Understanding Heart Disease
Introduction We all know that heart health is important and that we should maintain a healthy diet and take regular exercise, but our hectic lifestyles don t always allow for this. However, because heart disease and stroke are the main causes of death in Ireland, it s vital that we understand the risk factors involved and how best to manage them. This booklet will explain the many steps you can take to help keep your heart healthy. However, if you have any specific questions or concerns you should always talk to your GP. 1
Heart disease and stroke major health problems Heart disease and stroke account for almost 40% of deaths in Ireland, killing over 10,500 people here in 2004.* Lifestyle plays a major part in the development of heart disease and stroke. For example, an unhealthy diet can place you at risk as it can lead to obesity (being overweight) and can cause high cholesterol levels. Obesity currently accounts for at least 2,500 deaths in Ireland each year.** Smoking is also a major cause of heart disease and smokers are twice as likely to have a heart attack as non-smokers.*** The risk of heart disease also increases for people who get little or no physical exercise. However the good news is that the risk of developing heart disease and stroke can be significantly reduced or even prevented by taking various steps towards better heart health. Taking these steps should help you to feel better and to live a longer, healthier life. *Central Statistics Office Ireland **www.healthpromotion.ie ***www.irishheart.ie 2
What are heart disease and stroke? The heart is a muscular pump that constantly pumps blood around your body. Because it works very hard, the heart itself needs a good blood supply to its muscles. Small tubes called the coronary arteries carry blood containing oxygen and nutrients to the heart muscle. Narrowing of the coronary arteries makes it difficult for blood to reach the heart muscle and can lead to heart disease. A person with heart disease may experience chest pain called angina, especially after exercising. If an artery leading to the heart muscle becomes completely blocked, it is called a heart attack. During a heart attack cells in the heart muscle may die because they are starved of vital oxygen and nutrients. Like the heart, the brain is also supplied with arteries to feed it with oxygen and nutrients. If an artery leading to the brain is completely blocked, brain cells may die and brain damage may occur this is known as a stroke. Brain Heart Coronary Arteries Kidneys 3
What are the risk factors for heart disease? A number of factors which cause heart disease and stroke have been identified. Some of these are factors you have no control over, eg. your age or gender. These are known as non-modifiable risk factors. However there are also many modifiable risk factors which you do have control over, eg. high cholesterol, high blood pressure and smoking. By controlling your modifiable risk factors you can reduce your overall risk of developing heart disease or stroke. You can find out more about your modifiable risk factors on the following pages. Non-Modifiable risk factors Modifiable risk factors Family history Has a close relative died of heart disease? Gender Are you male? Age If you are male, are you over 40? If you are female, are you over 50? 1. High cholesterol 2. Smoking 3. High blood pressure 4. Obesity (being overweight) 5. Lack of exercise 6. Diabetes Source: European Society of Cardiology Guidelines. 4
1. Cholesterol One of the best ways to prevent heart disease is to keep your cholesterol at a healthy level and prevent it from getting too high. As having high cholesterol is not something you can just feel or see, many people don t realise that they have unhealthy cholesterol levels which are putting them at risk. This is why it is so important for people who may be at risk of developing heart disease or stroke to have their cholesterol levels checked regularly. This can be done easily by a GP or hospital clinic. What is cholesterol? Cholesterol is a soft, fatty, waxy substance which is found in the blood and plays many important roles in the human body. We need a certain amount of cholesterol to produce the cells in our bodies, for example; cells in our brain, nerves and skin. While some cholesterol is essential to our well-being, high levels have been strongly linked with an increased risk of developing heart disease and stroke. We get cholesterol from two sources: It is produced inside the body by the liver, It also found in some foods we eat, including meat, poultry, fish, seafood, eggs, and dairy products. 5
