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Heart Disease - Prevention

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Heart Disease - Prevention
Summary
  • There are six major preventable risks for Heart Disease: Smoking, High blood pressure, high cholesterol, obesity, lack of exercise and people that have diabetes.
  • Ask your Doctor for the latest information on the causes and prevention of Heart Disease.
Description

Heart Disease Prevention focuses on the elimination or reduction of known cardiac risk factors. This topic will explain each preventable risk factor and what you can do to reduce it.

There are six major preventable risks for Heart Disease.

  1. Smoking is the most significant risk factor for Heart Disease. Nicotine constricts the blood vessels, which increases heart rate and blood pressure. The blood circulating through the body contains less oxygen and is stickier. This means the heart has to work harder than it should, to supply the body with oxygen.1 To reduce the risk of developing Heart Disease, quit smoking. Even someone who has smoked for many years will benefit almost immediately by quitting. After one year, your risk of Heart Disease is only half of what it was when you were smoking.2 Your Doctor can advise you about programmes available in your area to help you quit smoking. Anti-smoking products may also help.

  2. High Blood Pressure or hypertension means the pressure of the blood on the surrounding arteries is too high. Blood pressure usually increases slowly over time, with few symptoms. Heart disease or stroke is often the first indication that anything is wrong. When blood pressure is high, the heart must pump harder and stronger to force the blood through the resistant arteries. The heart becomes enlarged and weakened and the arteries become damaged by the constant pressure. Hypertension is also associated with kidney disease and stroke.3 Have your blood pressure checked every six months, more often if you have hypertension. Reduce your risk factors for hypertension, which are similar to those for Heart Disease - smoking, obesity, lack of exercise and alcohol use. If you have hypertension, follow your Doctor's advice and remain on any prescription medications.

  3. High Cholesterol. Cholesterol is a fat that is produced in the body as well as being obtained in the diet. Cholesterol is present in animal fats such as meat, eggs and dairy. There are two main kinds of cholesterol in the blood, HDL or "good" cholesterol, which removes fats from the blood and returns them to the liver for processing and LDL or "bad" cholesterol, which builds up in the arteries. Excess cholesterol in the blood is deposited on the artery walls as plaques, a process called atherosclerosis. This causes arteries to become thicker and less flexible, and restricts blood flow to the heart. Have your Cholesterol levels checked. The aim is to increase HDL cholesterol and decrease LDL cholesterol. A diet low in saturated animal fats may help. For some people, diet alone is not enough to lower cholesterol levels and medications may be necessary. Antioxidants such as vitamins A, C and E, betacarotene, zinc and selenium can prevent the oxidation of cholesterol, which contributes to atherosclerosis.4

  4. Obesity means an excess of body fat. There are both genetic and environmental reasons for obesity. Obesity increases other cardiac risk factors. It lowers HDL "good" cholesterol, raises blood pressure and may lead to diabetes, especially if the person tends to carry excess weight around the abdomen. When a person regularly eats more calories than they use up, the excess calories are stored as fat and obesity results.5 If you are overweight, ask your Doctor for advice. Follow a diet low in saturated fats and sugars. Exercise more and eat less! See the Weight Management Diet.

  5. Sedentary Lifestyle - lack of exercise nearly doubles your risk of Heart Disease and makes you up to 50% more likely to suffer from high blood pressure.6 Exercise improves blood cholesterol levels, strengthens bones and muscles, lowers blood pressure and improves your energy and stress levels.

    Thirty minutes of moderate exercise each day is recommended for heart health. It does not have to be vigorous or sweaty, just regular. Walking, swimming, cycling, and even gardening and housework count towards your 30 minutes per day.7 See the Exercising for health topic for more information. See the Heart Disease and Exercise topic for more information.

  6. Diabetes Mellitus. Diabetes, particularly Type 2, increases the risk for Heart Disease because prolonged high blood sugar levels weaken the blood vessels. Diabetics are up to four times more likely to suffer from heart disease or stroke. In addition, diabetic nerve damage to the heart can make symptoms of heart disease harder to recognise.8 Have your blood sugar levels tested. Diabetics can reduce the risk of complications if blood sugar levels are consistently kept within normal limits. If you have diabetes, you may need to make changes to your diet. Medications and insulin may be required for those whose blood sugar levels cannot be controlled by diet alone. Regular exercise is essential.


Other Cardiac Risk Factors

  1. High Homocysteine. Homocysteine is an amino acid in the blood. It has recently been discovered that in high levels, it increases the risk of atherosclerosis and heart disease.9

    Ask your Doctor to check your blood level of homocysteine. If it is too high, folic acid, vitamin B6 and vitamin B12 can help reduce it.10 These nutrients are found in green leafy vegetables, oily fish, egg yolks and organ meats. Caffeine and alcohol should be minimised, as these are associated with an elevated homocysteine level.11

  2. Heavy Alcohol Use. While small amounts of red wine may have a mild protective effect on the heart, heavy alcohol use is considered a risk factor for Heart Disease. Heavy alcohol use lowers HDL "good" cholesterol and makes the blood more likely to clot. Alcohol is also linked to hypertension, arrhythmia, and cardiomyopathy (enlarged heart).12

    If you are a heavy alcohol drinker, ask your Doctor about how to reduce your intake of alcohol. Try alternating alcoholic drinks with water or pouring smaller serves and topping up with mixers or ice. Switch to light beer or low-alcohol wine and put your glass down between sips to make it last longer.13

  3. Contraceptive Pill The oral contraceptive pill increases the risk of blood clotting disorders in women with existing cardiac risk factors.14 The risks are more pronounced in women over 30 years who smoke or have a history of vascular disorders such as hypertension, varicose veins or deep vein thrombosis.

