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Heart Disease

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Heart Disease
Summary
  • The term Heart Disease generally refers to diseases affecting the pulmonary circulation.
  • A person with Heart Disease may have a number of differing symptoms depending on individual problems.
  • Heart Disease is largely preventable if the numerous associated risk factors are reduced.
Description

Heart Disease is a term used to describe diseases affecting the ability of the heart to function adequately within the circulatory system1.

The circulatory system can be divided into two main systems: the pulmonary system, consisting of the heart and lungs and the systemic or peripheral system, consisting of the network of veins and arteries throughout the rest of the body.2 The term Heart Disease generally refers to diseases affecting the pulmonary circulation. These include heart attack, high blood pressure (hypertension), arrhythmia, atherosclerosis (clogging of the arteries), aneurysm, endocarditis, congestive heart failure, angina and heart valve disease. Diseases affecting the peripheral circulation are described in the Circulation (Diseases Of) topic.

Heart Disease is not an inevitable result of ageing. Heart Disease is largely preventable if the numerous associated risk factors are reduced. These include:

  • Smoking. Smokers have more than twice the risk of Heart Attack than non-smokers. Smokers also have more severe or fatal Heart Attacks than non-smokers3.

  • High cholesterol. High blood cholesterol leads to atherosclerosis, the leading cause of Heart Attack4.

  • High blood pressure (hypertension). This increases the heart's workload, causing it to enlarge and weaken.

  • Obesity. Being overweight increases the heart's workload and raises blood pressure and cholest

  • Sedentary lifestyle (lack of exercise)5.

  • Diabetes mellitus. Around two-thirds of diabetics die from heart disease. 6 - High homocysteine levels. Homocysteine is an amino acid in the blood that is associated with Heart Disease.7 - Other factors include stress, hormonal medications such as the oral contraceptive pill or HRTScarabin PY, et al. Changes in haemostatic variables induced by oral contraceptives containing 50 micrograms or 30 micrograms oestrogen: absence of dose-dependent effect on PAI-1 activity.; Thromb-Haemost. 1995 Sep; 74(3): 928-32. and heavy alcohol use.


Risk factors that cannot be altered include increasing age, gender (men have a higher risk of Heart Disease than women), congenital heart defects and hereditary factors (having a parent with Heart Disease).8


Signs & Sypmtoms

Symptoms may include shortness of breath, hypertension, fatigue, moist cough, chest pain, and swollen neck veins, legs and ankles.9 Heart Disease can often progress to an advanced stage before the patient notices symptoms. More than one type of cardiovascular disorder can occur in the same person, or several problems and symptoms can be related to a single underlying cause. Therefore, a person with Heart Disease may have a number of differing symptoms depending on individual problems.

  • Management

    As with all conditions your Doctor should be consulted. Your Doctor will diagnose and treat this condition.

    • If your Doctor suspects Heart Disease, a full investigation with a variety of laboratory tests will be required. These may include blood tests, an electrocardiogram, an echocardiogram and chest X-rays.
    • Ask your Doctor how to reduce your risk factors. See the Heart Disease - Prevention topic for more information.

    * Severe Heart Disease may progress to Heart Failure. Careful management by a Doctor specialising in Heart Disease (a Cardiologist) is essential.


    Lifestyle

    Diet Hints

    Always follow the dietary advice given to you by your Doctor or Dietitian.


    Vitamins/Minerals/Herbs

    Nutritional supplements are only to be used if the dietary vitamin intake is inadequate.

    • Some studies have shown Coenzyme Q10 to be effective in improving heart function10 and reducing high blood pressure11.
    • Fish oil, which contains omega-3 fatty acids has been shown to reduce blood pressure.12 13 14
    • Garlic is thought to reduce cholesterol levels and lower blood pressure15. Patients taking anticoagulants (blood thinning drugs) should NOT take garlic supplements.
  • Pharmacist's Advice

    Ask your Pharmacist for advice.

    1. Quit smoking. Ask your Pharmacist about the range of anti-smoking products to help reduce cravings.
    2. The contraceptive pill and certain types of HRT (Hormone Replacement Therapy) may increase the risk of Heart Disease16 17. Women who have other risk factors for Heart Disease may wish to discuss their contraceptive and HRT needs with their Doctor.
    3. Ask your Pharmacist for advice about obesity and weight management.
    4. A blood pressure monitor can be obtained to enable you to check your blood pressure regularly at home.
    5. Cholesterol testing is available at many Pharmacies. Ask your Pharmacist to explain your Cholesterol levels to you.
    6. Exercise regularly. Thirty minutes per day of moderate exercise is recommended. See the Exercising for Health topic for further information. Before starting any exercise programme, have a complete medical check-up.
  • Notes

    Organisations & Support Groups

    Heart Foundation of Australia - http://www.heartfoundation.com.au/


    References

    1. www.intelihealth.com. Intelihealth- Home to John Hopkins Health Information. "Heart Disease", Oct 5, 1999.
    2. Waugh A. Anatomy and Physiology in Health and Illness (9th ed). London: Churchill Livingstone; 2001.
    3. Verdecchia P, et al. Cigarette smoking, ambulatory blood pressure and cardiac hypertrophy in essential hypertension. J-Hypertens. 1995 Oct; 13(10): 1209-15.
    4. McKenna CJ, et al. Secondary prevention in coronary Heart Disease. Fact: lowering cholesterol saves lives [editorial]; Ir-Med-J. 1995 Nov-Dec; 88(6): 191.
    5. Despres JP, et al; Exercise and the prevention of dyslipidemia and coronary heart disease.; Int-J-Obes-Relat-Metab-Disord. 1995 Oct; 19 Suppl 4: S45-51.
    6. American Heart Association. Risk Factors and Coronary Heart Disease. 2001. At URL http://www.americanheart.org/presenter.jhtml?identifier=4726.
    7. American Heart Association. What is Homocysteine? 2001. At URL http://216.185.112.5/presenter.jhtml?identifier=535.
    8. American Heart Association. Risk Factors and Coronary Heart Disease. 2001. At URL http://www.americanheart.org/presenter.jhtml?identifier=4726.
    9. Johnson J. Handbook for Brunner & Suddarth's textbook of medical-surgical nursing (9th ed). USA: Lippincott Williams and Wilkins; 2000.
    10. Langsjoen H et al. Usefulness of coenzyme Q10 in clinical cardiology: a long-term study. Mol Aspects Med 1994;15 Suppl:s165-75.
    11. Langsjoen PH et al. Isolated diastolic dysfunction of the myocardium and its response to CoQ10 treatment. Clin Investig 1993;71 (8 Suppl):S140-4.
    12. Yosefy C et al. The effect of fish oil on hypertension, plasma lipids and hemostasis in hypertensive, obese, dyslipidemic patients with and without diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids 1999 Aug;61 (2):83-7.
    13. Singer P et al. Fish oil amplifies the effect of propranolol in mild essential hypertension. Hypertension 1990 Dec;16(6):682-91.
    14. Toft I. Effects of n-3 polyunsaturated fatty acids on glucose homeostatis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995 Dec 15;123(12):911-8.
    15. The Review of Natural Products, Facts and Comparisons. Facts and comparisons Pub. Garlic.1998. USA. 
    16. Manson JE et al. Oestrogen plus progestin and the risk of coronary heart disease. N Engl J Med. 2003 Aug 7;349(6):523-34.
    17. Sinnathuray TA. Oral steroidal contraception: scientific basis and recent development. Malays J Reprod Health. 1988 Dec;6(2):70-82.
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