Coronary Heart Disease And Nutrition

What is coronary heart disease?

Heart disease is the leading cause of death affecting around 9 million people in 2019 worldwide.¹ There are 4 common types of heart disease, including strokes and TIAs (transient ischaemic attacks), peripheral arterial disease, aortic disease and coronary heart disease. They all appear under the term ‘cardiovascular disease,’ which are conditions affecting the heart and blood vessels. Coronary heart disease, also referred to as ischaemic heart disease or coronary artery disease, affects the coronary arteries surrounding the heart. The heart requires oxygenated blood to function, and the left and right coronary arteries surround the heart and supply this oxygen-rich blood to the heart and carry deoxygenated blood away from the heart. 

Coronary heart disease is when the heart’s blood supply is obstructed by fatty substances (plaque or atheroma) on the arteries' walls which are supplying blood to the heart. The build-up of fatty substances is called atherosclerosis which causes arteries to narrow, depriving vital organs of an efficient blood supply. Atherosclerosis can lead to chest pain (angina) and also increase the risk of blood clots which could restrict the flow of blood to the brain or the heart and consequently cause heart attacks and strokes.² 

Management of atherosclerosis

As discussed previously, atherosclerosis leads to the potential development of coronary artery disease. Atherosclerosis is irreversible; however, healthy lifestyle changes may prevent it from getting worse and causing further risk of health problems such as heart disease. 

Healthy lifestyle changes can be implemented by: 

• Quitting smoking 
• Following a healthy and balanced diet
• Exercising frequently 
• Reducing alcohol consumption 
• Maintaining a healthy Body Mass Index (BMI)

Occasionally, the changes mentioned above may not be enough, and additional treatments may be the only option, these include: 

• Taking statins - Statins help to lower LDL cholesterol production in the liver
• Medicine for high blood pressure
• Low-dose aspirin which helps to reduce the risk of blood clots 
• Medical procedure to bypass a narrowed artery

Can food cause coronary heart disease?

Coronary heart disease is caused by a build-up of plaque on the inner walls of the arteries surrounding the heart.

The contributing risk factors to developing coronary heart disease are :³ 

• Elevated blood pressure 
• High cholesterol levels 
• Diabetes 
• Smoking 
• Sedentary lifestyle 
• Being overweight 

There are some risk factors that we cannot control: 

• Family history of heart disease 
• Age 

Food can contribute to the cause of coronary heart disease

As mentioned above, there are risk factors that lead to heart disease, some of which are food-related. In most cases, a high-fat diet accompanied by a lack of exercise, alcohol consumption and smoking is linked to fat deposits in the coronary arteries causing an inefficient delivery of blood to the heart and body.

One of the main causes of elevated cholesterol levels in the blood is a diet high in saturated and trans fats. Saturated fats can usually be found in dairy products and fatty meats; whereas, trans fats are usually found in processed foods such as packaged goods, margarine and desserts.⁴ It is advised to opt for lean proteins and polyunsaturated fats instead, such as nuts seeds and fish, as they are much more beneficial alternatives. 

A diet high in vegetables, fruits, whole grains and legumes is high in dietary fibre which has been associated with a lower risk of coronary heart disease.⁵ There is also evidence to show that minimising the consumption of processed meats, sweetened beverages and refined carbohydrates contributes to a decreased risk of heart disease.⁶ In summary, keeping to a healthy weight, maintaining physical activity levels as advised by the government guidelines and quitting smoking will reduce your risk of developing heart disease. 

Coronary heart disease can cause symptoms similar to heartburn

Angina is a symptom of coronary heart disease, whereas heartburn is a common symptom of acid reflux. Although chest pain is a symptom of both angina and heartburn, there are key differences between the location of the pain and the type of pain between them both. 

Symptoms of Angina are: 

• Dull pain (or tightness) in the middle of the chest 
• Pain can spread to other parts of the body (arms, neck, jaw or back)
• Irregular heartbeat 
• Dizziness 
• Nausea and vomiting

Symptoms of Heartburn are: 

• Burning chest pain that initiates at the breast bone
• Pain travels up to the throat via the oesophagus
• Pain does not travel to different parts of the body 
• Acidic taste in the mouth/throat

When to contact a doctor

If you experience any of the symptoms mentioned above, contact your GP to make an appointment. If symptoms begin to worsen and you experience intense chest pain, pain running down the left arm, and sudden dizziness, it is advised to seek immediate help as these may be signs of a heart attack. 

Conclusion

Coronary heart disease affects the coronary arteries surrounding the heart. The arteries become blocked with plaque resulting in a narrower passage for blood to pass through. This restricts blood flow and therefore oxygen delivery to vital organs and may lead to blood clots and eventually heart attacks and strokes. A high-fat diet, lack of exercise, excessive intake of alcohol, genetics, smoking and age can all contribute to the risk of developing heart disease. Minimising the consumption of trans fats and saturated fats, sweetened beverages and implementing a high-fibre diet (with plenty of fruit and vegetables) contributes to a lower risk of developing coronary heart disease. In more extreme cases, when lifestyle changes and medications are not sufficient, heart surgery can be performed to bypass blockages and improve the flow of blood to the heart.