Are there different types of cholesterol? The word cholesterol is often seen as being negative but there are bad and good forms of cholesterol. Guidelines for healthy levels of cholesterol have been developed by the European Society of Cardiology and can be found on the following pages. Blockage causing Stroke Blockage causing Heart Attack LDL ( bad ) cholesterol LDL (low-density lipoprotein) cholesterol is known as the bad form of cholesterol. Too much LDL cholesterol in the blood tends to stick to the walls of arteries. This can build up over time causing a plaque to form. The plaque hardens the walls of the arteries and makes it more difficult for blood to get through. If an artery leading to the heart muscle becomes completely blocked, it is called a heart attack. LDL deposits build up inside arteries to form a plaque If an artery leading to the brain is completely blocked, brain cells may die and brain damage may occur this is known as a stroke. LDL cholesterol 3 should be 3 mmol/l or lower. 6
HDL ( good ) cholesterol HDL (high-density lipoprotein) cholesterol is known as healthy or good cholesterol because it removes LDL cholesterol from the walls of the arteries. This helps to prevent heart disease. HDL cholesterol should be 1 mmol/l or higher. 1 Triglycerides Triglycerides are another type of fat which is found in the blood and used by the body to provide energy. Triglycerides should be 2 mmol/l or lower. 2 Total cholesterol This is the sum of all the cholesterol in your blood, including LDL and HDL cholesterol. The higher a person s total cholesterol, the greater their risk for heart disease. How can I get my cholesterol tested? A simple blood test which your GP can provide the information that you and your doctor need to know about your cholesterol levels. Total cholesterol should be 5 mmol/l or lower. 5 You may need to fast for 12 hours beforehand to get an accurate result. The results will provide information about your levels of LDL, HDL, total cholesterol and triglycerides. Your doctor will discuss the results with you. Use the Cholesterol Tracker in the back of this booklet to record your cholesterol, triglyceride and blood pressure levels each time you visit the doctor. 7
2. Smoking Smoking is a major cause of heart disease and 7,000 people die from the effects of tobacco each year in Ireland*. Cigarette smoke contains carbon monoxide, a poisonous gas which reduces the amount of oxygen in the blood and forces the heart to work harder. Smoking increases LDL cholesterol and causes narrowing of the arteries**. It also causes many cancers and breathing conditions. QUIT SMOKING! * www.ash.ie ** www.irishheart.ie 3. High blood pressure (hypertension) Blood pressure is a measure of the force of the blood pushing against the walls of the arteries. If a person s blood pressure is too high this is known as hypertension. Hypertension can cause silent damage to the blood vessels and the heart. If untreated, this damage progresses over time and may lead to a heart attack or stroke. Blood pressure should be lower than 140/90 mmhg Hypertension usually has no symptoms so some people may have it for years without even knowing it. The only way you can find out if you have hypertension is by having your blood pressure checked. If your blood pressure is too high your doctor will suggest a treatment plan for you which may include medication to help lower the pressure. 8
4. Diabetes Diabetes is a condition which occurs when the sugar (glucose) level in the blood is too high. Having diabetes places you at a higher risk of a heart attack or other heart disease. Heart disease and stroke are the main causes of death in people with diabetes worldwide, with an estimated two out of three people with diabetes dying from these conditions.* Relatively small improvements in blood glucose, blood pressure and cholesterol can greatly reduce the risk for people with diabetes. What this means is that as well as taking care of your diabetes, you must also pay close attention to the health of your heart. *www.diabetes.org The latest European guidelines recommend that for people with diabetes: Total cholesterol should be less than 4.5mmol/l LDL cholesterol should be less than 2.5mmol/l HDL cholesterol should be more than 1mmol/l Trigylcerides should be less than 1.7mmol/l Blood pressure should be less than 130/80 mmhg 9
5. Obesity 6. Lack of exercise Obesity is the medical term used to describe the state of being overweight to the point where it is harmful to your health. Obesity causes heart disease, hypertension, non-insulin dependent diabetes and high levels of cholesterol. Lack of exercise has been clearly proven as a risk factor for heart disease but today s sedentary lifestyles mean that many people get little or no physical activity. Your Body Mass Index (BMI) is a number which is based on your height-weight ratio and gives an indication of whether you are overweight or not. Get 30-45 mins of physical activity 4-5 times weekly 30-45 minutes BMI should be less than 25 10
