Coronary heart disease is caused by fatty deposits building up in your coronary arteries – the vessels that supply blood to your heart. This narrows them, making it harder for blood to reach your heart.
If you have coronary heart disease, you may have:
- angina – chest pain when you’re physically active as a result of poor blood supply to your heart muscle
- a heart attack – when a coronary artery becomes completely blocked, part of your heart muscle is starved of oxygen and can be permanently damaged
- heart failure – this is when your heart can’t pump blood around your body properly, which can lead to breathlessness and swelling in your legs
Stopping smoking not only reduces your risk of developing heart disease, but also reduces the risk of many other serious illnesses, such as lung cancer and chronic obstructive pulmonary disease (COPD). Passive smoking (inhaling smoke from nearby smokers) may also increase your risk of heart disease. Try to reduce your exposure to this.
Stopping smoking is the most important thing you can do to help your health, and whatever your age, it's never too late to stop. As soon as you do, your health will improve. Within one year of giving up, your risk of a heart attack is halved. After 15 years, your heart attack risk will have fallen to the same level as someone who has never smoked.
Quitting smoking isn't easy and you may need to try several times before you succeed. You can refer yourself to your local NHS Stop Smoking Service, or your GP or practice nurse can refer you.
Taking regular exercise is one of the best things you can do for your heart. You can exercise at different intensities. Moderate means your breathing is faster, your heart rate is increased and you feel warmer. At this level of activity, your heart, lungs and muscles are being stimulated and this goes towards making you fitter. Vigorous intensity activity means that you will feel short of breath and your heart rate will be much faster than usual. You will probably find it difficult to talk or hold a conversation.
Aim to do some physical activity every day. The recommended healthy level of physical activity for adults is 150 minutes (two and a half hours) of moderate exercise over a week in bouts of 10 minutes or more. You can do this by carrying out 30 minutes on at least five days each week. Alternatively, you can do 75 minutes of vigorous intensity activity over a week, or a mixture of moderate and vigorous intensity exercise.
Exercising doesn’t have to mean going to the gym but can be things you build into your everyday routine such as walking as much as possible, taking the stairs instead of the lift, or getting off the bus one stop early. It’s important that you try to spend as little time as possible sitting or lying and being inactive. See our frequently asked questions for more information.
There are very few medical reasons not to be physically active, but check with your GP before starting to exercise if you're in doubt. The risk of doing yourself any harm is low if you start gently. Build up how often you do the activity before you increase how hard you work during a session. Sudden vigorous exercise, if you’re not used to it, can put your heart under too much strain and can be dangerous.
A healthy diet can help prevent heart disease. Aim to eat a balanced diet, basing your meals on wholegrain, starchy foods such as pasta, rice or potatoes, and eat plenty of fruit and vegetables. At least five portions a day is recommended. Include some dairy and non-dairy sources of protein, for example lean meat, fish, eggs, cheese or pulses and limit the amount of salt, sugar and fat in your diet.
Choose healthy cooking methods (grill, bake or steam rather than frying), trim fat off meat and remove skin from chicken. Try to eat one portion of oily fish, for example mackerel or sardines, a week. This can help to lower the cholesterol in your blood. Reducing the amount of salt you eat will help to lower your blood pressure.
Being overweight increases your risk of developing heart disease. You’re especially at risk if you have extra weight around your abdomen (tummy) and waist rather than on your bottom and thighs. Your GP will be able to advise if you need to lose excess weight. If you do, you will probably need to follow an exercise programme, as well as eating healthily.
Reducing the level of cholesterol in your blood can help to prevent heart disease. Some cholesterol is made by your body and some comes from the food you eat so try to cut down on the amount of fat in your diet. However, even if you already eat healthily, you may still have a high cholesterol level, particularly if other members of your family do. You may need to take medicines to reduce high cholesterol depending on what is causing it. See our frequently asked questions for more information.
It’s not possible to be precise about how much is safe for individual men and women to drink. Current guidelines, however, recommend not regularly drinking more than three or four units a day for men, and two or three units a day for women. Although ‘Regularly’ means every day or most days of the week, it’s a good idea to have at least two alcohol-free days a week so you don’t go over the limits. So over a week, men shouldn’t have more than 21 units and women shouldn’t have more than 14 units.
Drinking alcohol within the daily recommended amount may help to reduce the risk of heart disease if you’re over 45. If you drink more than this, any beneficial effect of alcohol is outweighed by the risk of damage to your heart, leading to high blood pressure, or weakening or enlargement of your heart muscle meaning it can’t pump blood effectively.
If you don’t drink alcohol, don’t start as there are other ways to protect yourself from heart disease, such as exercising regularly and stopping smoking. If you have heart disease or a heart condition, talk to your GP about whether it’s safe for you to drink alcohol.
Having at least two alcohol-free days a week will prevent your body from getting used to having alcohol every day. However, even if you haven't had any alcohol during the week, it isn’t safe to save up the allowance for a weekend drinking binge. Binge drinking is generally accepted to be drinking more than double the daily recommended amount at one time. Binge drinking is likely to be considerably worse for your health than drinking less but more often.
Think about the number of units you drink – some drinks may be stronger than you realise. The labels of many bottled and canned drinks will tell you the number of units they contain.
Diabetes (type 1 or type 2) puts you at a greatly increased risk of heart disease. You're also more likely to have high cholesterol levels and high blood pressure, especially if you have type 2 diabetes.
If you have diabetes, it's important to control your blood sugar, blood pressure and cholesterol level to try to minimise your risk of heart disease.
High blood pressure increases your risk of heart disease but you may not have any symptoms, so you may not know you have it. About a third of adults have high blood pressure. If you’re 40 or over, get your blood pressure checked by your GP or a nurse. He or she will be able to tell you if you need to take steps to lower it and how to do this.
