What causes heart disease?
Heart disease is caused by a furring up of the arteries with fatty deposits, a process known as atherosclerosis. This leads to narrowing arteries, which eventually stops enough oxygen reaching the heart, causing chest pain (angina). If the artery becomes blocked with a clot, this can result in a heart attack.
But heart disease doesn't just creep up on us overnight - it's the accumulation of unhealthy lifestyle choices made over many decades, including:
- too much saturated fat
- weight gain
- high blood pressure
- raised cholesterol
- not enough exercise
It's never too early to start thinking about your heart health though, so here's a step-by-step guide to keeping your heart healthy - at each stage of your life.
20s and 30s
These are the decades when it's vital to adopt healthy lifestyle habits.
- Eat a healthy low fat diet: Include at least five portions of fruit and vegetables a day, fibre-rich complex carbohydrates (wholemeal bread, pasta and rice), lean protein, low fat dairy products and at least two portions of fish a week, one of which should be oily. Avoid too much saturated fat (found in red meat, sausages, etc. and processed foods) and cut down on salt and sugar levels in processed foods and takeaways.
- Exercise regularly: Physically active people are half as likely to get cardiovascular disease as those who are inactive. Exercise helps reduce your blood pressure, work your heart muscle and raise levels of 'good' HDL cholesterol, which protects your arteries against disease and also helps you control your weight. Aim for at least 30 minutes of brisk exercise/activity five times a week.
- Give up smoking: Smoking is the biggest contributory factor to narrowing or 'furring up' of the arteries and, if this involves the arteries to the muscles of the heart, this can result in either angina (chest pain on exercise) or a heart attack. Ask your GP for support in quitting.
- Check your family history: If a close family member has suffered a heart attack or stroke at a young age, you may be at higher risk of heart disease, so see your GP for a cholesterol test.
- Be aware of ethnic risks: South Asian people living in the UK are one and half times more likely to die from coronary heart disease before the age of 75 than people from other ethnic backgrounds, so they need to see their GP for check-ups earlier than most.
40s and 50s
- Follow the healthy lifestyle habits mentioned above.
- Get a heart check-up: The British Heart Foundation recommends everyone aged 40 to 60 should have a heart health check-up to measure and assess risk factors for developing heart disease, including blood pressure, weight, blood glucose levels, cholesterol levels, etc. Book one with your GP or practice nurse.
- Measure your waist: A waist measurement of more than 37 inches (94cm) for a man and 32 inches (80cm) for a woman puts you at high risk of developing Type 2 diabetes, which greatly increases your chances of developing heart disease. Some studies suggest eating foods with a low glycaemic index, which release energy slowly, may help patients lose weight around their middle.
- Keep exercising: Exercising in middle age increases your life expectancy by two years (equivalent to giving up smoking). Aim for five sessions a week of at least 30 minutes.
- Have a post-menopause check: Women are protected against heart disease by the female sex hormone oestrogen but, as this ends with the menopause, it's important to have regular check-ups in your 50s.
60s and beyond
Your age puts you at higher risk of heart disease now, so regular check-ups are even more important.
- Stick to the lifestyle advice above.
- Get your blood pressure checked at least annually, more often if you have raised levels. If you're over 60, there is a 50 per cent chance you have high blood pressure, rising to 60 per cent by age 70 and over 70 per cent by the age of 75. It's the second biggest risk factor for heart disease after smoking. Cutting down on salt is the easiest way to reduce blood pressure, but you may also need medication including beta blockers or ACE inhibitors.
- Take cholesterol-lowering drugs: If your cholesterol levels are above 5 millimoles per litre of blood, you may be prescribed a statin to lower your levels. Following the Portfolio Diet, which is rich in almonds, oats and soya, can also help reduce your cholesterol, as can taking regular exercise.
- Control diabetes: Diabetes raises the risk of your arteries becoming blocked by atheroma (furring up inside the artery). Reduce the effect by keeping your blood sugar levels within normal levels with prescribed medication and/or insulin, and maintaining a normal weight.