by Dr Georgia Page
Cardiovascular disease accounts for over 1 in 4 deaths in Australia as is the leading cause of death for older Australians. Approximately 1.2 million Australians are living with heart disease, stroke or vascular conditions. However, cardiovascular disease is largely preventable and by reducing cardiac risk factors, leading a healthy lifestyle and having regular checks with your doctor you can reduce your risk.
What is Cardiovascular Disease?
Cardiovascular disease (CVD), which includes heart disease, stroke and peripheral vascular disease, occurs when arteries become narrowed or blocked. This is due to a build up of fatty material in the wall of the blood vessels called plaque. Over time the plaque increases in size which narrows the blood vessel so less blood is able to pass through. This is called atherosclerosis. If the heart doesn’t get enough blood due to narrowing of the coronary vessels supplying the heart people may experience chest pain or shortness of breath. If some of the plaque breaks off and a blood clot is formed the coronary vessels can block completely causing a heart attack. Similar can occur when the vessels supplying blood to the brain become blocked, leading to a stroke.
Symptoms of Coronary Heart Disease
In the early stage of cardiovascular disease you may have no symptoms. It may not be until you have significant build up of plaque or atherosclerosis that you experience symptoms. A heart attack occurs when the artery supplying blood to the heart is completely blocked.
Not everyone’s symptoms are the same, and can be different amongst men and women.
Common symptoms include:
- Chest pain (angina) – can be described as a discomfort/pressure or tightness
- Pain in the neck, jaw, or left arm
- Shortness of breath
- Cold and sweaty
- More tired than usual
Women are more likely than men to have non-chest pain symptoms and may also experience:
- Flu-like symptoms (including fatigue and tiredness)
- Back pain
- Symptoms that last for several days
If you develop sudden chest pain or are concerned you may be having a heart attack please call 000 for an ambulance immediately.
Risk factors for cardiovascular disease
Risk factors increase your chance of having a heart attack or stroke. 2/3 of Australian adults have more than 3 risk factors for cardiovascular disease. There are some we can modify or change but others we can’t (such as family history). Modifiable risk factors account for 90% of risk factors.
Modifiable Risk Factors
Smoking – can increase your risk in several range such as reducing the amount of oxygen in your blood, damaging the artery walls, and making your blood and artery walls more ‘’sticky’’ which increases your risk of blockage and clots. Not only does this increase risk of heart attack and stroke but can also affect the arteries going to the hands and feet causing gangrene.
High Cholesterol – if we have too much cholesterol, we get a build up of fatty material in our arteries causing atherosclerosis. We have bad cholesterol (LDL – Low density lipoprotein) which causes the build up of plaque, and good cholesterol (HDL – high density lipoprotein) that is protective. By decreasing the LDL by dietary modification or medication we can reduce the risk of cardiovascular disease.
High Blood Pressure – can put extra pressure on the heart and also speed up the process of atherosclerosis, therefore increasing risk of heart attack and stroke.
Diabetes – Those with diabetes are at the same high risk of having a heart attack as those who already have established coronary artery disease. By preventing diabetes from developing in the first place, or controlling blood sugar levels and risk factors in those that already have diabetes, you can reduce risk of heart disease.
Physical Activity – The Heart Foundation recommends 30 – 45 minutes of exercise (such as walking) five or more days a week to reduce your risk of heart disease. Exercise can also help control other risk factors such as hypertension and diabetes.
Being Overweight – increases your risk of cardiovascular disease as well as other health problems such as diabetes, high blood pressure and high cholesterol. Having increased weight around your stomach (central adiposity) carries the greatest risk.
Depression – people with depression are at greater risk of developing CVD so it is important to have a chat to your GP if your mood has been low. Social isolation and reduced social supports can increase risk. Improving social connections and socialisation can decrease this risk.
Non-Modifiable Risk Factors
Family history – having a strong family history of CVD is a risk factor you cannot change but you can still reduce your risk but reducing other modifiable risk factors. E.g. healthy lifestyle and not smoking. If you have a strong family history of heart attacks or stroke, especially in a family member under the age of 60, please discuss your risk with your doctor.
Gender – as a general rule men have a higher risk than women for developing CVD in their middle ages. This risk increases as they get older. A women’s risk increased after menopause
Aboriginal and Torres Strait
Islanders – are also at increased risk of CVD. They are twice as likely to die from heart disease compared to non-indigenous Australians. Ethnic backgrounds can also increase your risk such as Maori or Pacific Islander, South Asian or Middle Eastern descent.
Heart Health Check
It is important to see your GP for a heart health check, especially if you are at risk. Heart checks are recommended for those over the age of 45 and over the age of 30 for Aboriginal and Torres Strait Islanders. Due to the Covid-19 Pandemic there has been less face to face attendance to the doctors for check up’s so there is a lot of catching up to do.
Your GP can assess your risk factors (such as measuring your BP, cholesterol and blood sugar levels), determine your cardiovascular risk and work out a management plan to keep you on top of your heart health.
How to reduce your risk of Cardiovascular Disease
The first point of treatment in reducing your risk of CVD is lifestyle modification and controlling risk factors. This includes;
- Improving diet
- Increasing physical activity
- Quit smoking
- Reduce alcohol intake
- Maintaining a healthy body weight Improving blood pressure
- Reducing cholesterol
- Preventing / or controlling diabetes
Sometimes medication is required in addition to lifestyle factors if there is inadequate control of blood pressure, cholesterol and blood sugar levels. It can be difficult to try and reduce these risk factors alone and there is some great health professionals and resources out there that can assist you. This may include a dietitian, exercise physiologist, personal trainer, psychologist, Quitline, and online resources. Have a chat to your GP regarding what management options might be right for you.
Georgia enjoys all aspects of general practice and has been working at Your Family Doctors at Erina for the last 12 years. The practice has a fabulous team and they pride themselves on delivering good quality health care, with that special personal touch. For more information call 43654999, check the website www.yourfamilydoctors.com.au or like them on Facebook.