Cardiovascular disease
Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.
It's usually associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots.
It can also be associated with damage to arteries in organs such as the brain, heart, kidneys and eyes.
CVD is one of the main causes of death and disability in the UK, but it can often largely be prevented by leading a healthy lifestyle.
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Types of CVD
There are many different types of CVD. Four of the main types are described below.
Coronary heart disease
Coronary heart disease occurs when the flow of oxygen-rich blood to the heart muscle is blocked or reduced.
This puts an increased strain on the heart, and can lead to:
- angina – chest pain caused by restricted blood flow to the heart muscle
- heart attacks – where the blood flow to the heart muscle is suddenly blocked
- heart failure – where the heart is unable to pump blood around the body properly
Read more about coronary heart disease.
Strokes and TIAs
A stroke is where the blood supply to part of the brain is cut off, which can cause brain damage and possibly death.
A transient ischaemic attack (also called a TIA or "mini-stroke") is similar, but the blood flow to the brain is only temporarily disrupted.
The main symptoms of a stroke or TIA can be remembered with the word FAST, which stands for:
- Face – the face may have drooped on one side, the person may be unable to smile, or their mouth or eye may have dropped.
- Arms – the person may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
- Speech – their speech may be slurred or garbled, or they may not be able to talk at all.
- Time – it's time to dial 999 immediately if you see any of these signs or symptoms.
Read more about stroke and TIAs.
Peripheral arterial disease
Peripheral arterial disease occurs when there's a blockage in the arteries to the limbs, usually the legs.
This can cause:
- dull or cramping leg pain, which is worse when walking and gets better with rest
- hair loss on the legs and feet
- numbness or weakness in the legs
- persistent ulcers (open sores) on the feet and legs
Read more about peripheral arterial disease.
Aortic disease
Aortic diseases are a group of conditions affecting the aorta. This is the largest blood vessel in the body, which carries blood from the heart to the rest of the body.
One of most common aortic diseases is an aortic aneurysm, where the aorta becomes weakened and bulges outwards.
This doesn't usually have any symptoms, but there's a chance it could burst and cause life-threatening bleeding.
Read more about aortic aneurysm.
Causes of CVD
The exact cause of CVD isn't clear, but there are lots of things that can increase your risk of getting it. These are called "risk factors".
The more risk factors you have, the greater your chances of developing CVD.
If you're over 40, you'll be invited by your GP for an NHS Health Check every 5 years.
Part of this check involves assessing your individual CVD risk and advising you how to reduce it if necessary.
The main risk factors for CVD are outlined below.
High blood pressure
High blood pressure (hypertension) is one of the most important risk factors for CVD. If your blood pressure is too high, it can damage your blood vessels.
Read more about high blood pressure.
Smoking
Smoking and other tobacco use is also a significant risk factor for CVD. The harmful substances in tobacco can damage and narrow your blood vessels.
High cholesterol
Cholesterol is a fatty substance found in the blood. If you have high cholesterol, it can cause your blood vessels to narrow and increase your risk of developing a blood clot.
Read more about high cholesterol.
Diabetes
Diabetes is a lifelong condition that causes your blood sugar level to become too high.
High blood sugar levels can damage the blood vessels, making them more likely to become narrowed.
Many people with type 2 diabetes are also overweight or obese, which is also a risk factor for CVD.
Inactivity
If you don't exercise regularly, it's more likely that you'll have high blood pressure, high cholesterol levels and be overweight. All of these are risk factors for CVD.
Exercising regularly will help keep your heart healthy. When combined with a healthy diet, exercise can also help you maintain a healthy weight.
Being overweight or obese
Being overweight or obese increases your risk of developing diabetes and high blood pressure, both of which are risk factors for CVD.
You're at an increased risk of CVD if:
- your body mass index (BMI) is 25 or above – use the BMI healthy weight calculator to work out your BMI
- you're a man with a waist measurement of 94cm (about 37 inches) or more, or a woman with a waist measurement of 80cm (about 31.5 inches) or more
Read more about obesity.
