Despite tremendous progress in reducing premature mortality from heart disease, it remains the leading cause of death in people assigned both male and female in the United Kingdom.
Cardiovascular disease is responsible for more than 160,000 deaths per year, according to research published by the British Heart Foundation.1 It now affects around 7.6 million people in England, making it a significant proportion of all long-term diseases. Every year, billions of dollars are spent on research to find better ways to prevent and treat heart disease.
An Overview of Cardiovascular Disease
Types & Symptoms
Cardiovascular disease (CVD) refers to any disorder that affects the heart or blood vessels. It is typically associated with the formation of fatty deposits within the arteries (atherosclerosis) and an increased risk of blood clots. There are four types of CVD. Causes and symptoms vary depending on the type of CVD you have, but they also vary between individuals. You may not experience exactly the same symptoms as others.2
- Coronary heart disease: It happens when the flow of oxygen-rich blood to the heart muscle is restricted or reduced due to fatty deposits in the coronary arteries. These fatty deposits can cause the walls of your arteries to break, adding additional stress to the heart, leading to angina, heart attacks, and heart failure. The most common symptoms are chest pain, shortness of breath, feeling faint (dizziness) and feeling sick (nausea).3
- Stroke and TIA: This refers to conditions where the blood supply to some area of the brain is cut off, resulting in brain damage and possibly death. The term 'FAST' might help you remember the main signs of a stroke or TIA (F=the face has fallen on one side; A=unable to lift both arms; S=speech may be slurred or garbled; T=time to dial 999 immediately).4
- Peripheral arterial disease: There is a blockage in the arteries of the limbs, most commonly the legs. Many patients with PAD do not experience symptoms; however, some may experience dull or cramping limb discomfort, hair loss on the legs and feet, or numbness or weakness in the legs.5
- Aortic disease: A group of disorders that affect the aorta, the largest blood vessel in the body that carries blood from the heart to the rest of the body. An aortic aneurysm is a type of aortic disease in which the aorta weakens and bulges outward. This generally does not have symptoms, but it has the potential to burst and cause life-threatening haemorrhage.2
Make an appointment with your doctor if you suspect you are experiencing any of the above symptoms. Together, you can assess your risks, perform a few screening tests, and devise a plan to stay healthy.
The actual cause of CVD is unknown; however, numerous factors can increase your chance of developing it, referred to as "risk factors". The more risk factors you have, the more likely you are to develop CVD. Your GP will invite you to an NHS health check every 5 years if you are over the age of 40 for a CVD screening.6
- High blood pressure: One of the most important risk factors for CVD. If your blood pressure is too high, it can damage your blood vessels.
- Smoking: Tobacco contains toxic chemicals that can damage and constrict your blood vessels and increase your probability of developing lung cancers.
- Alcohol: Binge drinking can cause your heart to beat irregularly, leaving you feeling out of breath, exhausted, and affecting your blood pressure. These factors, when combined, can make you feel pretty ill, as well as increase your chance of a heart attack or sudden death. Heavy drinking can also weaken the cardiac muscle, making the heart less efficient at pumping blood. Cardiomyopathy is a condition that can lead to mortality, most commonly due to heart failure.7
- High cholesterol: Cholesterol is a fatty substance in your blood. Too much of it can cause your blood vessels to narrow, increasing your chances of having a blood clot.
- Diabetes: High blood sugar levels can damage the blood vessels that carry blood to and from your heart, starving the heart of oxygen and nutrients.8
- Inactivity: If you don't exercise regularly, you are more likely to have high blood pressure, high cholesterol, and be overweight. All of these are CVD risk factors.
- Being overweight or obese: Being overweight or obese increases your risk of developing diabetes and high blood pressure, risk factors for CVD. According to a published study, obesity is associated with an increased risk of developing cardiovascular disease (CVD), particularly heart failure (HF) and coronary heart disease (CHD). You are at risk if your BMI is 25 or more or if you have a waist measurement above 94 cm for people assigned male at birth and 80 cm for people assigned female at birth.
- Family history of CVD: If you have a family history of CVD, your risk of developing it is also increased. Tell your doctor about your family history so they can regularly check your blood pressure and cholesterol level.
- Ethnic background: In the UK, CVD is more common in people of South Asian and an African or Caribbean background.2
Treating Cardiovascular Disease
The treatment that you receive is determined by the type of heart disease that you have. CVD treatment typically includes a combination of lifestyle changes, medications, and surgery. We have learned a lot about the risk factors for CVD and can now offer lifestyle changes and medications to help reduce the risk.
- Stop smoking: If you smoke, try to quit as soon as possible as nicotine may damage your heart. NHS can provide smoking cessation services and nicotine replacement therapy if you find it difficult to quit by yourself.
- Have a balanced diet: Aim to eat more fruit and vegetables every day, and reduce or avoid red meat, processed meat, and sugar if possible.9 For hypertension patients, limit your salt consumption to a teaspoonful every day.10
- Exercise regularly: The NHS recommends that you have at least 150 minutes of moderate activity (e.g. brisk walking, cycling, and hiking) a week. If this is difficult for you, begin at a level that you are comfortable with and gradually increase the duration and intensity of your activity as your fitness improves.11 If you have existing conditions, talk to your doctor about your plan before starting.
- Maintain a healthy weight: A combination of regular exercise and a balanced diet can help you lose weight. You should aim to get your BMI below 25.
