Ischaemic heart disease is the amongst the leading causes of death in the United Kingdom in men and women.
What exactly is a heart attack?
The progression of heart disease is determined by the progression of atherosclerosis (or to put it plainly, how much plaque is built up in your blood vessels). Heart attacks result from the formation of atherosclerosis, and of sclerotic plaques which are liable to block the passage of blood in the blood vessels to the heart. Try picturing a pipe that’s clogged up with muck: whilst there’s just a little, water can flow through but the flow of water will get weaker and weaker as the muck gets clogged and eventually, unless we clean the pipe, no water will be flowing through. If you need a visual, watch this short video by the British Heart Foundation.
When this happens, without the supply of oxygen from the blood, the heart tissue will die. This is a heart attack.
Symptoms of heart attack:
Symptoms of heart attacks in both men and women:
chest pains, discomfort, pain or pressure in the chest. Radiations to the neck, shoulder, back, arms or jaw. In addition, there may be: heartburn, strong pulse, change in heart rate, difficulty breathing, nausea, vomiting or abdominal pain, cold sweats, dizziness.
Symptoms of heart attacks that are typical in women:
weaker symptoms that may appear even without chest pain. Sudden weakness, shortness of breath, general pain, burning in the chest, pain or discomfort in the back, neck, shoulder, arms or jaw.
The symptoms are different in women than in men, but if you suspect you are having a heart attack, seek urgent medical attention.
Risk Factors for having a heart attack are:
Smoking – causes heart disease, and not just lung cancer. Smokers are 2-6 times more likely to have a heart attack than non-smokers. Smoking also increases the risk of stroke. Women smokers who are also taking birth control pills are at high risk.
Sedentary lifestyle – lack of exercise leads to an increased risk of suffering from heart attacks. Exercise also reduces the risk of high cholesterol, hypertension, diabetes and obesity. So this is the most important risk factor that is under our control. 20-30 minutes of exercise 5 times a week is the common recommendation.
Hypertension – blood pressure measures two values: systolic (the high number) measures the pressure in the blood vessels that is caused by the heart during contraction, and diastolic measures the pressure in the blood vessels at rest when the heart fills up. This is the most important factor in preventing heart failure and stroke in women. There are no symptoms of hypertension and it should be measured. Today we are encouraged to have blood pressure of 120/80 or less.
Obesity – BMI greater than or equal to 30. Abdominal obesity in itself increases the risk of cardiovascular disease. Obesity also increases the risk of diabetes, high cholesterol and high blood pressure.
Diabetes – increases the risk of cardiovascular disease, and increases threefold the risk of death from heart disease.
Cholesterol – a third of our cholesterol comes from our diet, the rest is produced in the body. Cholesterol levels in postmenopausal women tend to be higher than in men. A low-cholesterol diet reduces the risk of cardiovascular disease.
Metabolic syndrome – metabolic syndrome is characterised by the appearance of at least 3 of the 5 symptoms: blood glucose after fasting over 110, triglycerides over 150, blood pressure above 130/85, HDL cholesterol low below 50 in women and 40 in men, abdominal obesity. Metabolic syndrome increases the risk of heart disease and heart attacks.
Age – in old age, the risk of cardiovascular disease increases. Men are at higher risk until age 50, but after menopause women are at equal risk.
Genetics – close family connection to someone who had a heart attack at a young age increases personal risk.
These risk factors explain about half of the cases, but there are other risk factors that are not yet clear to us.
How do you know what the condition of your heart is?
There are a variety of medical tests that the GP may ask for in order to see the condition of your heart: echocardiography, stress tests, blood tests (including CRP, which is a measure of inflammation in the body, and cholesterol), and, of course, a blood pressure test.
Treatment options:
According to Western medicine, cases of obstruction can be treated with medication. Common medications:
- Aspirin, which is a blood thinner
- Nitroglycerin, a drug that reduces chest pain
- Beta blockers are used to reduce the load on the heart
- Calcium channel blockers, to reduce blood pressure and chest pain
- ACE inhibitors that reduce blood pressure and improve heart function after a heart attack
- Statins that reduce cholesterol and lower the risk of recurrent heart attack
- Hormone replacement therapy maintains the levels of oestrogen hormones, but increases the risk of other diseases, and is therefore no longer recommended for heart disease.
In addition, there are interventional measures, such angioplasty or stent, for example, to dilate the blood vessels.
In severe cases you may be referred for coronary artery bypass grafting surgery.
How do you reduce the risk of a heart attack?
Medical monitoring of risk factors is an integral part of treatment. When you notice the beginning of a problem, seek treatment for existing risk factors in order to create a healthy lifestyle. By leading a healthy lifestyle, in most cases you can avoid the need to use medication! Even if the condition is more advanced, an improvement in lifestyle can lead to a regression of atherosclerosis and even recovery from heart disease! Nutrition, herbal medicine and lifestyle have a HUGE impact and it’s never too late to start!
It is important to remember that small changes cause big improvements!
For every 1% reduction in total cholesterol, we see a 2% improvement in complications of cardiovascular disease.
For every 1 mm reduction in systolic blood pressure, a 2% improvement in mortality is seen.
For diabetics, each 1% decrease in glycated haemoglobin (haemoglobin A1c) values produces a 14% improvement with regard to the risk of heart attack.