Family history of CVD
If you have a family history of CVD, your risk of developing it is also increased.
You're considered to have a family history of CVD if either:
- your father or brother were diagnosed with CVD before they were 55
- your mother or sister were diagnosed with CVD before they were 65
Tell your doctor or nurse if you have a family history of CVD. They may suggest checking your blood pressure and cholesterol level.
Ethnic background
In the UK, CVD is more common in people of south Asian and an African or Caribbean background.
This is because people from these backgrounds are more likely to have other risk factors for CVD, such as high blood pressure or type 2 diabetes.
Other risk factors
Other factors that affect your risk of developing CVD include:
- age – CVD is most common in people over 50 and your risk of developing it increases as you get older
- gender – men are more likely to develop CVD at an earlier age than women
- diet – an unhealthy diet can lead to high cholesterol and high blood pressure
- alcohol – excessive alcohol consumption can also increase your cholesterol and blood pressure levels, and contribute to weight gain
Preventing CVD
A healthy lifestyle can lower your risk of CVD. If you already have CVD, staying as healthy as possible can reduce the chances of it getting worse.
Ways you can reduce your CVD risk are outlined below.
Stop smoking
If you smoke, you should try to give up as soon as possible. The NHS Smokefree website can provide information, support and advice to help.
Your GP can also provide you with advice and support. They can also prescribe medication to help you quit.
Read more about stopping smoking and stop smoking treatments.
Have a balanced diet
A healthy, balanced diet is recommended for a healthy heart.
A balanced diet includes:
- low levels of saturated fat (found in foods such as fatty cuts of meat, lard, cream, cakes and biscuits) – try to include healthier sources of fat, such as oily fish, nuts and seeds, and olive oil
- low levels of salt – aim for less than 6g (0.2oz or 1 teaspoon) a day
- low levels of sugar
- plenty of fibre and wholegrain foods
- plenty of fruit and vegetables – eat at least 5 portions of fruit and vegetables a day
Read more about healthy eating.
Exercise regularly
Adults are advised to do at least 150 minutes of moderate activity a week, such as cycling or brisk walking.
If you find it difficult to do this, start at a level you feel comfortable with and gradually increase the duration and intensity of your activity as your fitness improves.
Visit your GP for a health check if you haven't exercised before or you're returning to exercise after a long break.
Read advice about starting exercise.
Maintain a healthy weight
If you're overweight or obese, a combination of regular exercise and a healthy diet can help you lose weight. Aim to get your BMI below 25.
If you're struggling to lose weight, your GP or practice nurse can help you come up with a weight loss plan and recommend services in your area.
Read more about losing weight and how your GP can help.
Cut down on alcohol
If you drink alcohol, try not to exceed the recommended limit of 14 alcohol units a week for men and women.
If you do drink this much, you should aim to spread your drinking over 3 days or more.
A unit of alcohol is roughly equivalent to half a pint of normal-strength lager or a single measure (25ml) of spirits. A small glass of wine (125ml) is about 1.5 units.
Your GP can give you help and advice if you're finding it difficult to cut down your drinking.
Get some tips on cutting down.
Medication
If you have a particularly high risk of developing CVD, your GP may recommend taking medication to reduce your risk.
Medications that may be recommended include statins to lower blood cholesterol levels, low-dose aspirin to prevent blood clots, and tablets to reduce blood pressure.
Common heart conditions
There are many different heart conditions and problems which are collectively called heart disease.
It’s always best to discuss your heart condition with your health professional or heart specialist who can advise you on the correct diagnosis and name of your condition and treatment plan.
Heart disease and different conditions affect the heart’s ability to work efficiently.
It can be worrying and confusing to be diagnosed with a heart condition, but there's a lot of information and support available to you. Sometimes understanding what is happening can help you worry less.
