by, either personally or by its impact on friends or relatives. Unfortunately, many aspects of modern life increase our risk of heart disease and, despite increased awareness of the dangers, the impact of heart disease is still very large in the UK and other countries.

The heart is, of course, fundamental to life. The right side of the heart pumps blood into the lungs where it picks up oxygen and unloads carbon dioxide, and the left side of the heart pumps the blood all around the rest of the body to keep all our organs, muscles and other soft tissues supplied with oxygen and nutrients. It is when something impacts on the heart’s ability to perform these functions that we develop symptoms of heart disease.

When considering heart disease, most people think of ischaemic heart disease which includes:

• Angina 
• Myocardial infarctions (better known as heart attacks) 

These are the most common underlying problem in people suffering with cardiac problems. 

The classic symptom of ischaemic heart disease is crushing central chest pain which may radiate up to the jaw or into the left arm. 

In angina, this pain usually comes on with exertion or with stress and then settles with rest, generally lasting just a few minutes.

In a heart attack, the pain persists for longer, and this represents more significant and lasting damage being done to the muscle of the heart.

If the damage to the heart is severe enough then the heart will stop beating properly altogether. This is cardiac arrest and leads to death unless someone responds immediately by delivering CPR. Learning CPR is lifesaving and something that everybody should think about doing as you simply never know when you may need to use it.

You can learn CPR in just 15 minutes through the British Heart Foundation free online training. Click here for more information.

Not everybody with angina or a heart attack will experience the classic symptoms.

Some people will experience angina or heart attacks as:

• Breathlessness
• Feeling clammy and sick
• Palpitations (a very forceful or rapid heartbeat)

Symptoms such as these should always be investigated. If they are short lived but keep occurring, then this is usually done via an initial assessment with your GP which will probably include an examination, blood tests and an ECG.

If the symptoms are severe and prolonged (lasting more than 5-10 minutes) then you should call for an ambulance to take you to hospital.

Heart disease can also cause the condition of ‘heart failure’. This is when the heart is no longer pumping as efficiently as it should. This causes fluid to build up in the lungs or elsewhere in the body – a condition known as oedema. 

Typically, heart failure causes symptoms of: 

• Breathlessness on exertion
• Feeling breathless when you lie down flat in bed
• Waking up breathless in the middle of the night, and swelling of the ankles. 

If heart failure is suspected, then an echocardiogram is performed. This is an ultrasound scan which allows doctors to see if it is pumping properly and if there is any evidence of significant damage after, for example, a previous heart attack.

If there is a problem affecting the electrical circuitry of the heart then people may experience palpitations. 

These are sometimes fleeting and short lived and are usually investigated with blood tests and ECGs, but if you experience a prolonged episode of palpitations then you should call for an ambulance, especially if these are associated with feeling faint, feeling short or breath, or with chest pain. 

High blood pressure is a big risk factor for heart disease. When blood pressure is raised, it puts stress on the walls of arteries which then encourages the build up of atherosclerotic plaques. Uncontrolled high blood pressure can also cause the heart muscle to become thickened or damaged which then impacts on the pumping efficiency. 

Another major risk factor for heart disease is diabetes which is another condition that is very common in the UK. 

Like ischaemic heart disease, a sedentary lifestyle and poor diet are risk factors for diabetes, but the raised blood sugar levels in diabetes also cause direct damage to the blood vessels that supply the heart. Identifying and treating diabetes early is therefore really important for reducing the risk of heart disease. You can check for diabetes via a simple blood test.

Fortunately, there are many effective treatments for heart disease but, better still, is to avoid it developing in the first place. Family history has a part to play but most of the other contributing factors to heart disease are things that you can change through lifestyle, diet and, if necessary, medication.

There are a number of key, modifiable risk factors for heart disease. 

1) Stop Smoking

Perhaps the biggest risk of heart disease is smoking. Smoking is bad for almost any part of the body you care to mention but, in the heart, it contributes to the build of fatty plaques (atherosclerosis) in the arteries around the heart that supply blood to the heart muscle itself. 

This build up of plaque narrows these arteries and restricts the blood flow. It is when the restriction is so great that not enough blood reaches the heart muscle that people start experiencing symptoms of angina. Sometimes the artery gets completely closed off, leading to death of part of the muscle, and this is what occurs in a heart attack.

The atherosclerotic plaques that build up in the arteries are composed in large part of cholesterol. The higher your level of blood cholesterol, particularly LDL or ‘bad’ cholesterol, the greater the risk that these plaques will develop. This is why it is important to check cholesterol levels and to reduce these when necessary. You can check Cholesterol levels through a simple blood test. Cholesterol can be improved to an extent with diet and exercise.

2) Introduce a Mediterranean diet

The diet that is commonly recommended to lower cholesterol is the Mediterranean diet.

This diet:

• Is low in dairy and red meat
• Is high in fibre
• Uses oily fish and chicken as sources of protein
• Includes olive oil which has cholesterol lowering properties.

3) More Exercise

Introducing even small amounts of exercise into your daily routine will also bring benefits.

The UK government recommends that all adults undertake at least 150 minutes of moderate intensity exercise each week.

The biggest health gains from exercise actually occur at the lower end of activity levels. What this means is that someone who goes from undertaking no exercise to doing just a little bit of exercise improves their health outcomes enormously.

This benefit is independent of weight loss, so increasing activity levels should be seen as an aim in itself, not just as a means to lose weight. People who are already very active will also get additional benefit from being more active, but the gains are less dramatic than for those who go from being very sedentary to moderately active.

4) Medications

If lifestyle measures are not enough to reduce the risk of heart disease, then there are a range of medications that can effectively reduce cholesterol and reduce cardiovascular risk for the future. 

4) Monitoring health -  blood tests

More targeted to general health, but regularly monitoring your health can pick up the early signs of health issues, including the risk of heart disease. Blood tests for Cholesterol and Diabetes are recommended tests.

Heart disease is common but much of it is preventable. The way to prevent it is generally straightforward – take regular exercise, stop smoking, eat healthily, and maintain a healthy weight. 

Other measures you can take to reduce your risks of heart disease are having your blood pressure checked, checking your levels of cholesterol and checking for diabetes or pre-diabetes. Once these are under control, your risk of developing problems with your heart will be much reduced.