Cardiovascular disease
WHAT IS CARDIOVASCULAR DISEASE?
Cardiovascular disease (CVD) is a term that’s given to conditions which affect the blood vessels or the heart. It’s usually linked to a build-up of fat in the arteries (atherosclerosis) or a higher risk of blood clots (thrombosis). It can also be linked to damage to arteries in organs like the heart, brain, kidneys and eyes.
CVD can be fatal, but it can also be prevented through lifestyle changes. The cause of CVD isn’t always clear but there are risk factors which can increase your risk of getting it. If you have more risk factors, you have a higher chance of developing CVD. There are risk factors you can control and some you can’t control.
If you’re over 40, your GP will invite you for an NHS Health Check. This happens every five years. This check includes looking at your individual risk for CVD and they’ll also advise you how to reduce your risk if needed.
TYPES OF CORONARY HEART DISEASE
There are many different types of CVD. The four main types are; coronary heart disease (CHD), Stroke and Transient Ischaemic Attacks (TIAs) Peripheral arterial disease, and Aortic disease. We’ll talk you through the symptoms, risk factors and what might help you if you have CVD.
The coronary arteries are the main blood vessels that make sure the heart has a supply of blood. CHD happens when there’s a reduced or blocked flow of oxygen-rich blood to the heart. This blockage can be due to a build-up of fatty substances (atheroma) in the coronary arteries.
This can put a strain on the heart which may lead to:
• Heart attacks – where the blood flow to the heart muscle is suddenly blocked and the blood can’t reach the heart muscle. This is a medical emergency and you need to call 999
• Heart failure – where the heart can’t pump blood around the body properly. This usually happens if the heart becomes weak or stiff
• Angina – this is chest pain caused by reduced or restricted blood flow to the heart muscle
Symptoms of CHD include:
• Chest pain (angina)
• Body pain
• Breathlessness or shortness of breath
• Feeling faint
• Nausea
CHD can be diagnosed using different tests.
What increases my risk of coronary heart disease?
There are several risk factors that can increase your risk of developing coronary heart disease. Some of these you can control and some of them you can’t.
Risk factors you can’t control are:
• Age
• Family history
• Ethnicity
• Being post-menopausal
Risk factors you can control include:
• Diet
• Level of physical activity
• Smoking habits
You can learn more about the risk of cardiovascular disease in the "Risk of cardiovascular disease" section of the page. Lifestyle changes can help reduce your risk of coronary heart disease. Learn more in the “Preventing cardiovascular disease in adults” section of this page. For face-to-face specialist assessment and advice, and if appropriate, diagnostics and treatment, from a private Cardiologist at Circle Health Group please please find out more on how to book here1.
A stroke is a serious life-threatening condition that happens when the blood supply to part of the brain is blocked, which kills brain cells that can cause brain damage and even be fatal. Strokes can affect people in different ways and can be life-changing. The sooner you receive treatment for a stroke, the less damage you’re likely to have.
A stroke is a medical emergency. If you’re experiencing any symptoms of a stroke, call 999.
The most common signs of a stroke can be remembered with the word FAST which stands for:
• Face – If someone’s had a stroke, their face including their mouth or eye might’ve drooped on one side. This can mean they aren’t able to smile
• Arms – if someone has a stroke, they might not be able to lift both their arms up and keep them there as their arms might be weak or numb. This can happen in one or both arms
• Speech – Their speech may be slurred and they may not be able to talk even though they look awake. They might also struggle to understand what you’re saying to them
• Time – Strokes are medical emergencies. It’s time to call 999 immediately if you see any of the signs or symptoms
TIA
A transient ischaemic attack (TIA) sometimes called a “mini-stroke” is similar to a stroke, but instead of blocking the blood flow to the brain, the blood flow is temporarily interrupted. This causes a lack of oxygen in the brain. The symptoms have a fast onset and are similar to a stroke. They can include:
• Disturbances in vision and speech
• Numbness or weakness in the face, arms and legs
A TIA doesn’t last as long as a stroke. They can last for a few minutes to hours. Most of them fully resolve within 24 hours. A TIA is a medical emergency, like a stroke. If you see any of the signs of a TIA or stroke, call 999 even if symptoms disappear. The ‘FAST’ symptoms also apply to TIAs. People think that strokes only happen to older people, but they can happen at any age. One in four strokes in the UK happen to people of working age.
