GP Zone Staff Zone

Understanding coronary heart disease

Heart disease is a concern for everyone. Research suggests there are just over 2.6 million people living with the condition in the UK. The older you are, the more likely you are to have heart disease. It affects about one in four men and one in five women aged 75 and over.

Coronary heart disease (CHD) develops when the artery supplying blood to the heart becomes partially or wholly blocked. It is often caused by fatty deposits building up on the inside lining of the arteries. This causes symptoms of chest pain, which is potentially treatable. CHD can result in a heart attack if the blood supply to the heart is stopped for long enough to cause damage.

You are more likely to develop coronary heart disease if:

The good news is that you can make changes to your lifestyle that will cut your risk of developing CHD in the future.

After coronary heart disease (CHD) has been diagnosed and treated, particularly if you stayed in hospital, you will need a period of rehabilitation. By focusing on exercise, relaxation and lifestyle, rehabilitation will help you get back to a normal life and keep you healthy. This is important, as CHD can be treated and managed but not cured.

What is angina?

Stable angina is a symptom that suggests that you have underlying coronary heart disease (CHD). Stable angina is chest discomfort brought on by activities such as exercise and emotional stress, which make high oxygen demands on your heart. It is caused by your arteries narrowing which means not enough oxygen rich blood can reach your heart muscle which causes discomfort.

The narrowing of the arteries is caused by atheroma. Atheroma is like fatty patches or 'plaques' that develop within the inside lining of arteries. (This is similar to water pipes that get 'furred up' with scale.) Plaques of atheroma may gradually form over a number of years in one or more places in the coronary arteries. In time, these can become bigger and cause enough narrowing of one or more of the arteries to cause symptoms.

What are the symptoms of angina?

The common symptom is a pain, ache or discomfort that you feel across the front of the chest when you exert yourself. For example, when you walk up a hill. You may also, or just, feel the pain in your arms, jaw, neck or stomach. If you experience these symptoms you should seek medical attention.

What is a heart attack?

A heart attack happens when a coronary artery that supplies oxygen and nutrients to the heart becomes completely blocked. The blockage often causes intense chest pain or a feeling of 'pressure' or 'heaviness' in the chest. You may also experience the following symptoms: sweating; light-headedness; nausea; breathlessness. Some people may fall unconscious.

If you think you are having a heart attack, dial 999 for immediate medical assistance

Understanding heart failure

Heart failure sounds alarming, but it does not mean that the heart has stopped completely. It describes what happens when the heart is having trouble pumping enough blood around the body, and it usually occurs because the heart muscle has become too weak or stiff to work properly.

It can affect the left, right or both sides of the heart, and this means that symptoms vary, depending on which side is affected. Heart failure is a long-term condition that affects about 800,000 people in the UK.

There are a number of conditions that make heart failure more likely to develop:

Many of the factors that increase the risk of developing heart failure can be managed either by making lifestyle changes or by taking medicines.

Understanding high blood pressure (Hypertension)

Blood pressure is defined as the amount of pressure exerted on the walls of the arteries as the blood moves through them. It is measured in millimetres of mercury (mmHg). Both the systolic and diastolic pressures are measured, and these figures are usually represented with the systolic pressure first, followed by the diastolic pressure.

There are two measurements used to assess blood pressure:

  • Systolic pressure is the blood pressure that is exerted when the heart beats and forces blood around the body
  • Diastolic pressure is the measure of blood pressure when the heart is resting between beats

So if your GP says that your blood pressure is '120 over 80', or 120/80mmHg, what they mean is that you have a systolic pressure of 120mmHg and a diastolic pressure of 80mmHg. High blood pressure (hypertension) is usually defined as having a sustained blood pressure of 140/90mmHg or above.

High blood pressure often causes no symptoms or immediate problems, but it is a major risk factor for developing a serious cardiovascular disease (conditions that can affect the circulation of blood around the body), such as a stroke or heart disease.

If you have high blood pressure, your heart has to work harder to pump blood around your body. Over time, this can weaken it. Also, the increased pressure can damage the walls of your arteries, which can result in a blockage or cause the artery to split (haemorrhage). Both of these situations can cause a stroke.

High blood pressure is common, with 40% of adults in England having the condition. The number of people who have high blood pressure increases with age. For reasons that are not entirely understood, people of Afro-Caribbean and South Asian (India, Pakistan and Bangladeshi) origins are more likely to develop high blood pressure than other ethnic groups.

In 95% of cases, there is no single identifiable reason for a raise in blood pressure. However, all available evidence shows that your lifestyle plays a significant role in regulating your blood pressure. Risk factors for high blood pressure include:

  • Age
  • Excessive alcohol consumption
  • Poor diet
  • Lack of exercise
  • Obesity

High blood pressure can be treated or prevented by making changes to your lifestyle, such as exercising more regularly, eating a healthier diet and cutting back on your consumption of alcohol. Medicines are also available that can help lower your blood pressure

Find out more about Heart Conditions.

Looking after yourself

When you've been diagnosed with a heart condition it's natural to need time to come to terms with what has happened to you and how your everyday life may be affected. Find out how to look after yourself here