Cardiovascular disease is
the leading cause of death worldwide, and it kills about 60 people under
retirement age every day in the UK.
Cardiovascular disease is
a general term that covers all health problems associated with heart or
circulatory system. This system made up of the main blood vessels, the arteries
and veins, and the smaller capillaries that take blood to and from the tissues
The main events due to
cardiovascular disease are angina and heart attack, which is due to coronary
heart disease, and stroke, which can also be called a brain attack. Cardiovascular
disease can also cause problems in the limbs or lungs if blood vessels taking
blood to them become narrowed or blocked.
Cardiovascular disease is due
to the process of atherosclerosis that occurs in the arteries as the body ages.
Atheroma, also called fatty deposits or plaques, build up and thicken the
artery walls. High levels of circulating low density cholesterol (‘bad
cholesterol’) accelerate this process, adding layers of fat within the
arteries. This is the basic underlying process that occurs in all types of
cardiovascular disease but the effects and symptoms vary depending on the site
of the affected blood vessels.
Different types of cardiovascular disease
The major sites affected
by diseased arteries are the heart, the brain and the limbs:
The heart: when
atherosclerosis affects the arteries supplying your heart, this reduces the
flow of blood to the heart muscle. As incoming blood delivers oxygen, this
means that the heart muscle cannot work efficiently. If you exercise, or just
run for the bus or up some stairs, this puts strain on the heart muscle and
causes typical angina pain. When the coronary arteries allow no blood flow, the
oxygen supply to the muscle of the heart is cut off altogether. This causes the
affected area of heart muscle to die, and the result is a heart attack, a
medical emergency that can be fatal if not treated quickly.
narrowing of the arteries can lead to blood clots in the brain, which cut off
the oxygen supply to large areas of brain tissue. This is known as a cerebral
thrombosis. If the clot causes the vessel to rupture, the bleeding that follows
is a cerebral haemorrhage. Both these events cause damage to the brain and the
resulting illness is commonly known as a stroke.
The limbs: it
may seem strange that cardiovascular disease can affect the limbs but narrowing
of the blood vessels that supply the legs, causes a lack of blood flow and
oxygen delivery to the working muscles. Aching legs or restless leg syndrome
can result, with leg ulcers likely as the problem gets worse. It is also
possible for a clot to form on the blood vessel in a limb, a condition known as
a deep vein thrombosis. Sometimes this clot, or part of it, breaks off and
travels elsewhere in the body. It stops when it blocks a smaller blood vessel.
This often happens in the lungs, causing a pulmonary thrombosis.
The symptoms of
Symptoms of heart disease typically include heavy or tight feelings within the
chest. Intense pain follows that can be felt in the throat or left arm as well
as in the chest itself. If pain of this type is experienced and does not
subside within 20 minutes, you should be seen urgently by a doctor or
Symptoms of a stroke normally arise suddenly, and can vary depending on the artery
affected. Symptoms can include paralysis or numbness of one side of the body,
difficulties speaking or swallowing, and problems with vision, balance and
Symptoms of peripheral vascular disease include pain in the legs, ulcers (large sores that
won’t heal) and even gangrene in the feet. This happens when the blood supply
is so poor that the muscles in the feet die. Amputation is then the only
cardiovascular disease is often not diagnosed until there are obvious symptoms.
A sudden heart attack or stroke can be fatal. If you experience symptoms or
think you may be at risk of cardiovascular disease, discuss this with your
doctor. Early diagnosis can reduce your risk of a serious cardiovascular event.
cardiovascular disease is usually based on symptoms, a physical examination and
other tests, such as a chest x-ray, an electrocardiogram (ECG; where the
electrical activity of the heart is monitored), or a coronary angiography. This
is a very useful imaging technique in which a fine tube is used to view inside
the arteries to detect narrowing.
Cardiovascular disease is
associated with several well-known risk factors, some of which you can avoid
and some you can’t.
risk factors that you can avoid or minimise include:
- Being overweight and/or having a large waist
circumference (being 'apple-shaped').
- Not getting much exercise or physical activity.
- High levels of LDL cholesterol.
- High triglycerides (usually caused by the build
up of fats from eating a high-fat diet).
- Low HDL cholesterol.
- High blood pressure.
- Poor kidney function.
Cardiovascular disease risk factors that you cannot
- Family history.
- Gender (being male increases the risk of
- Ethnic background (ancestry from India,
Pakistan, Bangladesh, or Sri Lanka increases the risk of cardiovascular
The main thing you can do
to avoid cardiovascular disease is to make lifestyle changes to reduce your
risk factors. These changes include stopping smoking, taking more exercise and
changing your diet.
Drug treatments can also
help control the symptoms of cardiovascular disease. Medications include
beta-blockers to control heart activity and reduce oxygen demand and diuretics
to lower blood pressure. Statins are often used to control cholesterol levels
and aspirin is commonly prescribed to help prevent blood clots.
In severe cases of
cardiovascular disease, you may be advised to have surgery. This can either be
an angioplasty, in which a small balloon or stent is inserted to open up a
blocked vessel, or a coronary artery bypass. This is a major operation in which
blood vessels from another site, usually the leg, are used to bypass the
blocked artery in the heart.