What increases my risk of stroke?
You can learn more about the risks of cardiovascular disease in the "Risk of cardiovascular disease" section of the page.
Specific risk factors for stroke include:
• Sex – women have some specific risk factors like pregnancy and if they take the combined contraceptive pill
• Having sickle cell disease
Peripheral arterial disease usually happens when blood flow to the arteries in the leg muscles is restricted by fatty deposits narrowing the arteries. You might hear of it as peripheral vascular disease.
Many people who have peripheral arterial disease usually have no symptoms, but if you do have symptoms, they may include having a painful ache in their legs when they walk which normally disappears after resting. Doctors may call this “intermittent claudication”. The pain can range in severity and can affect both legs at the same time, but in some cases, the pain can be worse in just one leg.
Other symptoms of peripheral arterial disease are:
• Loss of hair on your legs and feet
• Numbness or weakness in your legs
• Brittle and slow-growing toenails
• Open sores (ulcers) on your feet and legs which aren’t healing
• The skin colour on your legs changing colour for example if they turn paler than usual or turn blue. This can be harder to see on brown and black skin
• Having shiny skin
• In men, having erectile dysfunction
• Your leg muscles getting smaller (wasting)
The symptoms of peripheral arterial disease develop slowly over time in most cases. Make sure to speak to your GP if your symptoms develop quickly or get worse quickly as this could mean you need urgent treatment.
If you have leg pain when you’re exercising and this happens often, you need to speak to your GP. Some people may think these are part of growing older, but recurring leg pains need to be investigated by your doctor.
To diagnose peripheral arterial disease, your GP might do a physical exam by comparing the blood pressure in your arm and your ankle. A difference between them might suggest peripheral arterial disease.
What increases my risk of peripheral arterial disease?
Certain factors can increase your chances of developing peripheral arterial disease. You can learn more about the risks of cardiovascular disease in the "Risk of cardiovascular disease" section of the page.
Medication and lifestyle changes are the main treatments for peripheral arterial disease. Learn more in the “Preventing cardiovascular disease in adults” section of this page. Peripheral arterial disease isn’t life-threatening straight away, but the blocking of the arteries can lead to serious problems which could be fatal.
Aortic disease is the term given to a condition that affects the aorta – the largest blood vessel in the body. The aorta carries blood from the heart to the other parts of the body. An aortic aneurysm is a common aortic disease. This happens if the aorta gets weak and then bulges outwards. If you have an aneurysm and it gets bigger, you might have symptoms like:
• Back pain
• Tummy pain
• A feeling of pulsing in your tummy
Speak to your GP if:
• You have tummy or back pain that doesn’t go away
• You have tummy or back pain that keeps coming back
• You can feel a lump in your tummy
These symptoms could have other causes but it’s best to get them checked.
Call 999 immediately if you or someone else:
• Has sudden and severe pain in your tummy or back
• Is struggling to breathe or has stopped breathing
• Have pale or grey skin (if you have brown or black skin, this might be easier to see on the palms of your hands or the soles of your feet)
• Loses consciousness
The above symptoms could be signs of an abdominal aortic aneurysm bursting, which is a life-threatening emergency. This needs urgent treatment in the hospital. An ultrasound is the main test to diagnose an abdominal aortic aneurysm. An ultrasound test is offered to all men when they turn 65 as they’re most at risk of getting an abdominal aortic aneurysm. Treating an abdominal aortic aneurysm depends on the size and your symptoms. If it’s small, your doctor might recommend lifestyle changes to stop it from growing. In some cases, you might need:
• Surgery to reduce the risk of it bursting
• Medicines to reduce your blood pressure and cholesterol to stop it getting bigger
Your doctor can discuss your options with you.
What increases my risk of an abdominal aortic aneurysm?
