Cardiovascular disease

Cardiovascular disease (CVD) is a general term that describes a disease of the heart or blood vessels. 

Blood flow to the heart, brain or body can be reduced because of a:

• blood clot (thrombosis)  
• build-up of fatty deposits inside an artery, leading to the artery hardening and narrowing (atherosclerosis) 

Types of CVD

There are four main types of CVD:

• coronary heart disease 
• stroke 
• peripheral arterial disease 
• aortic disease 

Each type is discussed in more detail below.

Coronary heart disease

Coronary heart disease (CHD) occurs when your heart muscle's blood supply is blocked or interrupted by a build-up of fatty substances (atheroma) in the coronary arteries. 

The coronary arteries are the major blood vessels that supply your heart with blood.

If your coronary arteries become narrow due to a build-up of atheroma, the blood supply to your heart muscle will be restricted. This can cause angina (chest pains). 

If a coronary artery becomes completely blocked, it can cause a heart attack. This is a medical emergency.

Stroke

A stroke is a serious medical condition that occurs when the blood supply to the brain is disturbed.

Like all organs, your brain needs a constant supply of oxygen and nutrients to function properly. This is provided by the blood, so if your blood flow is restricted or stopped, brain cells will begin to die. This can lead to brain damage and possibly death.

Therefore, a stroke is a medical emergency and prompt treatment is essential. The sooner a person receives treatment, the less damage is likely to occur.

The main stroke symptoms can be remembered with the word FAST which stands for:

• Face – the face may have drooped on one side, the person may not be able to smile or their mouth or eye may have drooped 
• Arms – the person with suspected stroke may not be able to lift their arm and keep it raised due to weakness or numbness 
• Speech – the person's speech may be slurred or garbled, or they may not be able to talk at all despite appearing to be awake 
• Time – it is time to dial 999 immediately if you see any of these signs or symptoms 

Find out more about stroke 

Peripheral arterial disease

Peripheral arterial disease, also known as peripheral vascular disease, occurs when there is a blockage in the arteries to your limbs (usually your legs).

The most common symptom of peripheral arterial disease is pain in your legs when walking. This is usually in one or both of your thighs, hips or calves.

The pain can feel like cramp, a dull pain or a sensation of heaviness in the muscles of your legs. It usually comes and goes and gets worse during exercise that uses your legs, such as walking or climbing stairs.

Aortic disease

The aorta is the largest blood vessel in the body. It carries blood from your heart to the rest of your body.

The most common type of aortic disease is aortic aneurysm, which is where the wall of the aorta becomes weakened and bulges outwards. You will usually experience pain in your chest, back or abdomen (tummy).

Preventing CVD

Most deaths caused by cardiovascular disease are premature and could easily be prevented by making lifestyle changes, such as eating a healthy diet and stopping smoking. 

It is estimated that CVD is responsible for around 1 in 3 premature deaths in men and 1 in 5 premature deaths in women.

Many risk factors of cardiovascular disease (CVD) are linked. This means that if you have one of the risk factors you are also likely to have others.

High blood pressure (hypertension)

High blood pressure is a key risk factor for CVD. 

Poorly controlled high blood pressure can damage artery walls and increase the risk of developing a blood clot. 

Smoking (or other tobacco use)

The toxins in tobacco can damage and narrow coronary arteries, making them more vulnerable to coronary heart disease. 

Find out some effective to stop smoking

High blood cholesterol

High blood cholesterol can cause arteries to narrow and increase the risk of developing a blood clot. 

Diabetes

The high blood glucose (sugar) levels associated with type 1 diabetes or type 2 diabetes can damage the arteries. 

Many people with type 2 diabetes have other risk factors such as being overweight or obese.

Poor diet

A high fat diet can speed up the formation of fatty deposits inside arteries, leading to both high blood cholesterol levels and high blood pressure.

Find information on maintaining a healthy, balanced diet

Lack of exercise

People who don't exercise regularly usually have higher cholesterol, higher blood pressure and higher stress levels. 

They are also more likely to be overweight, another risk factor of CVD.

Being overweight

Being overweight or obese increases the risk of developing diabetes and high blood pressure. Both of which are risk factors of CVD. 

Excessive alcohol consumption

Excessive alcohol consumption can increase both cholesterol levels and blood pressure. 

Stress

Stress can increase blood pressure and the hormones associated with stress are thought to also increase blood glucose levels. 

Family history

People with a family history of CVD are more likely to develop it.

Ethnicity

Afro-Caribbean and South Asian communities are at higher risk of CVD.

Most risk factors for cardiovascular disease (CVD) are linked. This means that if you have one risk factor you'll probably also have others. 

An example of linked risks is that obese people are found to be more likely to have diabetes, high cholesterol and high blood pressure.

This means that to significantly reduce your risk of developing CVD, you need to look at your lifestyle as a whole.

In particular, you need to consider: 

• your diet  
• your weight  
• the amount of alcohol you drink  
• the amount of exercise and physical activity you do  
• whether you need to stop smoking  

Your diet

For a healthy heart, a low fat, high fibre diet that includes whole grains and plenty of fresh fruit and vegetables (at least 5 portions a day) is recommended. 

