Cardiovascular disease is defined as a disease that affects any area of the cardiovascular system, including the heart and blood vessels, and covers a range of diseases such as arteriosclerosis, atherosclerosis and coronary heart disease. Diet plays a vital part in the prevention and control of these diseases however other manageable factors such as smoking and physical inactivity also contribute to the diseases if not controlled correctly. However corrective action or cession can reduce the risk of these conditions.
There are two main types of cardiovascular diseases, arteriosclerosis and atherosclerosis. Arteriosclerosis is where lipid deposits cause the walls of the arteries to harden and lose their elasticity, whereas atherosclerosis is where plague builds up in the artery which can lead to a blockage, causing a heart attack (Bernstein & Luggen, 2011). Many of the factors which promote cardiovascular diseases can also promote blood clotting; these blood clots can get stuck in the remaining space the plague has not filled which can also lead to blockage and heart attack (Pozuelo, 2012).
The most common type of cardiovascular disease is coronary heart disease. The prevalence of this varies around the United Kingdom. With 4. 6% of people in Scotland having the disease 4. 3% in Wales 4. 2% in Northern Ireland and 3. 5% in England (Thomas, 2009). Coronary heart disease is more prevalent in affluent countries, where the population live on a diet high in fat and salt but low in fruit, vegetables and whole grains. Cardiovascular disease is the leading killer in the UK, in 2001 cardiovascular diseases caused over 120,000 deaths (Barasi, 2003). It is thought that there are currently 1.
6 million men and just over 1 million women in the UK with some form of cardiovascular disease (Ascheim & Ascheim, 2009). Diet is a major factor in cardiovascular disease; it is mainly linked to diets high in fat, salt and sugar but low in non-starch polysaccharide. The type of fat consumed is important, as saturated and trans fatty acids have negative impacts on cardiovascular diseases by increasing cholesterol and low-density lipoprotein (LDL) levels in the blood, while polyunsaturated fatty acids like omega 3 and 6 have LDL cholesterol lowering effects.
Polyunsaturated fatty acids can also reduce high-density lipoproteins (HDL) in the blood to a smaller extent, this leads to the overall HDL: LDL ratio decreasing (Barasi, 2003). There is evidence that a diet high in vegetables, fruits and grains but low in fat reduces the risk of cardiovascular disease. When including grains in the diet it has been found that whole grains rather than refined grains lead to weight loss around the abdomen as well as decreasing the LDLs in the patients’ blood. It is thought specific foods can also reduce the severity of cardiovascular disease.
For example, it is advised to eat oranges and broccoli as they are filling and prevent the individual from filling up on foods high in fat and salt, it has also been found that Swiss chard and low fat yoghurt can lower blood pressure (Bernstein & Luggen, 2011). A diet high in salt has been found to contribute to hypertension, a leading risk factor in cardiovascular diseases, meaning that a lowered salt intake is advised to reduce the risk of such diseases. Soluble fibre from foods such as oats can reduce cholesterol levels; however these effects are not substantial.
Foods which are rich in dietary fibre often fill up individuals which may lead to a lower overall energy intake. Diets high in non-starch polysaccharide have also been found to increase insulin sensitivity due to its association with a decrease in insulin levels, which then increases metabolic function (Barasi, 2003). Diet is not the only risk factor involved in cardiovascular disease other factors include smoking, family history of the disease, obesity, physical inactivity and high blood pressure (Bernstein & Luggen, 2011).
Many risk factors link together, for example if you are overweight or obese you are also likely to have a poor diet and be physically inactive. Smoking contributes to cardiovascular disease by the free radicals that enter the body through cigarette smoke causing peroxidation of lipids; these altered lipids then contribute to fatty streaks in the body (Barasi, 2003). The government have aimed to lower the amount of people smoking by introducing a smoking ban in public places in 2007, however this has had very little affect (Thomas, 2009).
