How to Prevent Cardiovascular Disease

Introduction 

Cardiovascular disease is a generalized term given to a range of conditions associated with problems in the heart and blood vessels that carry blood throughout the body. These conditions most commonly occur as the outcome of a continuous buildup of fat deposits in blood vessels such as the arteries. This buildup when occurring in the arteries is called atherosclerosis.

 This increases the risk of blood clot formation within the body. Cardiovascular diseases can affect multiple organ systems, including the brain, heart, kidneys, eyes, etc. 

Examples of cardiovascular diseases include; strokes, PVD (peripheral vascular disease) and Coronary Heart Disease (CHD) - alternatively known as Ischaemic Heart Disease or Coronary Artery Disease.

The exact cause of these diseases is unknown, however the environment, dietary habits, smoking, alcohol consumption, activity levels, genetics, other comorbidities (presence of other diseases with cardiovascular disease as an outcome), as well as mental and physical wellbeing, play an important role in contributing to the occurrence of these diseases.

 As of 2019, CVD is the primary cause of 17.9 million deaths per year thereby contributing to 31% of worldwide deaths (Waterall, 2021). Although that may bring about a sense of worry, it is vital to note that approximately 80% of cardiovascular diseases can be prevented by making healthy lifestyle choices.

The NHS has introduced a digital health check to give you an insight into your heart age in comparison to your real age. Click here to find out ‘How Healthy Is Your Heart’ ("What's your heart age?", 2016) [tool designed for people over 30 years of age].

Signs and Symptoms 

The signs and symptoms expressed by an individual can vary based on a variety of influencing factors and risk factors. Some people are more likely to not  show any symptoms causing the disease to go undetected until they have a heart attack (myocardial infarction), chest pain or sudden cardiac arrest.

 The National Heart, Lung and Blood Institute (U.S. Department of Health & Human Services) outlines a variety of signs and symptoms explained below (Coronary Heart Disease | NHLBI, NIH, 2021): 

Signs and Symptoms of heart attack or other acute coronary events (outcome of cardiovascular disease) include:

-  Angina: chest pain marked by a sense of tightness, burning, pressure, dullness or heaviness in the chest, caused by reduced blood flow to the heart muscles. The pain may also be experienced in the back, jaw, shoulders and/or throat, often similar to that experienced during indigestion. 

- Cold sweats or in combination with night sweats

- Disturbances in sleeping patterns

- Light-headedness or dizziness often experienced due to reduced blood flow, usually associated with blood vessel blockages (atherosclerosis) 

- Severe neck ache

- Shortness of breath or palpitations especially during strenuous physical activity, due to the presence of blockages within the cardiovascular and associated pulmonary systems. 

- Weakness, tiredness and fatigue due to lack of oxygen transport to the cells within the body. 

The blood carries oxygen required by cells to carry out regulatory activities. Lack of oxygen deprives the cells of nutrients causing them to exhaust the available energy stored within the body, physically occurring as fatigue. 

Signs and symptoms and gender

Females are more inclined to experience the following symptoms as opposed to males. Additionally, statistically females are less likely to experience chest pain (Maas and Appelman, 2010):

- Abdominal pain 

- Dizziness and lightheadedness

- Mild discomfort in the areas comprising the jaw, arms, back, or neck

- Nausea and/or vomiting 

- Pressure or tightness in the chest

- Sudden onset of fatigue and tiredness 

Signs and symptoms of PVD (Peripheral Vascular Disease) 

These signs include the symptoms experienced by areas other than the cardio-pulmonary areas within the body. Peripheral vascular disease refers to the disease associated with reduced blood flow throughout the body, due to the buildup of plaque or fatty deposits within the arteries and other blood vessels.

 This is the primary cause of reduced blood flow in the extremities, causing the following signs and symptoms (Firnhaber and Powell, 2019): 

- Coldness and/or numbness experienced in your legs when at rest.

- Sharp pain and /or cramping experienced in the calves, thighs and/or the gluteal area (buttocks).

- Ulcers develop in the feet and/or legs. These are marked by signs of poor wound healing due to the lack of blood flow to the lower extremities.

- If these symptoms are left unattended, they have the potential to culminate into serious problems. It is vital to contact your local healthcare provider when you experience any of these symptoms as leaving this untreated can culminate in the complete loss of blood flow and circulation to the feet and legs. 

This can further complicate and result in gangrene and fungal formations which could potentially lead to amputations.  

Signs and symptoms of stroke are attributed to cardiovascular artery disease effects on the brain. These include the following (Caplan, 2021):

- Dizziness

- Facial drooping (often on one side), inability to smile, drooping of eyes and mouth 

- Inability to move arms or balance arms upon movement attributing to weakness, numbness and/or tingling in the arms 

- Severe sudden onset headache 

- Speech impairments such as slurring of words, difficulty formulating words and sentences, problems in understanding speech, confusion, incoherency 

- Sudden loss of balance

- Visual problems, in one or both eyes 

Can You Reverse This Disease? 

