03 May Heart disease. Everything you need to know.
The Heart Truth!
- Cardiovascular disease (CVD) is the number one cause of death in Australia.
- There were 45,392 deaths attributed to heart disease in Australia in 2015.
- On average, one Australian dies as a result of CVD every 12 minutes.
- One in six Australians are affected by cardiovascular disease, accounting for more than 3.7 million Australians.
- Accounted for 518,563 hospitalisations in 2012/13.
- Remains the most expensive disease group in Australia, costing about $7.47 billion in 2008-09.
Cardiovascular disease (CVD) is a cluster of conditions that affect the heart and its surrounding blood vessels.
The most common types include:
- Coronary artery disease – Disease to the heart’s major blood vessels.
- A condition where the force of the blood pumping through the artery walls is too high.
- Heart attack – When blood flow to the heart is stopped due to a blocked artery (circulation problem).
- Cardiac arrest – The heart starts to malfunction and stops beating correctly due to an electrical malfunction (electrical problem).
- Congestive heart failure – A condition where the pumping capacity of the heart is reduced.
- Arrhythmia – A condition where the heart starts to beat abnormally, either too slow, too fast or skipping beats.
- Peripheral Artery Disease – A circulatory problem caused by narrowing of the arteries which reduces blood flow to your limbs.
- Stroke – Damage to the brain as a result of restriction to the blood flow.
- Congenital heart disease – Being born with an abnormality in the heart.
There are several risk factors associated with cardiovascular disease which increase your risk in suffering from the aforementioned conditions. Fortunately for YOU, some of these risk factors are modifiable (under your control) vs non-modifiable (not under your control). Both types of CVD risk factors have been categorised for your advantage to better control / prevent this epidemic.
Modifiable risk factors: (risk factors that CAN BE controlled, treated or modified)
Hypertension (high blood pressure)
- Is the leading cause of CVD death worldwide.
- Is known as the ‘silent killer’ as many people don’t realise they have it because there are often are no warning signs or symptoms.
- Smoking damages the lining of the arteries, negatively impacts your lipid profile (increases bad cholesterol and decreases good cholesterol) and increases the chances of obtaining a clot.
- Nicotine increases blood pressure, heart rate and makes the blood ‘stickier’ causing it to clump.
- Being exposed to second smoke will also increase your risk of CVD.
GOOD NEWS THOUGH…once you quit smoking your risk of CVD returns to the approximate level of a non-smoker.
Raised blood glucose (diabetes)
- If you are a diabetic you are 2-4 times more likely to develop CVD.
- Damages your blood vessels.
- If you are diabetic you are more likely to suffer from a heart attack, stroke, peripheral arterial disease and 2-3 times more likely to suffer from heart failure.
- You can potentially have a heart attack without realising it due to the nerve damage diabetes may cause.
- Physical inactivity is defined as less than 2.5 hours of moderate exercise each week, or less than 1 hour of vigorous exercise each week.
- It will increase your risk of CVD and dying prematurely from a multitude of diseases in comparison to individuals who engage in regular exercise.
- Sedentary behaviour will lead to weight gain, increases in blood pressure and waist circumference.
- Exercise will increase your hearts capacity to pump blood around the body, improve circulation, keep your arteries flexible, reduce cholesterol and fat levels, decrease heart rate and reduce overall stress of the heart. You will lose these benefits if you are physically inactivity.
- Consuming foods which are high in saturated and trans fats increase your levels of cholesterol.
- High intake of salt leads to increases in blood pressure.
- A unhealthy diet will lead to an increase in body fat and waist circumference which directed correlated to CVD and other chronic disease such as diabetes.
- Low fruit and vegetable intake accounts for 20% of heart disease worldwide. They also contain components which help protect the body against heart disease.
- Increased cholesterol will cause narrowing of the blood vessels and reduce the amount of blood flow through them.
- Cholesterol is increased from consuming foods which are high in saturated and trans fats.
- Your goal is to have a higher amount of ‘good’ cholesterol (HDL) and a lesser amount of ‘bad ‘cholesterol (LDL).
- Females generally have lower cholesterol as the female hormone estrogen acts to increase HDL cholesterol.