The causes of an abdominal aortic aneurysm aren’t always clear, but some people are at higher risk. These groups include:
• Being male and aged 65 or over
• If you smoke or used to smoke
• If you have a close relative who’s had an abdominal aortic aneurysm
• Have coronary or peripheral artery disease
• Have chronic obstructive pulmonary disease (COPD)
• Have a condition like Marfan syndrome
You can learn more about the risks of cardiovascular disease in the "Risk of cardiovascular disease" section of the page. In rare cases, abdominal aortic aneurysms can be caused by an infection.
Coronary heart disease, a form of cardiovascular disease, was the biggest killer of women in 2019. Before menopause, women have a lower risk of being affected by coronary heart disease. After the menopause, there’s a higher risk.
During menopause, the levels of oestrogen, progesterone and testosterone in the body reduce. Oestrogen is protective for the heart as it helps to control the levels of cholesterol and helps to reduce the chance of fatty deposits building in your arteries. It also helps keep your blood vessels healthy. A decrease in oestrogen levels can increase the cholesterol in your blood, therefore meaning fatty deposits can build up in your arteries. This can increase your risk of developing coronary heart disease, a heart attack or a stroke.
You can learn more about menopause and heart health with Boots.
High blood pressure can damage your blood vessels. This is one of the most important risk factors for cardiovascular disease. Blood pressure is recorded with two numbers:
• Systolic pressure (higher number) – the force of your heart pumping blood around your body
• Diastolic pressure (lower number) – the pressure in your arteries when your heart rests between beats
These are both measured in mmHg (millimetres of mercury). You can check your blood pressure at home or Boots stores in England using the NHS Blood Pressure Check Service27 if you’re eligible.
As a guide:
• High blood pressure is considered to be 140/90mmHg or higher
• Low blood pressure is considered to be under 90/60mmHg
• Ideal blood pressure is considered to be between 120/80mmHG
Blood pressure differs between people. Your normal may be different to someone else’s.
Being overweight can increase your risk of developing high blood pressure and diabetes, which are risk factors for cardiovascular disease. Your risk of cardiovascular disease is generally considered to be increased if:
• Your body mass index (BMI) is 25 or above
• You’re a man with a waist measurement of 94cm (about 37 inches) or more
• You’re a woman with a waist measurement of 80cm (about 31.5) inches or more
BMI measurements are useful for most people, but it isn’t accurate for everyone. For example, if you’re very muscular or you’re from an ethnic minority background. If you’re from an ethnic minority background, the BMI reading for you to be considered overweight or obese may be lower. You can check your BMI using the NHS BMI Calculator.
Smoking and other uses of tobacco can increase your risk of cardiovascular disease. These substances can damage your arteries and narrow your blood vessels. If you smoke, giving up smoking can help reduce your chances of cardiovascular diseases. The NHS Stop Smoking Service1 at selected Boots pharmacies can help.
Drinking too much alcohol regularly can increase your cholesterol and blood pressure. This can lead to weight gain and obesity – a risk factor for cardiovascular disease.
Cholesterol is a fatty substance that’s found in the blood. It’s essential for your body to function. It’s made in the body but also found in food. There are “good” types of cholesterol which carry cholesterol away from your cells. These are called high-density lipoprotein (HDL). There are also “bad” types of cholesterol called low-density lipoproteins (LDL). These carry cholesterol to your cells and if there’s too much of it, it can build up in your artery walls.
High cholesterol can cause your blood vessels to narrow and this can increase your risk of getting a blood clot. High cholesterol doesn’t usually give you any symptoms, you find out if you have it from a blood test. If your cholesterol levels haven’t changed after changing your diet and lifestyle your doctor might recommend some medicines to help.
Stress by itself won’t cause cardiovascular disease, but it’s linked to habits that can increase your risk. If you’re stressed, you might be more likely to turn to habits like smoking, overeating, drinking too much alcohol or not being physically active. These things may help you feel better at the time, but too much of them can impact your heart health.
Your risk of cardiovascular disease is higher if you have a family history of it. A family history is if:
• Your father or brother was diagnosed with cardiovascular disease before the age of 55
• Your mother or sister was diagnosed with cardiovascular disease before the age of 65
If you have a family history of cardiovascular disease, speak to your doctor or nurse. They might want to check your blood pressure and cholesterol level.
