Central and North West London NHS Foundation Trust Caring for your heart

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1 Central and North West London NHS Foundation Trust Caring for your heart A staff guide to preventing cardiovascular disease

2 Caring for your heart Cardiovascular disease (CVD), the main forms of which are coronary heart disease and stroke, remains the most common cause of death, and in the UK the incidence of CVD remains among the highest in the world. The good news is that the chances of being affected by CVD can be reduced by early identification of the factors that may put you at risk and by taking appropriate action at an early stage. And what is good for the heart and circulation, is also beneficial for your overall health, reducing the likelihood of other illnesses now and in later life. Coronary heart disease The heart has its own blood vessels, the coronary arteries, which bring oxygen-rich blood to the heart muscle. These coronary arteries can get furred up causing them to narrow or even get blocked. If this happens you can become very ill.

3 Heart attack A heart attack occurs when the blood supply to part of the heart muscle itself is severely reduced or stopped. The reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle is blocked. This is usually caused by the build-up of plaque (deposits of fat-like substances) and the affected vessels can eventually burst, tear or rupture, creating a snag where a blood clot forms and blocks the artery. This leads to a heart attack. If the blood supply is cut off for more than a few minutes, muscle cells suffer permanent injury and die. This can kill or disable someone, depending on how much heart muscle is damaged. Some heart attacks are sudden and intense where no one doubts what is happening. Others start slowly, with mild pain or discomfort. Often people affected aren t sure what is wrong and wait too long before getting help. Signs of a heart attack include some or all of the following: discomfort in the chest, in one or both arms, the back, neck, jaw or stomach, shortness of breath, along with sweating, nausea and light-headedness. Angina Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. It occurs when the heart muscle doesn t get as much blood (hence as much oxygen) as it needs. This usually happens because one or more of the heart s arteries (blood vessels that supply blood to the heart muscle) is narrowed or blocked. Typical angina is uncomfortable pressure or pain in the centre of the chest. The discomfort may also be felt in the neck, jaw, shoulder, back or arm, and is most commonly experienced after physical exertion.

4 Stroke Stroke is a cardiovascular disease that affects the blood vessels supplying blood to the brain. A stroke occurs when a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged by a blood clot or some other particle. Because of this rupture, or blockage, part of the brain doesn t get the flow of blood it needs. Deprived of oxygen, nerve cells in the affected area of the brain fail and die within minutes. When nerve cells can t function, the part of the body they control can t function either. The devastating effects of stroke are often permanent because dead brain cells aren t replaced. Effects of CVD on the heart and brain

5 What are the risk factors? A number of factors may lead to the development of cardiovascular diseases. It is now believed that these factors add up to increase your own risk. Family history of heart attack or stroke Your risk is greatly increased if someone in your immediate family has had a heart attack or stroke under 60 years old. Smoking Smoking causes furring up of the blood vessels, and makes your blood more likely to clot, eventually causing blockages. Obesity Excess weight increases the strain on the heart and can influence blood pressure and cholesterol, and could lead to diabetes. People with excess body fat, especially if it is around the waist, are more likely to develop CVD even if there are no other risk factors. High blood pressure This can run in families and is also more common in overweight people. High blood pressure is sometimes called the silent killer because most people who have it do not feel ill. The only way it can be detected is by having your blood pressure measured. Diabetes Diabetes dramatically increases a person s risk of heart disease and stroke. Being overweight increases the likelihood of developing diabetes as you get older. Lack of physical activity Physical activity exercises the heart and blood vessels. Lack of physical activity increases your risk of being overweight and your risk of cardiovascular disease.

6 High blood cholesterol Cholesterol is a soft, waxy substance found among the lipids (fats) in the bloodstream and in all your body s cells. It s normal to have cholesterol. It s an important part of a healthy body because it s used to form cell membranes, some hormones and serve other needed bodily functions. Too much cholesterol can cause furring of the blood vessels. You may need to have your blood cholesterol level checked, particularly when you have other risk factors for CVD. High alcohol intake This causes an increase in blood pressure and can also lead to an increase in blood cholesterol. Ways of reducing your risk of CVD Stop smoking You may be able to do this by yourself, but if you find it difficult, your GP or practice nurse can help by prescribing nicotine replacement therapy. You can obtain details of your local smoking cessation services from the CNWL Occupational Health Service (OHS) or your GP. Blood pressure checks Have your blood pressure checked at least every five years. This can be done quickly even if you are visiting your GP or the CNWL OHS for another reason. Eat healthily Eating a healthy diet with five helpings of fruit or vegetables each day and eating less sugary and fatty foods can help to prevent you becoming overweight. Regular exercise Any physical activity which makes you warm and slightly out of breath is beneficial. Your employer has arrangements with local leisure facilities that enable you to join at a reduced rate. Further details are available on the intranet. Alcohol intake Keep your alcohol intake below 21 units per week for a man and below 14 units per week for a woman a unit is half a pint of beer or one measure of spirits. Wine is now stronger than it used to be and a glass of wine (175mls) can be two or two and a half units.

7 The CNWL Occupational Health Service has a cardiovascular risk factor screening programme to help maintain and promote the health of staff. This programme is in line with national guidance. The programme involves one visit where your blood pressure, blood glucose and cholesterol will be measured along with your weight, height and waist. Then your cardiovascular risk will be calculated. You will be advised how to reduce your risk and be given a report of your results. A copy of these will be sent to your GP with your permission. Health concerns If you have a family history of heart attack or stroke before the age of 60, ask a health professional for their assessment. Where to get advice: The CNWL Occupational Health Service Tel: occupationalhealthcnwl@nhs.net British Heart Foundation Tel: Website: NHS Choices Website Website: coronary-heart-disease You can also contact your GP or a practice nurse at your local surgery. Call the CNWL OHS on

8 Confidentiality Use of personal data is protected by the Data Protection Act For information about accessing your health records please contact your organisation s Information Governance Team. Comments, compliments, complaints We welcome your views on our service. We have a comments box available for feedback. Alternatively, you can contact the complaints office on: Tel: pals.cnwl@nhs.net The service is open Monday - Friday, 09:00-17:00. Central and North West London NHS Foundation Trust, Stephenson House, 75 Hampstead Road, London NW1 2PL. Tel: Central and North West London NHS Foundation Trust February, 2014