Safe cholesterol ranges:
Total Cholesterol – below 4.0mml/L
LDL Cholesterol – below 2.0 mmol/L
HDL Cholesterol – above 1.0 mmol/L
Triglycerides – below 1.7 mmol/L
Individual ranges may vary if you have other chronic conditions or if you have suffered from a cardiac event.
Overweight and obesity
- Holding extra weight around the abdominal area will negatively affect your blood pressure, lipid levels and your bodies ability to regulate insulin (a hormone that regulates your blood sugar levels).
- As you increase your intra-abdominal weight your risk of obtaining diabetes and hypertension also increases.
- Is associated with increases in blood pressure, heart rate and may induce an irregular heartbeat. A stressful lifestyle will also encourage you to adopt poor lifestyle habits like eating unhealthy foods, smoking and decrease sleep. All these factors will have a negative effect on your heart health.
Non-modifiable risk factors: (risk factors that CAN NOT BE controlled, treated or modified)
- The risk of developing CVD increases with age.
- The chambers of the heart become weaker, stiffer and work less efficiently.
- Males are more at risk of heart disease in comparison to pre-menopausal women. However, once menopause has passed, both males and females are equally at risk.
- If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative), the risk increases.
Early investigation is vital in the battle against CVD. A proactive approach will help provide feedback regarding your overall health and risk of suffering from a CVD or cardiac event. It becomes particularly important as you get older and if you suffer from several of the CVD risk factors. Certain methods won’t be warranted unless advised by your cardiologist however there are other methods available to give you a indication of where your Cardiovascular health status is.
- Very simple measurement which will provide you with important information regarding the amount of fat located around your waist / organs.
- This measurement will give you an indication of how much visceral fat you have.
- Men: Increased risk 94-102cm, High Risk > 102cm
- Women: 80-88cm, High Risk > 88cm
Blood pressure measurement:
- This will give you a measure of the amount of pressure being exerted against the walls of your arteries.
- This can be measured at your local GP, pharmacist, gym or you can also purchase your own automated monitor.
- For interpretation of your blood pressure ranges click here.
Body fat percentage:
- Research has shown that body fat, and not BMI, is independently associated with cardiovascular risk factors, indicating that measurement of body fat is a better predictor.
- You can measure your body fat at your local gym with an Exercise Physiologist or Personal Trainer, alternatively you can purchase a scale and monitor this regularly at home.
- Conducting an annual blood test will give you a clear indication of what is happening inside your body and provide early detection of underlying issues regarding your health.
- Along with many other indicators, a blood test will provide you with your cholesterol levels, insulin control, fasting blood sugar levels, kidney and liver function, blood profile and cardiac damage after a cardiac event.
Echocardiogram (Heart ultrasound)
- This is an ultrasound of the heart conducted over the chest or in some cases down the throat (oesophagus).
- It provides information regarding the size of the heart, functionality of the chambers, valves and how strong your heart pumps out blood.
- Sticky dots (electrodes) with leads are placed over the chest and / or arms and legs to monitor the electrical activity of the heart.
- This test will help your doctor diagnose a heart attack or abnormal heart rhythms (arrhythmia).
- Is an ECG conducted while you are physically active. It will give you an indication as to how your heart is responding under stress.
Angiogram (cardiac catherisation)
- Usually conducted during or after a heart attack or angina (sharp chest pain).
- Involves a small tube (Catheter) being inserted in the artery in your groin, wrist or arm until it reaches your heart. With the use of special dye the x-ray will show your doctor if and where your arteries are narrowed and how well your heart is pumping.
- They will also help the doctor choose the best method of surgery if required.
An unhealthy diet is the most important risk factor in preventing and managing CVD because it’s the one risk factor that YOU have control over and the one that has the most affect on YOUR cardiac health. It will be hard to exercise all day, but we sure can keep eating all day! If we look back at the latter half of the century, we see our diets transition from plant based to energy dense, high fat, animal based artificial foods. Now if we combine that with being physically inactive….well, we get to where we are now. Good nutrition and eating healthy is vital not only for heart health but to prevent a range of other chronic diseases. Incorporate these strategies to save your life!