Coronary heart disease
The most common heart condition in Scotland is coronary heart disease. This is caused when the heart’s blood vessels - the coronary arteries - become narrowed or blocked and can’t supply enough blood to the heart.
It can lead to angina and/or a heart attack.
Read more about coronary heart disease
Angina
Angina is a pain or discomfort in your chest, arm, neck, stomach or jaw that happens when the blood supply to your heart becomes restricted because of your arteries becoming narrowed. This clogging is called atheroma. Angina is a symptom of coronary heart disease, not an illness in itself.
Angina is your heart’s way of telling you it’s not getting enough oxygen when you’re doing something strenuous or you’re feeling under stress. Many people learn to recognise how much activity will bring on an angina attack - this is called stable angina.
If you have unexplained chest pain, seek urgent medical advice - you will need an assessment of your overall health.
Unstable angina
Unstable angina can be undiagnosed chest pain or a sudden worsening of existing angina. It happens when the blood supply to the heart is severely restricted and angina attacks occur more frequently, with less and less activity.
These attacks may even happen at rest or wake you from sleep. They can last up to 10 minutes.
You should see your doctor urgently, and you may be admitted to hospital.
Until tests confirm the diagnosis, this is sometimes called Acute Coronary Syndrome (ACS).
Read more about angina
Heart attack
A heart attack - also known as myocardial infarction or MI - happens when the blood supply to part of your heart muscle becomes completely blocked. This is most commomly caused by a piece of fatty material breaking off and a blood clot forms within a coronary artery. This can cause damage to the part of your heart muscle which that particular coronary artery was supplying.
Read more about the symptoms of a heart attack
Heart failure
If the heart’s pumping action can’t work effectively, your heart muscle can’t meet your body’s demand for blood and oxygen, and your body develops various different symptoms, like fatigue and shortness of breath. This is called heart failure because of the failure of your heart to work efficiently.
Read more about heart failure
Arrhythmia (abnormal heart rhythms)
The heart muscle has its own electrical system which helps to stimulate the heartbeat. If the electrical signals within your heart are interrupted or disturbed, your heart can beat too quickly (tachycardia), too slowly (bradycardia) and/or in an irregular way. This is called an arrhythmia.
Read about arrhythmia on the Chest Heart & Stroke Scotland website
Valve disease
The valves open and close to regulate the flow of blood through the heart. Problems with the valves can increase the workload of your heart and can put a strain on your heart muscle, leading to a range of symptoms, like:
- shortness of breath
- swollen ankles
- fatigue
- chest pain (angina or palpitations)
- dizziness or fainting
Read about heart valve problems on the Chest Heart & Stroke Scotland website
High blood pressure
Another condition which can affect the heart is high blood pressure or hypertension. Although it’s not a disease in itself, hypertension can lead to an increased risk of developing serious conditions such as coronary heart disease, heart attacks and strokes.
Read more about high blood pressure and reducing the risks to your heart
Congenital heart conditions
Congenital heart conditions occur when there’s an abnormality or defect with the structure of the heart of a developing foetus while inside the mother’s womb. A baby may be born with only one defect or with several defects. Some types of congenital heart defects are life-threatening, either immediately to the newborn or over time.
Read more about congenital heart disease
Inherited heart conditions
Inherited conditions can be passed on through families. They are sometimes called familial or genetic heart conditions.
They can affect people of any age and can be life-threatening. The first sign there’s a problem is often when someone dies suddenly with no obvious cause.
These conditions are different from most congenital heart conditions, although some congenital conditions can also be inherited.
Read more about inherited heart conditions
Cardiovascular heart disease
Cardiovascular disease (CVD)
Heart disease includes conditions that narrow or block blood vessels (coronary heart disease). This can lead to a heart attack, angina and some strokes. Heart disease also covers conditions that affect your heart's muscle, valves or cause abnormal rhythms (arrhythmias).