It has been found that by quitting smoking it can reduce the risk of cardiovascular disease by up to a third. However, because smoking is so addictive, the right support and guidance on how to cope with a relapse needs to be given (Vlodaver et al, 2012). Age is something which obviously can’t be prevented but by having a healthy diet and participating in regular exercise the risk of cardiovascular disease can be decreased. During the aging process the arteries begin to harden especially in larger blood vessels such as the aorta (Bernstein & Luggen, 2011).
Women are protected better from cardiovascular diseases during child bearing years; however their risk increases after menopause (Barasi, 2003). Although family history increases the chances of developing cardiovascular disease later in life it cannot be used to predict that and individual will definitely get the condition as they grow old. It has been found that there are differences in the DNA causing coronary heart disease, however many people may be unaware that they have a family history of coronary heart disease (Vlodaver et al, 2012) making it hard for them to realise they need to carefully control diet and other risk factors.
Many early studies found it difficult to come to a conclusion about the effect of weight on cardiovascular diseases, mainly because many other factors can be linked to increased weight, such as physical inactivity and poor diet. It has been found that those who are obese are two to three times more likely to get some kind of cardiovascular disease than those who have a BMI under 25 (Barasi, 2003). Keeping active is important as we get older, however many elderly people do not do the same level of exercise as they did when they were younger, although it is still important.
Physical exercise helps energy balance, and will help prevent an individual becoming overweight; it also changes clotting factors in the blood (Barasi, 2003). These changes mean that if the arteries do become narrowed, the risk of blockage is decreased. It has been found that individuals with high blood pressure are also more likely to be physically inactive as well as having higher total cholesterol than normal. Hypertension is a main contributor to cardiovascular diseases as it can cause damage to the blood vessel walls leading to fibrous plague development (Barasi, 2003).
Following guidelines is important as if an individual continues with a diet high in saturated fat, their condition can easily worsen. Cardiovascular disease is also responsible for many early deaths in the UK. Cardiovascular diseases do not only cost the individual involved and their families. In 2004 cardiovascular diseases cost the UK ? 29. 1 billion, 60% of this was spent on healthcare for individuals, and with an additional 17% being spent on informal care related costs (Luengo-Fernandez, 2006).
It is estimated that up to 15% of people with cardiovascular disease suffer from depression. Suffering from depression can cause additional stress which can worsen an individual’s condition, increasing risk of heart attack, blood clots and arterial damage (Pozuelo, 2012). In extreme cases, individuals can suffer from heart failure, when this happens the best treatment is to get a heart transplant. This is not ideal as there are fewer heart donors available for a growing number of people who need them; the donor also needs to be a match to the recipient (Klein et al, 2011).
Cardiovascular diseases can be lethal, they not only affect those with the disease but also the wider economy with the costs they contribute to the NHS. Cardiovascular diseases are easily controllable and preventable through diet, exercise and even medical intervention if guidelines were followed by not only those with a form of cardiovascular disease but the population as a whole, the prevalence of these diseases and conditions could be greatly reduced. Word count: 1318.
References
Books Ascheim, D. Ascheim, R. 2009. Heart Health Your Questions Answered. London: Dorling Kindersley. Barasi, M. E. 2003. Human Nutrition: A Health Perspective. London: Arnold Bernstein, M. Luggen, A. 2011. Nutrition for the Older Adult. Massachusetts: Jones and Bartlett Learning. Klein, A. A. Lewis, C. J. Madsen, J. C. 2011. Organ Transplantation: A Clinical Guide. Cambridge University Press Pozuelo, L. 2012. Depression and Heart Disease. [Available at: http://my. clevelandclinic.org/heart/prevention/stress/depressionandheart. aspx] Thomas, P. 2009.
Challenges Facing the Welsh NHS in Tackling Cancer, Heart Disease and Healthcare Associated Infections. Cardiff: Institute of Welsh Affairs Vlodaver, Z. Wilson, R. F. Garry, D. J. 2012. Coronary Heart Disease: Clinical, pathological, imaging and Molecular Profiles. New York: Springer Journals Luengo-Fernandez, R. 2006. Cardiovascular medicine. Cost of cardiovascular diseases in the United Kingdom. 92 (1), 1.