Cardiovascular Disease encompasses diseases involving the heart and blood vessels that transport blood and other nutrients throughout the body. 

One of the most common associations is atherosclerosis, which is a progressive condition that builds up over time. 

Excess cholesterol consumption via dietary items, such as oily and fried foods, and excess sugar can cause the deposition of fats in the artery walls. This can prompt the white blood cells to attack this on account of recognizing these deposits as foreign, further causing immune-mediated inflammatory responses throughout the body. 

Additionally, upon the immune system attacking these ‘foreign’ deposits the attacked cells turn into dead cells that can accumulate in the arteries and/or other blood vessels leading to inflammation, scarring, calcification and stiffening in these areas. This causes the blood vessels to become narrower which reduces blood flow, thereby increasing the risk of heart attacks and strokes. 

Cardiovascular disease cannot be cured or reversed, but treatment can prevent and manage the symptoms. These preventive measures include:

 -Maintaining a healthy diet, balanced with the primary dietary elements, in their appropriate quantities, including external supplements in case of dietary restrictions is important.

-Regular exercising is a supplementary factor. 

-Avoiding stress or stressful situations, as it can aggravate the symptoms, severity and in some cases incidence of cardiovascular disease. 

-This can be reduced with good physical wellbeing and mindfulness to contribute to mental wellbeing. Smoking cessation is also a vital preventive and associated therapeutic modality. 

Blood thinners can help mitigate the risk of heart attacks experienced due to blockages in the arteries that supply blood to the heart muscle. These also help in preventing clot formation. These may be prescribed to you by your doctors and include low-dose aspirins, rivaroxaban, clopidogrel, ticagrelor and statins for high cholesterol levels, including simvastatin, rosuvastatin, atorvastatin, pravastatin, or beta blocker such as atenolol, metoprolol, bisoprolol.

 Diuretics, Calcium channel blockers, ACE inhibitors and other drugs are commonly prescribed to treat cardiovascular disease and their associated consequences. These reduce the harmful effects and risk of complications (NHS 2020). 

Lifestyle factors

The following lifestyle factors have the greatest impact on increasing your risk of this chronic health condition/disease.  We will also look at what you can do to reduce your risk from today. 

Nutrition 

Nutrition plays a key role in maintaining and improving general physical and mental wellbeing. (Casas, Castro-Barquero, Estruch and Sacanella, 2018). In accordance with the information published by the WHO (World Health Organisation), it is imperative to understand that moderate lifestyle changes have the potential to prevent the incidence in about 3/4^th of the cases of cardiovascular disease. This is supplemented by the evidence of the influence of different types of foods and nutritional elements that play a key role in preventing cardiovascular disease. It is also vital to note that vitamin D, docosahexaenoic acid (DHA) and omega-3 eicosapentaenoic acid (EPA) play a vital role in cardiovascular health (Reedy, et al., 2014). 

Foods including whole grains, vegetables, fruits, legumes, lentils, nuts, berries and seeds have useful antioxidative and anti-inflammatory properties amongst others. They have the potential to regulate certain fluid and electrolyte balances within the body and promote general health as well. Highly sugary foods, oily foods, fatty foods, fried foods, carbonated drinks, red meat, highly processed foods, excess dairy products and artificial sugars have a high potential of increasing the risk of cardiovascular diseases and their associated effects. This is due to their deposits within the body in the form of plaque and subsequent blockages causing reduced blood flow throughout the body (Pallazola, et al., 2019). 

Physical activity 

It is a known fact that exercise not only improves physical wellbeing, but also mental wellbeing. It can reduce a variety of risk factors such as obesity, stress, fatigue and other comorbidities (Nystoeiak and Bhatnagar 2018). Physical activity does not mean you have to drag yourself to the gym, if you find that painfully boring. Exercise can be in any form or the development of your hobbies. Yoga, tai-chi, swimming, jogging, cycling, hiking, squash, tennis, football, basketball, cricket, spinning, hockey, baseball and other sports can also be forms of exercise. If you are not a sports person, indoor cycling, treadmill or walks for nature lovers are useful alternatives.  

Obesity 

Obesity is an important causative agent in cardiovascular diseases. Prevention of obesity is extremely important not only to prevent and to reduce the severity and presentations of cardiovascular disease, but also, to prevent other complications affecting the kidneys, hormones, brain, liver and nerves. Obesity has multifactorial origins including biological, social, economic and psychological elements. However, the primary preventive measure includes healthy balanced diets, regular exercise, practising mindfulness and regular mental and health check-ups (Powell-Wiley, et al., 2021). 

Smoking 

Tobacco use, smoking, smokeless tobacco use, vaping and second-handed tobacco smoke play an important role in the incidence of cardiovascular disease. Toxins present in tobacco, including nicotine and carbon monoxide have the potential to trigger most of the symptoms of cardiovascular disease. This is because the toxins can cause platelets in the blood to join together, accumulating to form clots. These can lodge in the blood vessels causing blockages and heart attacks. They can also cause muscular spasms as they reduce the amount of blood reaching the muscles (heart). They also cause irregular heartbeats called arrhythmias and affect the brain centres due to the release of chemicals within the brain. They also reduce the amount of oxygen and nutrients reaching the cells, via blood. Smoking increases the risk of people around you as well. It is extremely vital to understand the implications of smoking and how to reduce and stop the habit. 

