22 January 2024

What is heart disease and can you prevent it? As experts warn of rise in early deaths

22 January 2024

The number of people dying prematurely from cardiovascular disease has risen to the highest level in more than a decade.

More than 39,000 people died prematurely in 2022 of cardiovascular conditions including heart attacks, coronary heart disease and stroke – the highest annual total since 2008. And data released by the British Heart Foundation (BHF) shows a reverse of previous falling trends for people dying from heart problems before the age of 75.

In 2022 the premature death rate for cardiovascular disease reached 80 per 100,000 people in England – the highest rate since 2011 when it was 83. This is the first time there’s been a clear reversal in the trend for almost 60 years, and the BHF says it may be connected to  an increasingly unhealthy population, widening health inequalities, pressure on the NHS and the pandemic.

“This is sobering evidence that we’re in the grip of a heart care crisis,” warns consultant cardiologist and BHF associate medical director Dr Sonya Babu-Narayan.

“Every part of the system providing heart care is damaged. But this is happening at a time when more people are getting sicker and need the NHS more than ever.

“It doesn’t need to be this way. Urgent intervention is long overdue – I find it tragic that we’ve lost hard-won progress to reduce early death from cardiovascular disease.”

What exactly is heart disease?

The BHF explains that heart disease, also known as cardiovascular disease (CVD), includes conditions that narrow or block blood vessels.  A fatty material called atheroma gradually builds up inside the coronary arteries and eventually narrows them so much that they can’t get enough blood to the heart.

If a piece of the fatty material breaks off, a blood clot can form and block the coronary artery, cutting off the supply of blood and oxygen to the heart muscle. This is a heart attack.

CVD also includes problems with the heart muscle and valves, or conditions causing abnormal heart rhythms (arrhythmias).

What are the symptoms?

Symptoms of heart disease vary depending on the specific condition, but they can include chest pains, weakness, pain or numbness in the legs and/or arms, breathlessness, a very fast or slow heartbeat or palpitations, dizziness, lightheadedness or feeling faint, fatigue, and swollen limbs.

What about risk factors?

There are many CVD risk factors, some of which you can’t do anything about, including gender (men are more likely to get heart disease earlier than women), age (risk increases the older you get), ethnicity (black Africans, African Caribbeans and South Asians are at higher risk of developing high blood pressure or type 2 diabetes, which are heart disease risk factors), and family history (a combination of your genes and habits you share with your family).

But there are also many risk factors you can tackle. The BHF says lifestyle risk factors include smoking, stress, alcohol, high blood pressure, high cholesterol, physical inactivity, being overweight or obese, and having diabetes.

“Cardiovascular disease is preventable in many cases, and for those who do develop it research has given us effective treatments, explains Babu-Narayan. “There are things we can all do to reduce our risk, including managing our weight, improving our diets and keeping physically active.

“Attending your routine health check when invited is crucial to enable early detection and treatment of risk factors for heart disease, such as high blood pressure and high cholesterol, which could help prevent heart attacks, strokes and vascular dementia.”

Can heart disease be prevented?

Changing your lifestyle by stopping smoking, reducing alcohol intake, eating a healthy diet, losing weight if necessary, and exercising can help reduce high blood pressure and high cholesterol, and reduce your risk of having heart and circulatory problems. Babu-Narayan explains that further treatments include medication, having devices fitted such as an Implantable Cardioverter Defibrillator (ICD) or a pacemaker, which help treat abnormal heart rhythms, having stents fitted, which help improve blood supply to the heart, or having surgery to replace or repair damaged heart valves.

But  CVD still causes around a quarter of all UK deaths, and Babu-Narayan warns: “We are still seeing more people than expected die from cardiovascular conditions overall – more than any other disease group.”

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