Am I at risk if my family has a history of heart disease?
Yes. If someone in your immediate family (your parents or siblings) developed heart disease or had a heart attack when they were under 55 (for men) or 65 (for women), you may have an increased risk of developing heart disease.
It isn't known for certain why some people get heart disease and others don't. It may be that you have inherited certain genes that make you more likely to develop high blood pressure or high cholesterol. It could also be that you have picked up certain lifestyle habits from your family and these are responsible.
You're more likely to develop heart disease if you:
- don't do enough exercise
- eat too many foods that are high in saturated fat, such as cake and biscuits, pastry, meat products and hard cheese
- eat too much salt
- are overweight
- have high cholesterol
- have high blood pressure
- have diabetes
If there is a history of heart disease in your family, speak to your GP to discuss your risk. Your GP can tell you how likely you are to develop heart disease and whether you need any treatment. He or she may recommend lifestyle changes and/or prescribe medicines to help.
How do the fats in my food affect my heart?
Fat is a good source of energy but eating too much of the wrong types increases your risk of heart disease.
Some fat is an essential part of a healthy diet but it's important not to eat too much and to be careful of the types of fat you eat.
Most of the cholesterol in your blood is made by your liver and the rest comes from the food you eat. Not all cholesterol is bad for you and your body needs a certain amount to be healthy. There are two types of cholesterol – a harmful type and a protective type. The harmful form is called low density lipoprotein (LDL) and the protective form is called high density lipoprotein (HDL). Not having enough HDL may increase your risk of heart disease. Having too much LDL can mean it builds up in your arteries and prevents blood from flowing through them properly.
You can help reduce your cholesterol level by cutting down on the amount of fat that you eat. There are different types of fat in food.
- Saturated fats, which increase the level of cholesterol in your blood. Examples of foods high in saturated fat include butter, cakes, biscuits, pastry, meat and hard cheese.
- Industrially produced trans fats – these have a similar effect on your cholesterol level as saturated fats. Foods containing hydrogenated vegetable oil may contain trans fats. Trans fats currently don't need to be labelled separately on food labels. These fats can be found in biscuits and cakes, fast food and some margarines.
- Monounsaturated fats, which help lower harmful cholesterol levels. Examples of foods high in monounsaturated fats include olive oil, avocados and almonds.
- Polyunsaturated fats, which lower harmful cholesterol and raise protective cholesterol levels. Examples of foods high in polyunsaturated fats include sunflower oil and brazil nuts.
There is a particular type of polyunsaturated fat called omega-3, which may help to reduce your risk of heart disease. The best source of omega-3 fats is oily fish, such as kippers, mackerel, sardines and salmon. Aim to eat at least one portion of oily fish per week, or up to three portions if you have had a heart attack. If you're pregnant or breastfeeding, or are a woman of childbearing age, don’t eat more than two portions a week.
Compare the labels on foods and choose those with less total fat or less saturated fat. Whenever you can, buy lower-fat versions of dairy foods, such as semi-skimmed or skimmed milk and reduced-fat yoghurt.
I have a heart condition and can’t move around easily. What types of physical activity can I do?
All physical activity is good for your heart and any increase in your activity levels will improve your health. If you're not used to regular exercise, it's important to talk to your GP before you start about what is best for you.
Even if you have restricted mobility, it's important to be as physically active as you can to keep your heart healthy.
The best kind of exercise for your heart is aerobic activity. This means it involves or improves the use of oxygen by your body. Aerobic activity can be any repetitive exercise that uses the large muscle groups of your legs, shoulders or arms. Swimming is a good choice if you have restricted mobility because the water supports your body weight.
Exercise can also improve your strength and flexibility, which are important to help you carry on with everyday functions as you get older.
It's important to realise that physical activity doesn't just mean structured exercise but can include daily activities such as:
- climbing stairs
If you can’t stand or walk easily, you can do chair-based exercises either at home or in a group session.
Always check with your GP before starting any type of exercise programme. He or she will be able to advise you on the best way of increasing your physical activity.
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- Conditions. American Heart Association. www.heart.org, published October 2012
- Start active, stay active: a report on physical activity from the four home countries' Chief Medical Officers. Department of Health, 2011. www.dh.gov.uk
- Blood pressure (high) – hypertension. Better Health Channel. www.betterhealth.vic.gov.au, published August 2011
- Stable ischaemic heart disease. BMJ Best Practice. www.bestpractice.bmj.com, published 28 January 2013
- What is coronary heart disease? National Heart, Lung and Blood Institute. www.nhlbi.nih.gov, published August 2012
- Information. ASH. www.ash.org.uk, published February 2011
- Alcohol and heart disease. Drinkaware. www.drinkaware.co.uk, published April 2013
- Healthy living. British Nutrition Foundation. www.nutrition.org.uk, published January 2013
- Blood pressure symptoms, causes, medicines and lifestyle. Blood Pressure UK. www.bloodpressureuk.org, accessed 16 June 2013
- Getting healthy. American Heart Association. www.heart.org, published December 2012
- Food fact sheet. Trans fats. The British Dietetic Association. www.bda.uk.com, published April 2013
- Healthy eating. National Heart Foundation of Australia. www.heartfoundation.org.au, accessed 29 April 2013
- Family history. World Heart Federation. www.world-heart-federation.org, accessed 29 April 2013
- What are coronary heart disease risk factors? National Heart, Lung and Blood Institute. www.nhlbi.nih.gov, published February 2011
- Alcohol guidelines. House of Commons Science and Technology Committee, www.publications.parliament.uk, published 7 December 2011
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