Heart & Circulation
Heart healthy – reducing the risk of CHD and Stroke
Most of the lifestyle issues that are talked about are aimed at reducing these two life-threatening problems.
The issues that most influence your risk of cardiovascular disease are:
The top 5 are things you can alter, with or without medical help. Whereas the 5th is of course, immoveable: you cannot change your parents.
The problem
The killer diseases are coronary heart disease [CHD] and stroke. The key risk is of a fatal heart attack or a fatal brain attack [stroke] when a blood vessel that supplies either of these organs becomes blocked and as a consequence the heart or brain suddenly stop working.
First understand what goes wrong
Doctors talk about ‘cardiovascular disease’: they mean damage to the arteries that supply important organs and the various consequences that follow from that. So for example, if the arteries in the heart [the coronary arteries] are narrowed then there is coronary heart disease [CHD] and the blood supply to the heart is reduced. The sufferer first experiences the exercise-based chest pain known as angina and may go on to have actual blockage of an artery, damage to the heart muscle and what is recognised as a heart attack.
The damage to blood vessels is called atheroma [this used to be called atherosclerosis].
So narrowing of the blood vessels of the heart [shown in the picture] starves the heart of oxygen and when there is damage to the tissues, this is what we call a heart attack.
If this process of tissue oxygen starvation occurs in the brain it can cause a stroke; in the lower limbs arterial narrowing causes pain on walking and eventually may lead to loss of a leg due to gangrene; in the eyes and ears blindness and hearing loss occur, respectively when critical vessels become blocked.
Narrowing of blood vessels in the penis leads to erectile dysfunction [ED]. This occurs on average 5 years before heart problems show. This is because the blood vessels in the penis are smaller than those in the heart and are affected earlier in the disease process. ED predicts CHD.
A coronary angiogram showing good flow in normal vessels
Who is healthy and who is at risk?
Smoking increases the risk of heart attack 5 times and the risk of stroke 2 times.
There are so many other risks of smoking that it just has to go!
Being overweight is a significant risk. Although the Body Fat % is an ideal scientific measure it is complicated to calculate.
However the Waist/Height Ratio is a good predictor and simple Waist Circumference is almost as good.
High blood pressure [hypertension] causes about 50% of strokes [World Heart Federation] and increases the ‘wear and tear’ on vessels in the heart increasing the risk of both atheroma and heart attack.
Hypertension can only be detected by direct measurement. There is no obvious predictor and there are no symptoms until the pressure is very high indeed. Get your BP checked, please.
Fitness is important, both as cardiorespiratory fitness and as muscle strength. Good fitness reduces death rates from heart disease [and also cancer]. Fitness has to be combined with non-fatness or serious excess risk remains.
Exercise has to be regular, raise the heart rate and make you somewhat short of breath.
Family History – did your Dad die in his 40‘s from a heart attack?
A parent or sibling with CHD increases you risk.
They may have had poor blood vessels, familial hypercholesterolemia, hypertension or been diabetic and you should have a personal risk assessment.
What do you need to do?
- Take responsibility for your weight and fitness.
- Stop smoking
- Get some simple measurements
You need
- Blood pressure
- Fasting Lipid Profile [cholesterol] and fasting blood sugar
- Waist/height ratio