- Eat plenty of fruits and vegetables.
- Avoid high amounts (every day) of animal based products.
- Choose low or reduced fat milk, yogurt and dairy products.
- Consume foods which are high in soluble fibre and healthy fats.
- Consume moderate amounts of good fats as they are energy dense.
- Avoid fast foods, foods with refined sugars and processed foods.
- Avoid added salt consumption.
- Remove poultry skin and trim all visual fats off meat.
- Control portion sizes of food intake.
- Consume plenty of water.
- Limit alcohol intake.
- Limit intake of caffeinated beverages.
- Use a food journal to monitor your food intake and review your weekly food consumption.
- Remove foods which are unhealthy from your pantry to avoid indulging at home.
Conducting exercise is vital in the prevention of CVD. Not only will it prevent several risk factors (obesity, increased lipids, hypertension), associated with the disease but it will also strengthen the cardiovascular system and prevent your risk of attaining a range of other chronic diseases.
The exercise guidelines to prevent CVD and maintain good health are:
- Conduct a minimum of 2.5 – 5 hours of physical activity each week.
- Work between low (55-70 % MHR*) and higher (>70 % MHR) intensities.
- Be active on most days of the week.
- Don’t think exercise only happens in the gym! Stretch your mind.
- Include resistance exercise, flexibility and balance components for a holistic approach.
- Incorporate group exercise (exercise groups, Yoga, Pilates, team sports) to take advantage of the psychological benefits (reduced anxiety, mindfulness, social interaction).
- Use an exercise diary or buddy up with a friend to keep you accountable.
- See a Exercise Physiologist or a Personal Trainer to set your program.
- Make exercise fun, exciting and adventurous; i.e. Exercise outdoors, go indoor rock-climbing, conduct hikes, swim in the ocean, challenge yourself! Grow!
*Maximal Heart Rate
This type of rehabilitation is defined by a holistic approach to help return an individual with heart disease to an active and normal lifestyle and to prevent the reoccurrence of a cardiac event. This specific type of rehabilitation is available through public sectors for specific cardiac conditions but available to everyone if your Exercise Physiologist is comfortable to manage your condition with your multidisciplinary team (Cardiologist, Doctor, Physiotherapist). Cardiac rehabilitation will help you understand your condition and how to live with it by making the appropriate changes to your lifestyle.
There are several procedures which can be conducted to help improve and/or restore the function of the cardiovascular system once you have suffered from a cardiac event.
It is normal to feel anxious to commence an exercise regime following a cardiac event or surgery. Is it safe to exercise? How much do I do? What do I do? Will I have another heart attack? This thought process is completely normal following a life threatening experience. Understanding your next step is crucial to help you return to your normal lifestyle and regain confidence.
The exercise guidelines and considerations for exercise after a cardiac event include:
- Consult with your cardiologist first and obtain exercise guidelines according to your specific condition.
- Start with low intensity short duration physical activity and progress weekly according to your capacity.
- Slow down or cease exercise if you are short of breath or if you have pains in the chest.
- If applicable, have your angina medication available while you are exercising.
- Consult with an Exercise Physiologist to conduct an exercise test to assess your capacity and set safe exercise limits to work within according to your specific condition and circumstances.
Lifestyle and behaviour
- Reduce / quit smoking.
- Reduce stress and anxiety levels. Incorporate self managing techniques such as yoga, meditation and learn to identify your triggers.
- Be more physically active throughout the day; i.e. increase walking, steps, reduce sitting time and choose alternative transport to work.
- If prescribed with cardiac medication, understand how to correctly consume them and consult with your doctor regarding any side effects that they may produce.
In a nut shell
Your actions following any cardiovascular interventions are paramount to ensure that you don’t return under the knife. The longevity of any cardiovascular revision will be based on your compliance with exercise, improving your eating habits and changing your lifestyle. Working together with your Cardiologist, General Practitioner and Accredited Exercise Physiologist will be imperative in your rehabilitation following surgery and or better yet use these guidelines to prevent any cardiovascular complications in the first place. BE PROACTIVE!
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