Your diet should include no more than 6g (0.2oz or one teaspoon) of salt a day, as too much salt will increase your blood pressure. This amount is contained in the everyday food and drinks you consume so avoid seasoning or cooking with added salt. It's also a good idea to limit the amount of salty foods you eat, such as ready-made meals and canned or tinned food.

Avoid eating foods high in saturated fat, as they will increase your cholesterol level. This includes:

• meat pies  
• sausages and fatty cuts of meat  
• butter and ghee (a type of butter often used in Indian cooking)  
• lard  
• cream  
• hard cheese  
• cakes and biscuits  
• foods that contain coconut or palm oil 

Find out more about maintaining a healthy, balanced diet

Exercise and weight management

If you're overweight or obese, you can lose weight using a combination of regular exercise and a calorie-controlled diet.

The recommendation for adults is 30 minutes of moderate-intensity aerobic exercise every day, at least 5 days a week. Cycling or brisk walking are examples of moderate intensity exercise. 

Other activities you could incorporate into your exercise programme include: 

• swimming 
• running  
• hill walking  

If you find it difficult to do 150 minutes of moderate intensity exercise each week, start at a level you feel comfortable with. Break it down into 10 minute chunks throughout the day.

Find out how to keep active

The amount of alcohol you drink

If you drink alcohol, you should not exceed the recommended daily limits: 

• 3 to 4 units for men 
• 2 to 3 units for women

A unit of alcohol is roughly equivalent to half a pint of normal strength lager, a small glass of wine or a single measure (25ml) of spirits. It's important to check the percentage proof on the label of the drink bottle or can, as some can be higher than the average unit volume.

You should see your GP if you are finding it difficult to moderate your drinking. Counselling services and medication can help you reduce your alcohol intake.

Find out how to drink alcohol responsibly

Smoking

If you smoke, it is strongly recommended you give up as soon as possible.

Find some effective ways to stop smoking, or phone Quit Your Way Scotland for free on 0800 84 84 84 (7 days a week, 8.00am to 10.00pm) for advice and support. 

Medication

If you have a particularly high risk of developing CVD, your GP may prescribe medication to help reduce your risk. 

Medication used to prevent CVD includes:

• blood pressure tablets (such as angiotensin-converting enzyme (ACE) inhibitors) – used to treat high blood pressure  
• statins – used to lower blood cholesterol levels 
• low-dose aspirin – used to prevent blood clots 

There's lots of good quality evidence to show that eating and drinking habits established during childhood can continue for many years into adulthood. 

Therefore, while bad eating habits in childhood may not pose an immediate health risk, they could lead to serious health problems in adulthood.

Four important things to consider are the amount of:

• fat in your child's diet 
• sugar in your child's diet 
• salt in your child's diet 
• exercise your child does  

Fats and sugar

It's recommended that you limit the amount of saturated fat and sugar your child eats.

Too much saturated fat and sugar in your child's diet can lead to high cholesterol, diabetes and high blood pressure in later life. 

It can also increase your child's risk of becoming overweight or obese and cause tooth decay.

Children’s foods that are high in saturated fats and sugar include:

• chocolate 
• sweets 
• fast food (such as burgers or chicken nuggets) 
• fizzy drinks 
• ice cream 
• biscuits 
• crisps 
• processed foods (such as microwave meals, hot dogs and breakfast cereals that contain additional sugar)

Salt

Eating high levels of salt in childhood has been linked to an increased risk of high blood pressure, heart disease and stroke in adulthood.

For babies and children, the current recommended limits of salt are:

• less than 1g of salt a day for children aged 0-6 months 
• 1g a day for children aged 7-12 months 
• 2g a day for children aged 1-3 years 
• 3g a day for children aged 4-6 years 
• 5g a day for children aged 7-10 years 
• 6g a day for children aged 11-14 years

It's easy to underestimate how much salt is contained in food. For example, a Happy Meal consisting of small fries, a hamburger and a coke contains 1.8g of salt, which is over half the recommended daily limit for a five year old.

Pre-packaged and ready-to-eat foods, particularly those not specifically designed for children, often contain high levels of salt. For example, a 200g tin of tomato soup contains 1.4g of salt.

You should always check the label of any foods you give your children so you can keep an eye on their daily salt consumption.

Exercise

Most children are naturally active and full of energy. However, children who spend a lot of time doing things that don't involve much physical activity, such as watching television and playing computer games, don't generally get the exercise they need.

It's recommended that:

• children under 5 years of age who can walk unaided should be physically active every day for at least 180 minutes (3 hours), spread throughout the day, indoors or out. 
• children and young people (5-18 years of age) should do at least 60 minutes (1 hour) of aerobic activity every day, which should include a mix of moderate-intensity activities, such as fast walking, and vigorous-intensity activities, such as running. 

This amount of exercise is enough to strengthen bones and muscles and can help prevent children putting on weight.

There are many different ways for children to exercise. Simply walking or cycling to school is a good way to start. Team sports can also be great fun and can improve co-ordination, balance and team skills. 

Most community sports centres run team activities for children, such as football, basketball and volleyball. Ask your local sports centre for more information.

If your children do not like team sports, there are plenty of other fun activities for them to try, such as hiking, swimming, dance and kickboxing.