For more information on how to give up smoking click here (Robinson & Smith, 2021).

Alcohol 

Alcohol has damaging effects not only on the cardiovascular system, but throughout the body. Although a variety of genetic factors, behavioural and biological components influence the associations of alcohol consumption and cardiovascular health, the quantity and frequency of alcohol consumption increase the adverse effects of alcohol on health. Alcohol has the potential to cause alterations in blood circulation, increase in oxidative stress, death of cells and tissues, tissue scarring and failure of cells and subsequently other associated organs (Piano, 2017). Binge drinking is a common cause of irregular cardiovascular symptoms such as increased heart beats or arrythmias. This is typically measured as consuming 15 units (7.5 pints) of alcohol in a 24-hour period. The Chief Medical Officers’ guidelines for males and females indicate that it is safest not to consume more than 14 units of alcohol per week. 14 units is equivalent to six pints of average strength lager (4% ABV), or six medium glasses of wine (175ml, 12% ABV).These alcohol intakes should be spread out over several days so as to avoid binge drinking. Alcohol consumption also increases the risk of cancer. The following tools can help in understanding your health and alcohol.

• For alternative to cocktails (type of alcoholic drinks) click here 
• To build an action plan to reduce drinking click here 
• To find out if you are drinking too much click here 
• To reduce your drinking by planning drink-free days click here
• To understand your alcohol consumption, click here
• To get help, advice and information about drinking click here
• For information about AA (Alcoholics Anonymous - support organisation for recovery and continued progressives sobriety), Great Britain click here  

Sleep 

Research supports that a good and healthy sleeping pattern is associated with reduced risk of cardiovascular diseases in individuals across the globe. (Fan et al., 2019). Most adults need seven to eight hours of complete, uninterrupted sleep throughout the night in order to maintain good health both physically and mentally. During normal sleep our blood pressure tends to reduce, as a result, lack of sleep and increase it and add to fatigue. Sleep problems such as sleep apnoea can also increase the risk of cardiovascular diseases as it reduces the amount of oxygen reaching the components of the body. In order to reduce this risk, physical activity and a good diet are vital. It is also worth considering reducing caffeine, sugar and carbonated drinks and increasing the intake of whole foods, vitamins and minerals. Avoiding artificial lights, screen time and the use of nicotine before sleeping can help improve the quantity and quality of your sleep. 

Mental health 

The leading causes of mortality and morbidity, globally, are cardiovascular disease and mental illness, with research supporting the association between cardiovascular disease and mental illness such as schizophrenia, depression, anxiety, bipolar disorder and more (De Hert, Detraux and Vancampfort 2018). People with severe mental illnesses have a higher risk of developing more pronounced effects of cardiovascular disease. However, it is vital to maintain our mental health in order to prevent the onset of cardiovascular and/or mental illness and promote general well being. 

There are a variety of tools present online to help you with practicing mental health measures, as listed below:

- To join online communities or support groups to cope, discuss and understand mental illness click here

- To find applications (mobile phone based) to help monitor your mental health click here 

- For a depression screen tool click here

Wellness 

Wellness refers to a positive physical and mental state contributing to the general well-being of an individual. Mindfulness is a key factor of maintaining a generalised sense of well-being. 

It is a way of paying attention and increasing our awareness with regard to our physical health, mental health, emotional health, people and our surroundings in the environment. Mindfulness involves the use of small practices such as meditation, breathing exercises, cognitive therapy, active discussions and more. Additionally, maintaining a schedule, and finding out your dietary and exercise likes, dislikes and patterns can help streamline an approach to help you cater to your own needs whilst actively maintaining a healthy lifestyle. 

Conclusion 

Heart diseases, cardiovascular diseases and associated complications sound dangerous, risky and fatal. However, if you increase your sense of awareness towards yourself, your mind, body and surroundings whilst applying the actionable preventive measures as described above, you have a very good chance of staying miles away from these diseases! Healthy dietary patterns, regular exercise, maintaining a healthy weight, reducing stress, mediation, smoking cessation, reduction in alcohol consumption, regular health check-ups, using dietary supplements and keeping an eye out for warning signs can definitely make you more cautious towards cardiovascular diseases. 

It is vital to familiarise yourself with the signs and symptoms as well as risk factors of cardiovascular disease in order to allow early detection and subsequent treatment, to improve the prognostic outcome. For more information on preventing the incidence of cardiovascular disease, as outlined by WHO, click here 

Diagnostic testing 

At Klarity we use the latest technology when it comes to diagnostic testing. Our home blood tests give you health insights and personalised recommendations.  Find out which test you should take.