- To read more about a specific heart disease condition, read more about on our heart and circulatory conditions page.
What are the symptoms of cardiovascular heart disease?
Symptoms of heart disease vary based on what condition you have and can include:
- chest pain
- pain, weakness or numb legs and/or arms
- breathlessness
- very fast or slow heartbeat, or palpitations
- feeling dizzy, lightheaded or faint
- fatigue
- swollen limbs.
What increases my risk of cardiovascular heart disease?
A risk factor is something that increases the chance of getting a condition. The more you have, the higher your chance of CVD. Even if you can’t change all your risk factors, there are steps you can take to reduce your risk.
There are several risk factors for CVD, including:
- smoking
- stress
- alcohol
- high blood pressure
- high blood cholesterol
- being physically inactive
- being overweight or obese
- diabetes
- family history of heart disease
- ethnic background
- sex - men are more likely to get CVD earlier than women
- age - the older you are, the more likely you are to get CVD.
How is cardiovascular heart disease diagnosed?
Diagnosis of coronary heart disease depends on your symptoms and what condition your doctor thinks you may have.
Tests may be based on your family history and can include:
What is the treatment for cardiovascular heart disease?
Treatment will depend on your condition, but usually includes:
- lifestyle changes
- medication
- a device such as an ICD or pacemaker
- stents
- heart surgery.
- Cardiovascular Disease (CVD) - types, causes & symptoms | British Heart Foundation (bhf.org.uk)
Everything you need to know about heart disease
Heart disease refers to any condition affecting the heart. There are many types, some of which are preventable.
Unlike cardiovascular disease, which includes problems with the entire circulatory system, heart disease affects only the heart.
According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the United States. Around
In this article, learn more about the types, causes, and symptoms of heart disease.
There are several different types of heart disease, and they affect the heart in different ways.
The sections below will look at some different types of heart disease in more detail.
Coronary artery disease
Coronary artery disease, also known as coronary heart disease, is the most common type of heart disease.
It develops when the arteries that supply blood to the heart become clogged with plaque. This causes them to harden and narrow. Plaque contains cholesterol and other substances.
As a result, the blood supply reduces, and the heart receives less oxygen and fewer nutrients. In time, the heart muscle weakens, and there is a risk of heart failure and arrhythmias.
When plaque builds up in the arteries, this is called atherosclerosis.
Congenital heart defects
A person with a congenital heart defect is born with a heart problem. There are many types of congenital heart defect, including:
- Abnormal heart valves: Valves may not open properly or may leak blood.
- Septal defects: There is a hole in the wall between either the lower chambers or the upper chambers of the heart.
- Atresia: One of the heart valves is missing.
Congenital heart disease can involve major structural issues, such as the absence of a ventricle and problems with the main arteries that leave the heart.
Many congenital heart problems do not cause any noticeable symptoms and only become apparent during a routine medical check.
According to the American Heart Association (AHA), heart murmurs often affect children, but only some are due to a defect.
Arrhythmia
Arrhythmia refers to an irregular heartbeat. It occurs when the electrical impulses that coordinate the heartbeat do not work properly. As a result, the heart may beat too fast, too slowly, or erratically.
There are various types of arrhythmia, including:
- Tachycardia: This refers to a rapid heartbeat.
- Bradycardia: This refers to a slow heartbeat.
- Premature contractions: This refers to an early heartbeat.
- Atrial fibrillation: This is a type of irregular heartbeat.
A person may notice a feeling like a fluttering or a racing heart.
Brief changes in heart rhythm are not a cause for concern, but treatment will be necessary if they persist, as this can affect the heart’s function.
In some cases, arrhythmias can even be life threatening.
Dilated cardiomyopathy
In dilated cardiomyopathy, the heart chambers become dilated, meaning that the heart muscle stretches and becomes thinner. The most common causes of dilated cardiomyopathy are prior heart attacks, arrhythmias, and toxins.
