Cardiovascular disease (CVD) is still the biggest killer in western societies. According to the British Heart Foundation, 2.6 million people in the UK suffer from CVD and every year 260,000 have a heart attack. Sadly, 30% of those people die before reaching hospital.

These statistics may make gloomy reading but much can be done to prevent this disease.

What is Cardiovascular Disease?

Cardio refers to the "heart" and vascular refers to the "blood vessels", therefore cardiovascular disease is a malfunction of any of these components. Over 90% of CVD is caused by arteriosclerosis or atherosclerosis. Both of these cause a hardening or thickening of blood vessel walls.

Arteriosclerosis is usually caused by a build-up of calcium deposits in the endothelium (lining of the arteries).

Atherosclerosis (athero: Greek for paste) is caused by fat deposits in the endothelium. These two conditions take several years to develop and symptoms, such as high blood pressure and angina (chest pain) tend to appear when the arteries are quite blocked. When the blood vessels that supply the heart become totally blocked, this can result in a heart attack. A blocked artery in the brain can result in a stroke.

Risk Factors for CVD

There are a number of factors which may increase the incidence of CVD, both avoidable and unavoidable.

Unavoidable risk factors include:

Age - arteries naturally stiffen with age. Gender - men tend to have a higher incidence of heart disease, although women rapidly catch up after menopause. Family History - there seems to be a slightly higher risk if others in the family have CVD. Race - Asians and Afro-Caribbeans tend to have a higher risk when adopting a Western lifestyle.

Avoidable risk factors are:

Smoking High alcohol consumption Physical inactivity Obesity Type 2 Diabetes Stress

Symptoms of CVD

Common symptoms are:

Pain in the chest, teeth, neck or arms when walking uphill or in a hurry. Severe and prolonged breathlessness or undue fatigue Irregular heartbeats or palpitations, especially when in a hurry Light headedness, fainting, double vision, nausea, mental confusion or temporary paralysis when exercising.

As these symptoms appear when the disease has progressed quite far, regular health assessments are recommended, especially after the age of 40. Most of these can be done at your GP surgery. They include taking your pulse to check the rate and rhythm, your blood pressure (ideally less than 140/90), and a urine test to check for diabetes. Blood tests are also useful which may include a cholesterol check. This should be a fasting blood test to be as accurate as possible. Another useful test is a CRP which checks for inflammation as heart disease may be caused by inflammation of the arteries. Other tests that are not commonly available by your GP are Homocysteine - an amino acid detected in the blood and believed to be an early marker for heart disease; and Pulse Wave Analysis - a painless test that measures the stiffness of the arteries by a medical device called a CardioTrack.

Lifestyle Recommendations

There is much you can do to prevent CVD, so here are a few suggestions.

Do not smoke Limit alcohol - max. 2 units a day for women and 3 units for men. Exercise - at least half an hour, three times a week. This should significantly increase your heart rate whilst exercising. Maintain a healthy weight. Drink 2 litres of water a day. Limit salt, sugar and artificial additives Avoid hydrogenated vegetable oils/fats and instead choose olive oil. Eat plenty of fruit and vegetables (at least 5 portions a day) Eat at least 2 portions of oily fish a week or supplement with fish oils to keep up your Omega 3 fatty acid intake.

For those with CVD, supplements containing vitamin B6, B12, folic acid, Vitamin C, and CoEnzyme Q10 may be beneficial to support the cardiovascular system. See Cardiovascular Support overleaf.

Sue Bedford is a Registered Nurse with a Diploma in Nutrition, specialising in health screening and health promotion. More information can be found at www.healthychoices.co.uk