How can I reduce my risk? A healthier lifestyle is your best defence against developing heart disease and stroke. There are many things you can do to protect yourself. Eat a healthier diet A balanced diet which is low in fat can help you to protect your heart by lowering the amount of LDL cholesterol in your bloodstream. Try to eat less saturated fats like butter, margarine, chocolate and cream. Instead, swing the balance in favour of more fresh foods, fruits and vegetables, whole grain and oat-based cereals, low-fat dairy products, nuts and seeds, oily fish and lean meat. Eating less salt (sodium) will also benefit your blood pressure levels. The diet sheet which accompanies this booklet provides some useful tips on healthier eating. Eat 5 portions 5 of fruit and veg a day 11
Get active A reasonable level of regular exercise is not only good for your heart but also helps you to look and feel better. When combined with a balanced diet it helps to keep your weight at a healthy level. Taking the first steps to being more active can be as simple as taking the stairs rather than the lift, doing some gardening or walking to your local shop instead of driving there. Before undertaking any exercise plan, please discuss it with your doctor first. Give up smoking If you re a smoker, giving up will reduce your risk of heart disease and stroke and improve all aspects of your general health. The good news is that within five years of quitting, the risk of a heart attack falls to about half that of a smoker. Within 10 years, you will have about the same risk of heart disease as someone who has never smoked.* *www.irishheart.ie Get 30-45 mins of physical activity 4-5 times weekly 30-45 minutes QUIT SMOKING! Maintain a healthy weight If you re overweight, a sensible diet coupled with regular exercise will help get your BMI to a healthier level. If you re already at a healthy weight, you can help maintain it by taking exercise and eating well. BMI should be less than 25 Getting your cholesterol and blood pressure to target If lifestyle changes do not bring your cholesterol or blood pressure to healthier levels then your doctor may decide that you need to take medication. There are medications available which lower your cholesterol and blood pressure. You will need to take your medication every day for long-term benefits. 12
Interactive Screener Know Your Risk Answer the questions below by ticking the appropriate circle. Non-modifiable risk factors (things you can t change) If male, are you over 40 years old? YES NO Is your blood pressure 140/90 mmhg or higher, OR you have been told by your doctor that your blood pressure is too high?* YES NO Do you have diabetes OR do you need medicine to control your blood sugar? YES NO Do you have a Body Mass Index (BMI) score of 25 or more? If female, are you over 50 years old? YES NO YES NO Has a member of your immediate family died from heart disease? YES NO Modifiable risk factors (things you can change) Do you smoke? YES NO Do you get less than a total of 30 minutes of physical activity on most days? YES NO Complete this screener and then bring it to your doctor. Your doctor is the best person to assess your risk and advise you on your heart health. *If you don t know your blood pressure or cholesterol, ask your doctor about getting them checked. Is your total cholesterol level over 5 mmol/l?* YES NO 13
Cholesterol Tracker You can use this chart to record your cholesterol and blood pressure scores at each visit to your doctor or clinic. It will help you to keep track of your progress over time. Date Total cholesterol LDL cholesterol HDL cholestero 14
l Triglycerides Blood pressure 15
Useful websites www.healthpromotion.ie - Health Promotion Unit www.irishhealth.com - Independent health website www.bordbia.ie - Bord Bia www.bim.ie - Bord Iascaigh Mhara 16
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EPBU/2015/097/1 Date of Preparatoin: August 2015 Pfizer is Ireland s largest biopharmaceutical company and a leading employer at locations across the country. With a rich heritage of innovation and expansion over a forty year period in Ireland, our capital investment exceeds $7billion. We are committed to applying science and our global resources to improve health and wellbeing at every stage of life. Through working in partnership our goal is to ensure that people everywhere have access to innovative treatments and quality health care.