Cardiovascular disease

Introduction

Cardiovascular disease (CVD) is a general term that describes a disease of the heart or blood vessels.

Blood flow to the heart, brain or body can be reduced as a result of a:

  • blood clot (thrombosis)
  • build-up of fatty deposits inside an artery, leading to the artery hardening and narrowing (atherosclerosis)

Types of CVD

There are four main types of CVD:

  • coronary heart disease
  • stroke
  • peripheral arterial disease
  • aortic disease

Each type is discussed in more detail below.

Coronary heart disease

Coronary heart disease (CHD) occurs when your heart's blood supply is blocked or interrupted by a build-up of fatty substances (atheroma) in the coronary arteries. The coronary arteries are the two major blood vessels that supply your heart with blood.

If your coronary arteries become narrow due to a build-up of atheroma, the blood supply to your heart will be restricted. This can cause angina (chest pains). If a coronary artery becomes completely blocked, it can cause a heart attack.

Read more about coronary heart disease.

Stroke

A stroke is a serious medical condition that occurs when the blood supply to the brain is disturbed.

Like all organs, your brain needs a constant supply of oxygen and nutrients to function properly. This is provided by the blood, so if your blood flow is restricted or stopped, brain cells will begin to die. This can lead to brain damage and possibly death.

Therefore, a stroke is a medical emergency and prompt treatment is essential. The sooner a person receives treatment, the less damage is likely to occur.

The main stroke symptoms can be remembered with the word FAST which stands for:

  • Face  the face may have drooped on one side, the person may not be able to smile or their mouth or eye may have drooped
  • Arms  the person with suspected stroke may not be able to lift their arm and keep it raised due to weakness or numbness
  • Speech  the person's speech may be slurred or garbled, or they may not be able to talk at all despite appearing to be awake
  • Time  it is time to dial 999 immediately if you see any of these signs or symptoms

Read more about stroke and recognising the signs of stroke.

Peripheral arterial disease

Peripheral arterial disease, also known as peripheral vascular disease, occurs when there is a blockage in the arteries to your limbs (usually your legs).

The most common symptom of peripheral arterial disease is pain in your legs when walking. This is usually in one or both of your thighs, hips or calves.

The pain can feel like cramp, a dull pain or a sensation of heaviness in the muscles of your legs. It usually comes and goes and gets worse during exercise that uses your legs, such as walking or climbing stairs.

Read more about peripheral arterial disease.

Aortic disease

The aorta is the largest blood vessel in the body. It carries blood from your heart to the rest of your body.

The most common type of aortic disease is aortic aneurysm, which is where the wall of the aorta becomes weakened and bulges outwards. You will usually experience pain in your chest, back or abdomen (tummy).

Preventing CVD

Most deaths caused by cardiovascular disease are premature and could easily be prevented by making lifestyle changes, such as eating a healthy diet and stopping smoking.

It is estimated that CVD is responsible for around 1 in 3 premature deaths in men and 1 in 5 premature deaths in women.

Read more about how to prevent cardiovascular disease.

Risk factors for cadiovascular disease

There are nine main risk factors for cardiovascular disease (CVD), including high blood pressure, smoking, poor diet, lack of exercise and being overweight or obese.

Many of the risk factors are linked, which means that if you have one of the risk factors you are also likely to have others.

The risk factors for CVD are discussed in more detail below.

  • High blood pressure (hypertension)  is by far the most important risk factor for CVD. Poorly controlled high blood pressure can damage your artery walls and increase your risk of developing a blood clot.
  • Smoking (or other tobacco use)  the toxins in tobacco can damage and narrow your coronary arteries, making you more vulnerable to coronary heart disease.
  • High blood cholesterol  can cause your arteries to narrow and increase your risk of developing a blood clot.
  • Diabetes  the high blood glucose (sugar) levels associated with type 1 diabetes or type 2 diabetes can damage the arteries. Many people with type 2 diabetes are also overweight or obese.
  • Poor diet  a high fat diet can speed up the formation of fatty deposits inside your arteries, leading to both high blood cholesterol levels and high blood pressure. 
  • Lack of exercise  people who do not exercise regularly usually have higher cholesterol levels, high blood pressure, high stress levels and are also more likely to be overweight.
  • Being overweight or obese  being overweight or obese increases your risk of developing diabetes and high blood pressure. People who are overweight or obese often have poor diets and do not exercise regularly. Read more about obesity.
  • Excessive alcohol consumption  can increase both your cholesterol levels and blood pressure.
  • Stress  stress can increase your blood pressure and the hormones associated with stress are thought to also increase your blood glucose levels.

Read more about preventing cardiovascular disease in adults and preventing cardiovascular disease in children

Preventing cardiovascular disease in adults

Most risk factors for cardiovascular disease (CVD) are linked, which means that if you have one risk factor you will probably have others as well.

For example, people who are heavy drinkers usually have poor diets and are more likely to smoke. Also, obese people are more likely to have diabeteshigh cholesterol and high blood pressure.

Addressing one risk factor, such as giving up smoking, will bring important health benefits, but to significantly reduce your risk of developing CVD, you need to look at your lifestyle as a whole.

In particular, you need to consider:

  • your diet
  • your weight
  • the amount of alcohol you drink 
  • the amount of exercise and physical activity you do
  • whether you need to stop smoking

Each of these is discussed below. 

