What is Cardiovascular disease?
Cardiovascular disease (CVD) refers to all diseases of the heart and circulation and this covers a range of conditions such as coronary heart disease (CAD), stroke and peripheral artery disease (PAD). The main cause of CVD is when there is a build-up of plaque in the arteries, this is known as Atherosclerosis. It is one of the biggest killers in the world, therefore, it is important to know what you can do in your lifestyle to reduce your risk.
Coronary heart disease (CHD)
- It’s estimated someone dies from CHD every 8 minutes in the UK
- 45% of deaths in the UK from coronary heart disease are attributed to high levels of ‘bad’ cholesterol
- The risk of having a stroke doubles in someone with CHD or who has had a heart attack
CHD is the most common. This occurs when the flow of oxygen-rich blood to the heart muscle is blocked or decreased. This then puts a strain on the heart and can lead to heart attacks, angina or heart failure. A high level of ‘bad’ cholesterol is one of the main risk factors for CHD, when cholesterol builds up in the arteries, causing them to narrow and harden, it’s harder for the blood to flow easily through them. This means the heart has to work harder to pump blood around the body. Over time, this can weaken the heart so it doesn’t work as well as it should. If blood flow is restricted, it can also make it harder to deliver enough oxygen to our organs, this is called ischaemia.
CHD can sometimes lead to several common conditions such as:
- Angina (restriction of blood to the heart muscle resulting in chest pain)
- Heart attack (blood flow to the heart is suddenly blocked)
- Heart failure (the heart is unable to pump blood around the body properly)
What is Cholesterol?
Cholesterol is a waxy substance found naturally in the blood. Your body needs cholesterol to function properly but too much cholesterol can cause you problems. It is an essential part of every cell in our body and has many important functions. For example, it’s used as a building block to make hormones such cortisol, testosterone and progesterone. However, if too much cholesterol circulates in the blood, this can affect the risk of coronary heart disease.
Most of the cholesterol in our body is made by the liver. Our liver is also responsible for controlling the amount of cholesterol that circulates in our blood and distributing it to the areas that need it. A small amount of cholesterol comes from the foods we eat.
We have two types of fat in the body: saturated and unsaturated. When we have too much saturated fat via our diet, it can raise your cholesterol levels. If you have high cholesterol, your risk of heart disease and stokes may increase.
Cholesterol is broken down into good (HDL) and bad (LDL) cholesterol. Good cholesterol is improved through exercise whereas bad cholesterol is improved via heart healthy fats within the diet.
LDL transports cholesterol from the liver to sites such as cells and tissues. However, if the arteries are damaged, LDL can lose some of its cholesterol along the way. When LDL levels are high, there’s a greater chance that cholesterol will be deposited in the arteries. Cholesterol can start to build up in the arteries over a period of time and combine with other substances to form a fatty plaque known as an atheroma in the artery walls. This causes the arteries to narrow and harden – a process known as atherosclerosis. This means blood flows less easily around the body and our heart has to work harder to pump it around.
HDL carry excess cholesterol away from the arteries and takes it to the liver. Here, cholesterol is broken down and then eliminated from the body.
Triglycerides are another type of fat which provide energy to cells and tissues. If our energy needs are met, excess triglycerides are stored in fat cells until they’re needed. Triglyceride levels tend to be higher in people who are overweight, inactive, have type 2 diabetes, metabolic syndrome, eat a diet high in fatty and sugary foods, or drink too much alcohol.
Testing cholesterol is performed through a blood test.
- Total cholesterol – this is the total amount of cholesterol in the blood and includes both ‘good’ and ‘bad’ cholesterol. HDL or ‘good’ cholesterol – the higher the better
- Non-HDL or ‘bad’ cholesterol
- Total cholesterol to HDL ratio –looks at the proportion of HDL in relation to total cholesterol
Cholesterol and Diet
There are some foods that have natural cholesterol in them such as kidney, eggs and prawns. This is called dietary cholesterol. Dietary cholesterol has much less of an effect on the level of cholesterol in your blood than the amount of saturated fat you eat does.
