Medical Spotlight: Heart Disease

Heart disease – sounds bad, doesn’t it?  Heart disease is an umbrella term referring to a spectrum of conditions that affect the heart, blood vessels or both.  With ischaemic heart disease being the leading cause of death in Australia and many developed countries across the world, heart disease is not to be taken lightly.  The key to preventing and managing heart disease is maintaining a healthy lifestyle and treating the causes of heart disease early to prevent more serious conditions from developing.

So what falls under the term heart disease?

A large number of conditions fall under the umbrella term heart disease.  The most important conditions include:

  • Hypertensive heart disease: over a long period of time, hypertension, or high blood pressure, can cause damage to the heart and blood vessels.
  • Ischaemic Heart Disease: this occurs when the heart is not getting enough blood causing damage or dysfunction of the heart muscle tissue known as ischaemia.  Ischaemic heart disease is usually caused by atherosclerosis which refers to a build-up of fat and fibrous tissue within the blood vessels leading to a narrowing of the lumen of the vessel.  Ischaemic heart disease itself is an umbrella term referring to several different conditions including:

Angina: pain in the chest caused by a reduction in blood flow and therefore oxygen delivery to the heart muscle which causes mild damage to (but not death) of the tissue.
Acute myocardial infarction or a heart attack: where complete or nearly complete occlusion of one or more of the vessels supplying the heart occurs leading to death of varying amounts of heart muscle tissue.
Heart failure: most commonly caused by a previous heart attack, heart failure occurs when the heart can no longer pump enough blood to meet the demands of the body.

Other less common forms of heart disease include valvular heart disease, congenital heart disease and rheumatic heart disease.

What are the risk factors for heart disease?

There are a number of different risk factors for heart disease which are commonly divided into two categories – those that can’t be changed, known as unmodifiable and those that can, known as modifiable risk factors.  The unmodifiable risk factors include increasing age, with an estimated 90% of deaths due to ischaemic heart disease occurring in people aged over 60, being male and having a family history of heart disease.  If you tick these boxes, don’t dismay, although you are at slightly higher risk you can protect your heart by maintaining a healthy lifestyle which we will discuss later on.

The modifiable risk factors are things that we can actively avoid in order to reduce the risk of heart disease.  These include:

  • Smoking: the number one most easily avoidable risk factor for heart disease – kids, don’t smoke!
  • Being overweight or obese: particularly central obesity, so those people out there with skinny arms and legs but a big round belly are not in the clear.  In fact, the risks are now defined as having a BMI over 25kg/m2 or having a waist circumference of greater than 94cm for men and greater than 80cm for women.

Inactivity or a sedentary lifestyle: there is growing evidence to suggest that sitting for long periods of time, as seen in people working a desk job, is a major risk factor for heart disease as well as a range of other conditions.

Medical risk factors: there are a few risks factors that your doctor should pick up on including:

High blood pressure (hypertension)
High cholesterol (hypercholesterolaemia)
High blood sugar levels (diabetes)
How can I protect myself from heart disease?

This is the golden question and in fact, protecting your heart is quite simple and involves maintaining a healthy lifestyle.  First and foremost, don’t smoke – if you currently smoke, try to quit and if you don’t smoke, for god’s sake, don’t start!  Secondly, maintain a healthy weight.  If you’re overweight and struggle to lose weight, consider seeing your doctor for some recommendations on how to reduce your weight healthily and sustainably.  One way to do this, and the third way to protect yourself from heart disease, is regular exercise.  Try to get at least 30 minutes of moderate intensity exercise (i.e. you’re puffing and sweating a little and your heart rate is up) most, if not every, day of the week.  Finally, try to keep your saturated fat intake to a minimum, this includes fat found in animal products such as butter, bacon and red meat.  Try to replace these artery clogging fats with heart friendly un-saturated fats including omega-3’s found in oily fish and vegetables such as avocado.

In summary, heart disease is common and largely preventable or at least manageable.  Just a few simple lifestyle modifications including regular exercise and a healthy diet and you’ll make sure you’re ticker is healthy for years to come.