The lowdown on heart health

Heart-related diseases cause a quarter of all deaths in the UK, but there are simple ways to prevent problems and new treatments that can make a huge difference

CAUSES: HIGH CHOLESTEROL

There are two main types of cholesterol, one good, the other bad. Cholesterol is carried in your blood by proteins, which together are called lipoproteins. High-density lipoprotein (HDL) is the ‘good’ cholesterol. This is because it gets rid of the ‘bad’ cholesterol – nonhigh- density lipoprotein (non-HDL) from your blood. It takes cholesterol you don’t need to the liver, where it is broken down and passed out of the body. If there is too much non-HDL it can build up on the walls of blood vessels, causing narrowing of the arteries, which increases your risk of heart attack or stroke.

HIGH BLOOD PRESSURE

Medically known as hypertension, this means your heart has to work harder to pump blood around your body. If you ignore it this can lead to heart attacks or strokes – about 50 per cent are associated with high blood pressure. Around 28 per cent of adults in the UK have high blood pressure and more than half of them are not receiving effective treatment. So get checked.

DIABETES

People with diabetes are up to three times more likely to suffer from heart disease.

OBESITY

About 30 per cent of UK adults are obese or overweight, and one in six heart disease deaths are linked to a high body mass index (BMI), so maintaining a healthy weight can be a key factor in reducing your risk.

FOOD AND DRINK

The received wisdom has always been that dairy products are bad for heart health, but a recent study found that drinking a glass of milk a day can significantly reduce the risk.

Researchers looked at more than two million people in the US and the UK who have a genetic mutation that enables them to consume large amounts of milk. Professor Vimal Karani, a nutritionist at the University of Reading who led the study, says:

‘We found that participants with a genetic variation that we associate with higher milk intake had higher BMI and body fat but, importantly, lower levels of good and bad cholesterol. We also found that they had a significantly lower risk of coronary heart disease. All of this suggests that reducing the intake of milk might not be necessary for preventing cardiovascular disease.’

Other foods that have previously been considered bad for heart health are also being found to have a positive effect. Research has shown that people who regularly consume 20g – or two squares – of 70 per cent dark chocolate have improved blood flow. But be warned – processed chocolate with fewer cocoa solids will provide no improvement, scientists say.

Avocados are rich in vitamin B5, which can improve adrenal health, while their creamy texture and high protein levels can quell cravings for more fatty, unhealthier foods.

Stress can be a major cause of heart disease. If you start to feel those tell-tale signs of worry, then try eating a handful of pumpkin seeds. They are high in stress-relieving magnesium and are also great for those trying to lose weight – a double whammy when it comes to reducing your risk of heart problems. Green tea, nuts and wholegrain bread can all make a difference too.

Of course the biggest controversy is over alcohol. The most recent advice from the World Heart Federation, issued last month, is that even a daily glass of wine can be harmful.

SURGERY

If you do require heart surgery, make sure you understand what type of procedure you are having and what you can do to be healthy as possible both before and after the operation.

Transcatheter aortic valve implantation (Tavi) is the medical name for replacing a faulty heart valve. If you’re an adult in need of a valve replacement and aren’t well enough to have surgery to repair an existing valve, you may be offered a Tavi procedure instead.

There are four valves in your heart. The job of each one is to make sure blood is pumped through the heart in the correct direction. Valve surgery aims to open up narrowed valves to improve their function.

You can expect some discomfort after surgery, and it takes two to three months to fully recover. Coronary bypass surgery is

a common procedure that is used to relieve chest pain (angina) produced by lack of blood flow to the heart muscles. The surgeon will remove a blood vessel from your leg, arm or chest and bypass the narrowed section of your coronary artery.

After your operation you’ll be moved to intensive care for monitoring. Most people get excellent relief from chest pain and improved quality of life, but the surgery is not a cure, so your doctor will also talk to you about lifestyle changes.

STATINS

Statins are used to lower the level of cholesterol in the blood and protect the artery walls. If you’re diabetic you’re at a much more likely to develop heart and circulatory disease, and taking statins will help to reduce this risk. Even if you’re in good health, you may be prescribed statins if you’re at high risk of developing cardiovascular disease – for example, if you have a family history of heart and circulatory disease or high cholesterol in your family. Research also suggests statins can help reduce your risk of stroke if you’re aged over 65.

‘Essentially, statins slow the body’s production of cholesterol by blocking its synthesis,’ says Naveed Sattar, professor of cardiovascular and medical sciences at the University of Glasgow. Statins can have side-effects, but the risks are massively outweighed by the benefits to heart health.

‘They are many times safer than aspirin, and there are over 30 randomised trials that show statins work fantastically well to lower cholesterol and reduce the risk of heart attack and stroke risks,’ says Sattar.

A study by Oxford University suggests that even healthy adults with no symptoms should take statins because of protective effects they can have.

EXERCISE

While much of the focus over the years has been about keeping your weight down to reduce heart disease, a new school of thought is that it is better to be a little overweight and physically fit rather than thinner and not active.

Stephen Harridge, professor of human and applied physiology at King’s College London, says: ‘Exercise tends to get relegated in importance for health because of the large focus on diet. People don’t want to hear about what else they might have to do in addition to dieting.

‘Exercise flexes our blood vessels, and the more flexible they are the better your blood pressure is likely to be. Pumping blood more efficiently also helps prevent deposits forming on the walls of our arteries, which leads to atherosclerosis, the furring of the arteries and cardiovascular disease.’

The key, say experts, is to exercise enough to get out of breath. A gentle walk can be good for reducing stress levels, but it won’t improve your cardiovascular fitness. A brisk walk, swimming, jogging or playing tennis are better for improving your heart health.

‘Aerobic exercise seems to do something magical,’ says David Russell-Jones, professor of diabetes and endocrinology at the University of Surrey. ‘It helps keep blood sugar levels under control and reduces blood pressure.’

Vigorous exercise also increases levels of ‘good’ HDL cholesterol and reduces ‘bad’ LDL cholesterol. A recent study found that just 15 minutes of aerobic exercise each day could increase your lifespan by three years.

THE FACTS

  • Coronary heart disease (CHD) is the leading cause of death in the UK, with one person dying from CHD every eight minutes.
  • Around twice as many people live with heart and circulatory diseases in the UK than with cancer and Alzheimer’s disease combined, with CHD killing twice as many women in the UK as breast cancer.
  • It’s not only older people who suffer: around 43,000 people under the age of 75 die in the UK from these conditions each year.
  • But there’s good news too. Since the British Heart Foundation was set up in 1961 the annual number of deaths from heart disease has dropped by around half.
  • In the 1960s more than seven out of 10 heart attacks in the UK were fatal. Today at least seven out of 10 people survive.
  • For more information, advice and support visit the British Heart Foundation’s website at bhf.org.uk.

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