Trans fats can also raise cholesterol levels. Therefore reducing the amount of bad fat in the diet can help to reduce your risk of heart disease.
Further, fibre can also lower your risk of heart disease and we should aim for roughly 30g per day.
Therefore, eating a healthy diet and also exercising could lower cholesterol or prevent cholesterol from become high.
Other risk factors which increase your risk of heart disease include:
- high blood pressure
- sedentary lifestyle
- drinking alcohol
- low consumption of fruit and vegetables
- type 2 diabetes
- a family history of CVD
- being older, male
Saturated and unsaturated fat
Foods high in saturated fat include:
- meat pies
- sausages and fatty cuts of meat
- butter, ghee and lard
- hard cheeses
- cakes and biscuits
- foods containing coconut or palm oil
Try to replace foods containing saturated fats with small amounts of foods high in unsaturated fats, such as:
- oily fish – such as mackerel and salmon
- nuts – such as almonds and cashews
- seeds – such as sunflower and pumpkin seeds
- vegetable oils and spreads – such as rapeseed or vegetable oil, sunflower, olive, corn and walnut oils
These can be found naturally in animal products e.g. milk, cheese, meat.
Processed foods such as cakes and confectionary items contain trans fats too.
High fibre intake may lower your risk of heart disease and cholesterol. High fibre foods include:
- wholegrain bread or cereal
- potato with the skin
High blood pressure
High blood pressure (HBP) is very difficult to physically notice. If untreated it can cause a higher risk of strokes, kidney disease, heart failure or heart attacks.
HBP is two numbers, the contraction of the heart (systolic) and the relaxation of the heart (diastolic).
As a general guide:
- high blood pressure is considered to be 140/90mmHg or higher (or 150/90mmHg or higher if you’re over the age of 80)
- ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg
Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control.
Lifestyle changes are important to help maintain a good blood pressure. Those at risk from high blood pressure include:
- are overweight
- eat too much salt and do not eat enough fruit and vegetables
- do not do enough exercise
- drink too much alcohol or coffee (or other caffeine-based drinks)
- do not get much sleep or have disturbed sleep
- are over 65
- have a relative with high blood pressure
- are of black African or black Caribbean descent
- live in a deprived area
Therefore, we can reduce this risk by:
- reduce the amount of salt you eat and have a generally healthy diet
- cut back on alcohol
- lose weight if you’re overweight
- exercise regularly
- cut down on caffeine
- stop smoking
There are a number of dietary guidelines we can follow.
- cut your salt intake to less than 6g (0.2oz) a day, which is about a teaspoonful – find out how you can reduce the amount of salt in your diet
- eat a low-fat, balanced diet – including plenty of fresh fruit and vegetables; get tips on eating more healthily
- be active – read some tips about getting more exercise
- cut down on alcohol – get tips on cutting down, including downloading a drinks diary and keeping track of your drinking
- lose weight – find out what your ideal weight is using the BMI healthy weight calculator and read advice about losing weight if you’re overweight
- drink less caffeine – found in coffee, tea and cola
- stop smoking – get help quitting
- Boost potassium as this can lessen the effects of sodium. High potassium based foods include avocado, coconut, banana.
Insomnia is linked to high blood pressure and heart disease.
Poor sleep over time can lead to increased stress, less motivation to be physically active and unhealthy food choices.
Getting enough exposure to natural light early in the day is important for healthy sleep habits.
If you’ve been keeping an eye on your blood pressure and cholesterol levels, there’s something else you might need to monitor: your triglycerides.
Having a high level of triglycerides in your blood can increase your risk of heart disease. But the same lifestyle choices that promote overall health can help lower your triglycerides, too.
Triglycerides (TRIGS) are a type of fat found in your blood. After you eat, any calories that are not used are converted into Trigs which are stored in our fat cells. These are then released in between meals via hormones for energy. Therefore, if you eat more than you burn, this could result in high levels of Trigs.