In the UK, you have an increased risk of developing cardiovascular disease if you have a South Asian, Black African or African Caribbean background. This is because these ethnic backgrounds are more likely to have other risk factors like type two diabetes or high blood pressure.
Having a healthy lifestyle can help reduce your risk of developing cardiovascular disease. If you already have cardiovascular disease, making lifestyle changes to stay as healthy as possible can help reduce the chances of it getting any worse.
Stop smoking
If you smoke, giving up smoking can help reduce your chances. The NHS Stop Smoking Service1 at selected Boots pharmacies can help.
Eat a balanced diet
A balanced diet can help keep your heart healthy. A balanced diet means eating a wide range of foods in the right proportions.
Try to include:
• Plenty of fruit and veg
• Plenty of wholegrain starchy foods like brown rice, bread or pasta
• Some dairy products like milk
• Some protein like meat, fish, eggs and non-dairy sources
• Small amounts of food and drinks high in fat and sugar
When you can, choose options that are lower in salt, fat and sugar that can support weight management. Find out more.
Exercise Regularly
Exercise is a great way to help you stay well. It’s recommended that adults ages 19-64 years should try to do at least 150 minutes of physical activity over a week. If this is difficult for you, start small and work your way up. Speak to your GP before starting any new forms of exercise if you have an existing medical condition or haven’t exercised in a while.
Reduce your alcohol intake
Try not to exceed the recommended amount of 14 units per week for both men and women. If you are drinking this amount, try to spread it over three days or more. If you’re finding it difficult to reduce your drinking, speak to your GP for advice.
Maintain a healthy weight
Exercising and eating a healthy diet can help you lose weight if you’re overweight.
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FREQUENTLY ASKED QUESTIONS
Having high cholesterol can cause your blood vessels to narrow and become blocked. This is because it can lead to a build-up of fat in your artery walls. This means blood isn’t able to flow around your body easily. This can make your heart work harder and therefore lead to diseases of the heart and blood vessels (cardiovascular disease).
Here’s a short general guide to blood pressure readings.
High blood pressure:
- This is from 140/90 mmHG or more if your reading was taken at the GP;
- or 135/85mmHG if taken at home.
- If you’re over 80, high blood pressure is from 150/90mmHg or more if your reading was taken at the GP;
- or 145/85mmHG if taken at home.
ideal blood pressure:
- This is usually between 90/60mmHg and 120/80mmHG
- The target blood pressure for people over 80 years old is below 150/90mmHg if taken at a GP;
- or 145/85mmHg if taken at home.
If your blood pressure is between 121/81mmHG and 139/89mmHG, you could be at risk of developing high blood pressure if you don’t keep it well controlled. Blood pressure differs between people. Your high or low may be normal for someone else and vice versa.
Chemicals in cigarettes like tar can make your artery walls sticky. This means that fatty deposits can stick to the walls and begin to block your arteries. This means blood isn’t able to flow around your body easily. This can make your heart work harder and therefore lead to diseases of the heart and blood vessels (cardiovascular disease).
If you have a family history of CVD, you might have a higher risk of developing it. Hereditary conditions are caused by faults in one or more of your genes (genes are inherited from parents). A family history condition is when the condition is caused by a combination of your genes and the lifestyle or habits you share with your family. This means you might not inherit the genes for CVD, but you might share similar habits that can increase your risk of CVD.
1 Subject to availability. Eligibility criteria apply. Charges may apply.
12 Please note, free home postal delivery is only available to patients registered with a GP in England. However, the option to collect in-store is available for all customers registered with a participating GP anywhere in the UK. For patients registered with a participating GP surgery only. Prescription charges may apply.
27 The NHS Blood Pressure Check Service is for adults aged 40 years and over who do not currently have a diagnosis of hypertension, for adults under 40 years of age who have a recognised family history of hypertension may be tested at the discretion of the pharmacist, and adults who have been referred by their GP
** Cardioace® includes Thiamin (vitamin B1), which contributes to the normal function of the heart.
** Stop smoking aid, contains nicotine, requires willpower, always read the label
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