As a result, the heart becomes weaker and cannot pump blood properly. It can result in arrhythmia, blood clots in the heart, and heart failure.
It usually affects people aged 20–60 years, according to the AHA.
Myocardial infarction
Also known as heart attack, myocardial infarction involves an interruption of the blood flow to the heart. This can damage or destroy part of the heart muscle.
The most common cause of heart attack is plaque, a blood clot, or both in a coronary artery. It can also occur if an artery suddenly narrows or spasms.
Are there different types of heart attack? Learn more here.
Heart failure
When a person has heart failure, the heart is still working but not as well as it should. Congestive heart failure is a type of heart failure.
Heart failure can result from untreated coronary artery disease, high blood pressure, arrhythmias, and other conditions. These conditions can affect the heart’s ability to pump properly.
Heart failure can be life threatening, but seeking early treatment for heart-related conditions can help prevent complications.
Hypertrophic cardiomyopathy
This condition usually develops when a genetic problem affects the heart muscle. It tends to be an inherited condition.
The walls of the muscle thicken, and contractions become harder. This affects the heart’s ability to take in and pump out blood. In some cases, an obstruction can occur.
There may be no symptoms, and many people do not receive a diagnosis. However, hypertrophic cardiomyopathy can worsen over time and lead to various heart problems.
Anyone with a family history of this condition should ask for screening, as receiving treatment can help prevent complications.
Hypertrophic cardiomyopathy is the main cause of cardiac death among athletes and people aged under 35 years, according to the AHA.
Mitral valve regurgitation
This event occurs when the mitral valve in the heart does not close tightly enough and allows blood to flow back into the heart.
As a result, blood cannot move through the heart or the body efficiently, and it can put pressure on the veins leading from the lungs to the heart. In time, the heart can become enlarged, and heart failure can result.
Learn more about heart valves here.
Mitral valve prolapse
This happens when the valve flaps of the mitral valve do not close properly. Instead, they bulge into the left atrium. This can cause a heart murmur.
Mitral valve prolapse is not usually life threatening, but some people may need treatment.
Genetic factors and connective tissue problems can cause this condition, which affects around 2% of the population.
Aortic stenosis
In aortic stenosis, the pulmonary valve is thick or fused and does not open properly. This makes it hard for the heart to pump blood from the right ventricle into the pulmonary artery.
In aortic stenosis, the aortic valve opening is too narrow, restricting blood flow from the left ventricle to the aorta. It can also impact the pressure in the left atrium.
A person may be born with it, or it may develop over time due to calcium deposits or scarring.
The symptoms of heart disease depend on the specific type a person has. Also, some heart conditions cause no symptoms at all.
The following symptoms may indicate a heart problem:
- angina, or chest pain
- difficulty breathing
- fatigue and lightheadedness
- swelling due to fluid retention, or edema
In children, the symptoms of a congenital heart defect may include cyanosis, or a blue tinge to the skin, and an inability to exercise.
Some signs and symptoms that could indicate heart attack include:
- chest pain
- breathlessness
- heart palpitations
- nausea
- stomach pain
- sweating
- arm, jaw, back, or leg pain
- a choking sensation
- swollen ankles
- fatigue
- an irregular heartbeat
Heart attack can lead to cardiac arrest, which is when the heart stops and the body can no longer function. A person needs immediate medical attention if they have any symptoms of heart attack.
If cardiac arrest occurs, the person
- immediate medical help (call 911)
- immediate cardiopulmonary resuscitation
- a shock from an automated external defibrillator, if available
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Heart disease develops when there is:
- damage to all or part of the heart
- a problem with the blood vessels leading to or from the heart
- a low supply of oxygen and nutrients to the heart
In some cases, there is a genetic cause. However, some lifestyle factors and medical conditions can also increase the risk. These include:
- high blood pressure
- high cholesterol
- smoking
- a high intake of alcohol
- overweight and obesity
- diabetes
- a family history of heart disease
- dietary choices
- age
- a history of preeclampsia during pregnancy
- low activity levels
- high stress and anxiety levels
The
The treatment options will vary depending on the type of heart disease a person has, but some common strategies include making lifestyle changes, taking medications, and undergoing surgery.