Having high levels of Trigs can lead to the thickening of artery walls (arteriosclerosis) or the hardening of arteries. This increases this risk of heart disease, strokes or heart attacks. If you have extremely high amounts of Trigs you could also suffer from pancreatitis. A group of conditions such as being overweight, having a high waist circumference, high blood pressure, abnormal cholesterol levels and high blood sugar levels can also lead to a higher risk of high Trigs.
High triglycerides can also be a sign of:
- Type 2 diabetes or prediabetes
- Metabolic syndrome — a condition when high blood pressure, obesity and high blood sugar occur together, increasing your risk of heart disease
- Low levels of thyroid hormones (hypothyroidism)
- Certain rare genetic conditions that affect how your body converts fat to energy
Sometimes high triglycerides are a side effect of taking certain medications, such as:
- Estrogen and progestin
- Beta blockers
- Some immunosuppressants
- Some HIV medications
A simple blood test can reveal whether your triglycerides fall into a healthy range:
- Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L)
- Borderline high — 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
- High — 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
- Very high — 500 mg/dL or above (5.7 mmol/L or above)
Your doctor will usually check for high triglycerides as part of a cholesterol test, which is sometimes called a lipid panel or lipid profile. You’ll have to fast before blood can be drawn for an accurate triglyceride measurement.
Triglycerides and cholesterol are different types of lipids that circulate in your blood:
- Triglycerides store unused calories and provide your body with energy.
- Cholesterol is used to build cells and certain hormones.
List of Heart healthy foods
TRIGS and Lifestyle
Choose healthier fats: exchange saturated fats (found in meat based products) for more plant based products. For example, exchange some red meat intake for oily fish such as tuna, trout or salmon. Processed and confectionary foods contain high amounts of trans fats or hydrogenated oils and fats. Have these in very small amounts.
Alcohol is very high in sugar and calories both of which have an effect on raising Trig levels. Reducing your alcohol intake to 14 units or under per week (this equates to 6 glasses or under) may be beneficial. This includes having at least 3 alcohol free days in the week and 2 in a row.
Sugar and refined carbohydrates such as foods made with white flour can raise Trig levels. Therefore, have these in moderation and small amounts.
Losing weight and being a healthy weight can also help to reduce the risk of high Trigs or can help to get your levels back within normal range. Those with high Trigs should aim to lose weight through regular exercise and calorie control. This is because extra calories which are not needed will be converted into Trigs for later to be sorted and used as energy.
High blood pressure
Regular physical activity such as 150 minutes a week, or 30 minutes most days of the week can lower your blood pressure by about 5 to 8 mm Hg if you have high blood pressure. It’s important to be consistent because if you stop exercising, your blood pressure can rise again.
If you have elevated blood pressure, exercise can help you avoid developing hypertension.
Some examples of aerobic exercise include walking, jogging, cycling, swimming or dancing. You can also try high-intensity interval training. Strength training also can help reduce blood pressure. Aim to include strength training exercises at least two days a week.
Cholesterol can be lowered if you have an active lifestyle. 150 minutes of moderate activity per week is suggested or 75 minutes of vigorous activity per week.
Exercise suggestions to raise your heart rate can include brisk walking, hill walking, sprints, dancing, HIIT workouts.
Regarding your exercise, regularity or at least 30 minutes per day is important to help maintain or lose weight but also to boost the good cholesterol. This in turn can help lower your Trig levels. Incorporate daily tasks into physical exercise e.g. vacuuming, dusting, cleaning, and taking the stairs, lunch break walks, skipping or running on the spot.
List of heart healthy foods
- Leafy green vegetables
- Whole grains
- Fatty Fish
- Dark chocolate
- Olive oil
- Green tea
The British Heart Foundation suggests a well balanced diet rich in fruit and vegetables, at least 5 portions of fruit and vegetables a day.
Pulses and beans count at one portion.
Contact a NUTRIPATH Nutritionist for a bespoke nutritional plan at