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Heart disease is the UK's No.1 killer - here's how to beat it

There are ways to reduce the risk of disease affecting your body's most vital organ

    Surgery has helped reduce the number of deaths from heart disease
    Surgery has helped reduce the number of deaths from heart disease

    The heart is a remarkable organ. It beats approximately 100,000 times a day, 35 million times a year - and at least three billion times over your lifetime if you live to the age of 80.

    Given that workload, it's perhaps surprising that it doesn't go wrong more often.

    We've made real progress over the past few decades. Death rates from cardiovascular disease among the under-75s - what is called premature mortality - have fallen significantly since the 1970s.

    New techniques and medication are continuing to transform the way we treat the diseases that affect the heart.

    Nonetheless, cardiovascular disease still takes a heavy toll, affecting seven million people in the UK, costing the NHS £6.8 billion every year and causing more than a quarter of all deaths.

    Stats

    7m
    The amount of peope in the UK suffering from cardiovascular conditions
    1/4
    Heart disease causes a quarter of all deaths in the UK
    35m
    The number of time a person's heart beats a year. It will beat at least three billion times over the lifetime of someone who lives until the age of 80

    So what can go wrong with the heart - and what can we do to prevent it happening?

    The key cause of heart attacks is arteriosclerosis, the furring of the arteries which occurs when cholesterol and fatty deposits build up within artery walls, setting up an inflammatory reaction, a build-up of calcium and eventually blood clots which block the flow of blood.

    Furring the arteries starts very early in life and, if unchecked, will get worse as you get older. But the process is not inevitable and, by tackling those factors which increase your risk, you can significantly bring down the likelihood of a heart attack.

    The top risk factors include high blood pressure, smoking, obesity, lack of exercise, high cholesterol levels, alcohol consumption and a poor diet.

    Diabetes is a condition which also increases risk if not managed appropriately.

    The NHS health check, offered to everyone between the age of 40 and 74, helps people identify these risks in their own lives, so they can change their lifestyle or take medication and so help prevent problems with their heart.

    Just a modest reduction in systolic blood pressure (measured as 10mm Hg), for example, can reduce the risk of a cardiovascular problem by 28 per cent.

    And we know that the more risk factors you can tackle, the better.

    Living with several at once can multiply your likelihood of heart problems many times.

    For instance, if you're a smoker, have high blood pressure, diabetes and high cholesterol, each of which on their own double or quadruple your risk of a heart attack, then your risk rises not 8-16 times but by more than 40 times.

    The "heart age" tool, available on the NHS Choices website, can tell you whether your estimated heart age is older than your actual age, suggesting the need to reduce your risk, and the site gives practical advice on improving your heart health.

    But if you are one of those who unfortunately goes on to suffer a heart attack, what can you expect?

    A heart attack is, although the terms are often mistakenly used interchangeably, not the same as a cardiac arrest which is where the heart stops altogether and which is often, although not always, caused by a heart attack.

    A heart attack commonly causes crushing chest discomfort, sometimes going down the arms or up to the neck.

    Getting the blocked coronary artery open quickly after a heart attack is crucial. In the 1990s and early part of this century, we had significant success using clot-busting drugs in a process known as thrombolysis.

    More recently, we have realised that if you can get someone having a major heart attack into hospital quickly where an interventional cardiologist can reopen the artery, then the outcomes are better still.

    We use a tube called a catheter inserted through the wrist or the groin to pass a fine wire, about the thickness of the finest fuse wire, into the blocked artery, with a balloon or stent then used to restore blood supply.

    This procedure has been transformational. When I qualified in medicine in 1977, about 20 to 25 per cent of people admitted with a major heart attack would die in hospital.

    After the introduction of clot-busting drugs, death rates at 30 days following heart attacks fell to around 10 per cent and, with the use of active intervention techniques they have fallen further still to around 8 per cent.

    But it's not just about the acute procedures when you have a heart attack. Taking the right medication afterwards also has a significant impact on survival rates.

    For cardiac arrest, speed is absolutely of the essence and prompt life support (CPR) and defibrillation, both of which can be delivered by members of the public with only simple training, can make all the difference to survival.

    As we age, there are other problems that can affect the heart, and, with these conditions, increasing awareness and early diagnosis are crucial.

    It is estimated that 1.4 million people in England have atrial fibrillation, or abnormal heart rhythm, but around half a million of those are undiagnosed.

    Treatment with anti-coagulants can reduce the risk of the strokes associated with this condition.

    There is a drive, too, to increase awareness and diagnosis of heart valve disease, and of heart failure, a complex set of symptoms where the heart does not pump blood as efficiently as it should as a result of damage to the heart muscle, most commonly due to previous heart attacks but also including high blood pressure, some infections or side-effects of some cancer medications.

    Medical advances mean that an increasing proportion of our population is living longer. That's something we should celebrate. But it does mean more of us will be living with heart disease in our older years.

    Much progress has been made in prevention, diagnosis and treatments - and there are new drugs and technology on the horizon paving the way for future advances.

    But there is still more to be done. Whatever your age, and however many years you have left to live, those years will be better if you address the risks to your heart.

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