The following sections will look at some of these options in more detail.
Medications
Various medications can help treat heart conditions. The main options include:
- Anticoagulants: Also known as blood thinners, these medications can prevent clots. They include warfarin (Coumadin).
- Antiplatelet therapies: These include aspirin, and they can also prevent clots.
- Angiotensin-converting enzyme inhibitors: These can help treat heart failure and high blood pressure by causing the blood vessels to expand. Benazepril (Lotensin) is one example.
- Angiotensin II receptor blockers: These can also control blood pressure. Valsartan (Diovan) is one example.
- Angiotensin receptor neprilysin inhibitors: These can help open up narrowed arteries to treat heart failure.
- Beta-blockers: Atenolol (Tenormin) and other medications in this class can reduce the heart rate and lower blood pressure. They can also treat arrhythmias and angina.
- Calcium channel blockers: These can lower blood pressure and prevent arrhythmias by reducing the pumping strength of the heart and relaxing the blood vessels. One example is diltiazem (Cardizem).
- Cholesterol-lowering medications: Statins, such as atorvastatin (Lipitor), and other types of drug can help reduce levels of low-density lipoprotein cholesterol in the body.
- Digitalis: Preparations such as digoxin (Lanoxin) can increase the strength of the heart’s pumping action. They can also help treat heart failure and arrhythmias.
- Diuretics: These medications can reduce the heart’s workload, lower blood pressure, and remove excess water from the body. Furosemide (Lasix) is one example.
- Vasodilators: These are medications to lower blood pressure. They do this by relaxing the blood vessels. Nitroglycerin (Nitro Stat) is one example. They can also help ease chest pain. Learn more about vasodilation here.
A doctor will work with the individual to find a suitable option.
Sometimes, side effects occur. If this is the case, it may be necessary to review the medication regimen.
Surgery
Undergoing heart surgery can help treat blockages and heart problems when medications are not effective.
Some common types of surgery
- Coronary artery bypass surgery: This allows blood flow to reach a part of the heart when an artery is blocked. Coronary artery bypass grafting is the most common surgery. A surgeon can use a healthy blood vessel from another part of the body to repair a blocked one. (CABG)
- Valve replacement or repair: A surgeon can replace or repair a valve that is not functioning properly.
- Repair surgery: A surgeon can repair congenital heart defects, aneurysms, and other problems.
- Device implantation: Pacemakers, balloon catheters, and other devices can help regulate the heartbeat and support blood flow.
- Laser treatment: Transmyocardial laser revascularization can help treat angina.
- Maze surgery: A surgeon can create new paths for electrical signals to pass through. This can help treat atrial fibrillation.
Heart transplants are another option. However, it can be hard to find a suitable donor at the right time.
Find out how long it takes to recover from bypass surgery here.
Some lifestyle measures can help reduce the risk of heart disease. These include:
- Eating a balanced diet: Opt for a heart-healthy diet that is rich in fiber and favors whole grains and fresh fruits and vegetables. Also, it may help to limit the intake of processed foods and added fat, salt, and sugar.
- Exercising regularly: This can help strengthen the heart and circulatory system, reduce cholesterol, and maintain blood pressure.
- Maintaining a moderate body weight: A person can check their body mass index (BMI) here.
- Quitting or avoiding smoking: Smoking is a major risk factor for heart and cardiovascular conditions.
- Limiting alcohol intake: Females should consume no more than one
standard drink per day, and males should consume no more than two standard drinks per day. - Managing underlying conditions: Seek treatment for conditions that affect heart health, such as high blood pressure, obesity, and diabetes.
Taking these steps can help boost overall health and reduce the risk of heart disease and its complications.
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