- Reduce alcohol: Try not to drink more than 14 units (6 pints of beer or 10 small glasses of wine) per week and spread it over three days or more.12
- Manage stress: Chronic stress is also a risk factor for CVD. If you are constantly overwhelmed, nervous, or dealing with stressful life events like moving, changing jobs, or going through a divorce, consult your doctor for advice.13
If lifestyle changes alone are not enough to control your heart condition, your doctor may prescribe some medications. The type of medication you receive will be determined by the type of heart disease you have. Some medications may also be provided to reduce or eliminate the risk of CVD. However, always consult your doctor before starting any medication. Some commonly prescribed medications include:3
- Blood-thinning medicines: aspirin, clopidogrel, and rivaroxaban
- Statins: atorvastatin, simvastatin, and rosuvastatin
- Beta-blockers: atenolol, bisoprolol, and metoprolol
- ACE inhibitors: ramipril and lisinopril
- Calcium channel blockers: amlodipine, verapamil and diltiazem
If the medications are ineffective, your doctor may propose certain procedures or surgery. The type of operation or surgery will be determined by the type of heart disease and the severity of heart damage.14 For example, if your arteries are completely or nearly completely blocked by plaque formation, your doctor may place a stent to restore normal blood flow.15
Some common interventional procedures or surgery include:3
- Percutaneous coronary intervention (PCI): a tiny balloon is put into the restricted artery to push the fatty tissue outwards, allowing blood to flow more freely
- Bypass surgery: a blood vessel is placed between the major artery leaving the heart and a part of the coronary artery beyond the narrowed or obstructed portion
- Heart transplant: using a healthy donor heart to replace a damaged or malfunctioning heart
Can you cure cardiovascular disease?
Unfortunately, CVD cannot be cured. When the heart muscle is destroyed as a result of a heart attack, it cannot regenerate. For example, once a heart attack has occurred and the heart muscle has died, we cannot repair those cells.
Similarly, if a heart valve becomes hard and calcified, there is no way to recover its flexibility. It has to be fixed or replaced.
Treatment can help manage symptoms and reduce the likelihood of further problems. Certain lifestyle changes and close monitoring can help improve or even prevent CVD.
Cardiovascular diseases are incurable but manageable. The treatment options can help recover from the damaging effects of CVD and live long, productive lives. It is critical to take control of your general health today before a diagnosis is made. This is especially true if you have a family history of heart disease or other diseases that put you at risk of heart disease. Start your lifestyle changes now - it will definitely benefit you in the future.
- Facts and figures [Internet]. [cited 2022 Mar 22]. Available from: https://www.bhf.org.uk/what-we-do/news-from-the-bhf/contact-the-press-office/facts-and-figures.
- Cardiovascular disease. nhs.uk [Internet]. 2017 [cited 2022 Mar 22]. Available from: https://www.nhs.uk/conditions/cardiovascular-disease/.
- Coronary heart disease. nhs.uk [Internet]. 2018 [cited 2022 Mar 22]. Available from: https://www.nhs.uk/conditions/coronary-heart-disease/.
- Symptoms of stroke. Stroke Association [Internet]. 2014 [cited 2022 Mar 22]. Available from: https://www.stroke.org.uk/what-is-stroke/what-are-the-symptoms-of-stroke.
- Peripheral arterial disease (PAD). nhs.uk [Internet]. 2017 [cited 2022 Mar 22]. Available from: https://www.nhs.uk/conditions/peripheral-arterial-disease-pad/.
- 9 Health tests that could save your life for over 50s. Age UK [Internet]. [cited 2022 Mar 22]. Available from: https://www.ageuk.org.uk/information-advice/health-wellbeing/health-services/health-tests-that-could-save-your-life/.
- Alcohol and the heart | Drinkaware [Internet]. [cited 2022 Mar 22]. Available from: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/alcohol-related-diseases/alcohol-and-the-heartlongtermheavydrinkingcanleadtoheartdisease.
- Diabetes and heart disease. Diabetes UK [Internet]. [cited 2022 Mar 22]. Available from: https://www.diabetes.org.uk/guide-to-diabetes/complications/cardiovascular_disease.
- Eat well. nhs.uk [Internet]. 2018 [cited 2022 Mar 22]. Available from: https://www.nhs.uk/live-well/eat-well/.
- High blood pressure (hypertension) - Prevention. nhs.uk [Internet]. 2017 [cited 2022 Mar 22]. Available from: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/prevention/.
- Exercise. nhs.uk [Internet]. 2018 [cited 2022 Mar 22]. Available from: https://www.nhs.uk/live-well/exercise/.
- The risks of drinking too much. nhs.uk [Internet]. 2018 [cited 2022 Mar 22]. Available from: https://www.nhs.uk/live-well/alcohol-support/the-risks-of-drinking-too-much/.
- The Effects of Stress on Your Body. Healthline [Internet]. 2017 [cited 2022 Mar 22]. Available from: https://www.healthline.com/health/stress/effects-on-body.
- Heart disease - Diagnosis and treatment - Mayo Clinic [Internet]. Mayoclinic.org. [cited 22 March 2022]. Available from: https://www.mayoclinic.org/diseases-conditions/heart-disease/diagnosis-treatment/drc-20353124
- Heart Disease: Risk Factors, Prevention, and More. Healthline [Internet]. 2018 [cited 2022 Mar 22]. Available from: https://www.healthline.com/health/heart-disease.