    If you use the oral contraceptive pill, you should take extra care to reduce other risk factors, particularly smoking. You may wish to consider a non-hormonal form of contraception such as condoms or diaphragms.
  • Management

    As with all conditions your Doctor should be consulted. Your Doctor can arrange cholesterol and triglyceride tests that will give a breakdown of the levels of 'good' and 'bad' cholesterol. A test can also be organised for measuring homocysteine levels. Ask your Doctor for the latest information on the causes and prevention of Heart Disease.


    Lifestyle

    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 function15 and reducing high blood pressure16.

    • Fish oil, which contains omega-3 fatty acids has been shown to reduce blood pressure.17 18 19

    • Garlic is thought to reduce cholesterol levels and lower blood pressure20. Patients taking anticoagulants (blood thinning drugs) should NOT take garlic supplements.

    • Homocysteine levels should be checked by your Doctor. If your homocysteine levels are high you are at increased risk of developing heart disease 21. Folic acid and vitamins B6 and B12 help to reduce elevated homocysteine levels.

  • Pharmacist's Advice

    Ask your Pharmacist for the latest information on Heart Disease Prevention.

    1. Quit smoking. Anti-smoking products may help reduce cravings. Ask your Pharmacist for advice.
    2. Ask your Pharmacist for weight management advice if necessary.
    3. Have regular exercise and adequate rest. Before starting any exercise regime, see your Doctor first for assessment.
    4. Alcohol intake should be kept to a safe level.
    5. A blood pressure monitor can be obtained to enable you to check your blood pressure at home.
    6. Cholesterol testing is available at many pharmacies.
    7. Follow the Heart Diet. If the diet is inadequate consider some supplements such as fish oil, vitamins B6 and B12 and folic acid.
  • Notes

    Organisations & Support Groups


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


    References

    1. American Heart Association. Cigarette Smoking and Cardiovascular Diseases. 2001. At URL http://216.185.112.5/presenter.jhtml?identifier=4545.
    2. American Heart Association. Smoking Cessation. 2001. At URL http://216.185.112.5/presenter.jhtml?identifier=4731.
    3. Waugh A et al. Anatomy and Physiology in health and illness (9th ed). London: Churchill Livingstone; 2001.
    4. French R. How to avoid heart disease. WellBeing Magazine, 1999:76.
    5. American Heart Association. Obesity and Overweight. 2001. At URL http://216.185.112.5/presenter.jhtml?identifier=4639
    6. American Heart Association. Physical Activity and Cardiovascular Health Fact Sheet 2001. At URL http://www.americanheart.org/presenter.jhtml?identifier=820
    7. American Heart Association. The Benefits of Daily Physical Activity. 2001. At URL http://www.americanheart.org/presenter.jhtml?identifier=764.
    8. American Heart Association. Diabetes. 2001. At URL http://www.americanheart.org/presenter.jhtml?identifier=11243.
    9. Chai AU et al. Homocysteine: a new cardiac risk factor? Clin Cardiol 2001 Jan;24(1):80-4.
    10. Molloy AM et al. Folates and prevention of disease. Public Health Nutr 2001 Apr;4(2B):601-9.
    11. Jacques PF et al. Determinants of plasma total homocysteine concentration in the Framingham Offspring cohort. Am J Clin Nutr 2001 Mar;73(3):613-21.
    12. Schoppet M et al. Alcohol and the heart. Herz 2001 Aug;26(5):345-52.
    13. Heart Foundation of Australia. Low fat cooking tips: Alcohol. 2001. At URL http://www.heartfoundation.com.au/search/index_fr.html
    14. Lidegaard O et al. Oral contraceptives and thrombosis. From risk estimates to health impact. Acta Obstet Gynecol Scand 1999 Feb;78(2):142-9.
    15. Langsjoen H et al. Usefulness of coenzyme Q10 in clinical cardiology: a long-term study. Mol Aspects Med 1994;15 Suppl:s165-75.
    16. Langsjoen PH et al. Isolated diastolic dysfunction of the myocardium and its response to CoQ10 treatment. Clin Investig 1993;71 (8 Suppl):S140-4.
    17. 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.
    18. Singer P et al. Fish oil amplifies the effect of propranolol in mild essential hypertension. Hypertension 1990 Dec;16(6):682-91.
    19. Toft I. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995 Dec 15;123(12):911-8.
    20. The Review of Natural Products, Facts and Comparisons. Facts and comparisons Pub. Garlic.1998. USA.
    21. Chai AU et al. Homocysteine: a new cardiac risk factor? Clin Cardiol 2001 Jan;24(1):80-4.
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