Alcohol

If you drink alcohol, you should not exceed the recommended daily limits of 3-4 units for men, and 2-3 units for women.

A unit of alcohol is roughly equivalent to half a pint of normal strength lager, a small glass of wine or a single measure (25ml) of spirits.

You should see your GP if you are finding it difficult to moderate your drinking. Counselling services and medication can help you reduce your alcohol intake.

Read more about alcohol units and treating an alcohol addiction.

Diet

For a healthy heart, a low fat, high fibre diet that includes whole grains and plenty of fresh fruit and vegetables (at least five portions a day) is recommended.

Your diet should include no more than 6g (0.2oz or one teaspoon) of salt a day. Too much salt will increase your blood pressure. Limit the amount of salty foods you eat, such as ready-made meals and canned or tinned food.

Do not eat foods high in saturated fat because this will increase your cholesterol level. These foods include:

  • meat pies
  • sausages and fatty cuts of meat
  • butter and ghee (a type of butter often used in Indian cooking)
  • lard
  • cream
  • hard cheese
  • cakes and biscuits
  • foods that contain coconut or palm oil

Eating some foods high in unsaturated fat can help decrease your cholesterol level. These foods include:

  • oily fish
  • avocados
  • nuts and seeds
  • sunflower oil
  • rapeseed
  • olive oil

Read more about healthy eating.

Exercise and weight management

If you are overweight or obese, you can lose weight using a combination of regular exercise and a calorie-controlled diet.

The recommendation for adults is 30 minutes of moderate intensity aerobic exercise every day for at least five days a week.

Read more about the physical activity guidelines for adults.

Cycling or brisk walking are examples of moderate intensity exercise. Other activities you could incorporate into your exercise programme include:

If you find it difficult to do 150 minutes of moderate intensity exercise each week, start at a level you feel comfortable with.

For example, do 5-10 minutes of light exercise a day and gradually increase the duration and intensity of your activity as your fitness level improves.

Read more about the benefits of exercise and losing weight.

Smoking

If you smoke, it is strongly recommended you give up as soon as possible.

The NHS Smokefree website provides information, support and advice. Your GP will also be able to recommend and prescribe medication to help you quit.

Read more about stopping smoking.

Medication

If you have a particularly high risk of developing CVD, your GP may prescribe medication to help reduce your risk. Medication used to prevent CVD includes:

  • blood pressure tablets, such as angiotensin-converting enzyme (ACE) inhibitors  used to treat high blood pressure
  • statins  used to lower blood cholesterol levels
  • low-dose aspirin  used to prevent blood clots

Preventing cardiovascular disease in children

There is a significant amount of good quality evidence to show that eating and drinking habits established during childhood can continue for many years into adulthood.

Therefore, while bad eating habits in childhood may not pose an immediate health risk, they could lead to serious health problems in adulthood.

Four important things to consider are the amount of:

  • fat in your child's diet
  • salt in your child's diet 
  • sugar in your child's diet
  • exercise your child does 

Salt

Eating high levels of salt in childhood has been linked to an increased risk of high blood pressureheart disease and stroke in adulthood.

For babies and children, the current recommended limits of salt are:

  • less than 1g of salt a day for children aged 0-6 months
  • 1g a day for children aged 7-12 months
  • 2g a day for children aged 1-3 years 
  • 3g a day for children aged 4-6 years
  • 5g a day for children aged 7-10 years 
  • 6g a day for children aged 11-14 years

It is easy to underestimate how much salt is contained in food. For example, a Happy Meal consisting of small fries, a hamburger and a coke contains 1.8g of salt, which is over half the recommended daily limit for a five year old.

Pre-packaged and ready-to-eat foods, particularly those not specifically designed for children, often contain high levels of salt. For example, a 200g tin of tomato soup contains 1.4g of salt.

You should always check the label of any foods you give your children so you can keep an eye on their daily salt consumption.

Read more about salt: the facts.

Fats and sugar

You should also limit the amount of saturated fat and sugar your child eats.

Too much saturated fat and sugar in your child's diet can lead to high cholesteroldiabetes and high blood pressure in later life. They can also increase your child's risk of becoming overweight or obese. A diet high in sugar can also cause tooth decay.

Children’s foods high in saturated fats and sugar include:

  • chocolate
  • sweets
  • fast food, such as burgers or chicken nuggets
  • fizzy drinks
  • ice cream
  • biscuits
  • crisps
  • processed foods, such as microwave meals, hot dogs and breakfast cereals that contain additional sugar

Read more about fat: the facts and sugars.

Exercise

Most children are naturally active and full of energy. However, children who spend a lot of time doing pastimes that do not involve much physical activity, such as watching television and playing computer games, do not get the exercise they need.

It is recommended that:

This amount of exercise is enough to strengthen bones and muscles and can help prevent children putting on weight.

There are many different ways for children to exercise. Simply walking or cycling to school is a good way to start. Team sports can also be great fun and can improve co-ordination, balance and team skills.

Most community sports centres run team activities for children, such as football, basketball and volleyball. Ask your local sports centre for more information.

If your children do not like team sports, there are plenty of other fun activities for them to try, such as hiking, swimmingdance and kickboxing.

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Map of medicine: Cardiovascular disease risk management