CORONARY HEART DISEASE

This fact sheet provides you with basic information about coronary heart disease. It is not a substitute for medical or dietetic advice and you should contact your GP and the British Heart Foundation for further information. Visit www.bhf.org.uk.

Cardiovascular disease includes both stroke and coronary heart disease and these are the two major causes of ill health and death in the UK. Coronary heart disease can take different forms, including stable angina, unstable angina, acute heart attack and sudden death.

Atherosclerosis is where fatty deposits (plaques) start to form on the lining of the arteries, which result from excessive amounts of fat in the blood.

The plaques can break away and cause clots, which can lead to a heart attack or stroke.Blood pressure can increase temporarily during exercise, excitement and emergencies.

If it stays high it can cause damage to the blood vessels and increase the risk of atherosclerosis (furring of the arteries) which can lead to coronary heart disease.

Fatty plaques are formed when the cholesterol level in the blood is too high. There are two types of fat in the blood: cholesterol and triglycerides. There are two types of cholesterol, HDL (good cholesterol which carries cholesterol away from the body) and LDL (bad cholesterol). High LDL cholesterol and triglycerides are risk factors for heart disease.

Make changes to your lifestyle to reduce your risk of heart disease, which may involve changing smoking habits, alcohol intake, diet, activity levels, weight management, reducing blood pressure and managing stress. There is a genetic influence on heart disease that you can't change.

Weight loss can aid control of blood pressure, cholesterol levels and reduce the risk of heart disease. Reducing weight, particularly from around the middle, can reduce the effort the heart has to make. Even a 10kg weight loss can result in a decrease of cholesterol of 10%, LDL by 15% and triglycerides by up to 30%.

The Mediterranean diet can reduce the risk of heart disease and help lower cholesterol. Fitbug promotes this style of eating which includes less fatty meat and full fat dairy products, more rice, pasta, fruit, vegetables, peas, beans and pulses, red wine and olive oil.

Reduce your saturated fat intake by choosing lean cuts of meat, eat more chicken (no skin) and fish, low fat dairy products, less processed food and use butter sparingly. Replace saturated fat with monounsaturated fat by including olive oil, rapeseed oil or groundnut oil, spreads based on these sources of fat, nuts and seeds. Keep total fat intake low by checking food labels to see if they are less or more than 1/3rd of energy from fat.

Too much saturated fat can increase total cholesterol and LDL. Monounsaturated fat decreases total cholesterol and LDL. Polyunsaturated fat in high amounts reduces all types of cholesterol, including HDL, so is not desirable.

Try and include more oily fish in your diet, eg mackerel, herrings, pilchards, sardines, salmon or trout, as it contains omega 3 fats which help to reduce the risk of the blood clotting. Other sources of omega 3 fats are nuts, seeds, rapeseed oil and cereals.

Increase the amount of fruit and vegetables in your diet to five or more portions per day. Choose a wide variety for a balance of the antioxidants vitamins A, C, E and selenium which help protect the heart against disease.

Include more fibre in your diet, both soluble and insoluble. Insoluble fibre is found in wholegrain foods and reduces the absorption of fat. Soluble fibre is found in peas, beans, pulses, fruit, vegetables and oats and can help to reduce cholesterol levels.

Decrease salt intake by choosing no added salt foods, use more fresh produce, avoid adding salt to cooking or at the table to help reduce your blood pressure.

Moderate alcohol intake to no more than two units per day. Alcohol contains 7kcal per gramme and the energy from alcohol is used first by the body. This increases the risk of dietary fat being stored as body fat.

Alcohol does reduce the risk of blood clotting; red wine contains antioxidants and helps to decrease LDL cholesterol whilst increasing HDL cholesterol at moderate intakes of 1-2 units per day.

Basing your meals around carbohydrate, including a wide variety of starchy foods and choosing those higher in fibre will make you feel satisfied for longer and keep your energy levels high. This will help you manage your weight better, which will help to reduce your blood pressure.

Tea contains flavonoids which can help to protect your heart and you can include this in moderation (4 cups per day).