Preventing Heart Disease - A Summary

What can reduce the risk of developing heart disease (and stroke)?

You should not smoke

If you smoke, stopping smoking is often the single most effective thing that you can do to reduce your risk of developing heart disease. The risk falls rapidly as soon as you stop smoking (but takes a few years before the increased risk reduces completely). If you find it hard to stop smoking, then see your practice nurse for help. Medication may be advised to help you to stop.

If possible, take some regular exercise

Anything that gets you mildly out of breath and a little sweaty is fine. For example: jogging, heavy gardening, swimming, cycling, etc. A brisk walk each day is what many people do - and that is fine. However, research studies suggest that the more vigorous the exercise, the better for health - particularly for preventing heart disease.

To gain most benefit you should do at least 30 minutes of exercise on most days (at least five days a week). Several short bursts of exercise in any day is thought to be just as good. For example, cycling to work and back 15 minutes each way is a total of 30 minutes.

Eat a healthy diet. Briefly this means:

• AT LEAST five portions, ideally more, of a variety of fruit and vegetables per day.
• THE BULK OF MOST MEALS should be starch-based foods (such as cereals, wholegrain bread, potatoes, rice, pasta), plus fruit and vegetables.
• NOT MUCH fatty food such as fatty meats, cheeses, full-cream milk, fried food, butter, etc. Use low fat, mono-, or poly-unsaturated spreads.
• INCLUDE 2-3 portions of fish per week. At least one of which should be 'oily'.
• LIMIT SALT to no more than 6 g a day (and less for children). See below for details.
• If you eat meat it is best to eat lean meat, or poultry such as chicken.
• If you do fry, choose a vegetable oil such as sunflower, rapeseed or olive oil.

Limit your salt intake

Adults should eat no more than 6 g salt a day. This is about a teaspoon of salt. The current average daily intake of salt in the UK is 9 g per day. About three quarters of the salt we eat is already in the foods we buy. By simply checking food labels and choosing foods with lower salt options, it can make a big difference. A tip: sodium is usually listed on the food label. Multiplying the sodium content by 2.5 will give the salt content. Also, try not to add salt to food at the table.

Try to lose weight if you are overweight or obese

The increased health risk of obesity is most marked when the excess fat is mainly in the abdomen rather than on the hips and thighs. As a rule, a waist measurement of 102 cm or above for men (92 cm for Asian men) and 88 cm or above for women (78 cm for Asian women) is a significant health risk. You don't need to get to a perfect weight. If you are obese or overweight you can greatly reduce you health risk by losing 5-10% of your weight. This is often about 5-10kg (11-22 lb).

Have your blood pressure checked at least every 3-5 years

High blood pressure usually causes no symptoms, so you will not know if it is high unless you have it checked. Treatment may be advised if your blood pressure remains high.

Have a cholesterol check if aged 40 or more, or if you have a strong family history

A high level of cholesterol adds to your increased risk, but it can be lowered with treatment. All people aged 40 or more should have a blood cholesterol check. It is also usually advised at any age if you have an increased risk of developing heart disease or stroke. For example, if you have a father or brother who developed heart disease or a stroke before they were 55, or in a mother or sister before they were 65. Also if you have a first degree relative (parent, brother, sister, child) with a serious hereditary lipid disorder. For example, familial hypercholesterolaemia or familial combined hyperlipidaemia.

Don't drink too much alcohol

A small amount of alcohol (1-2 units per day) may help to protect you from heart disease. One unit is about half a pint of normal strength beer, or one small glass of wine, or one pub measure of spirits. However, too much can be harmful. Men should drink no more than 21 units per week (and no more than 4 units in any one day). Women should drink no more than 14 units per week (and no more than 3 units in any one day).

Why not see your practice nurse for a check?

A 'risk factor calculator' is commonly used by doctors and nurses. A score is calculated which takes into account all your 'risk factors' such as age, sex, if you smoke, blood pressure, cholesterol level, etc. The score gives a fairly accurate indication of your risk of developing heart disease (and other cardiovascular diseases such as stroke) over the next 10 years. If your risk is high then treatments may be advised such as tackling any lifelstyle issues (smoking, weight, inactivity, etc) and drugs to reduce cholesterol and blood pressure.

The following people should be assessed to find their health risk score:

• All adults aged 40 or more.
• Adults of any age who have a strong family history as detailed in the section above about cholesterol

Further help and information

British Heart Foundation

14 Fitzhardinge Street, London, W1H 6DH
Tel (Heart Information Line): 08450 70 80 70 Web: www.bhf.org.uk

Heart UK

7 North Road, Maidenhead, Berkshire, SL6 1PE
Helpline: 0845 450 5988 Web: www.heartuk.org.uk
Provides information on heart disease and its management by lifestyle and drugs. Aims to help anyone at high risk of heart disease especially families with inherited high cholesterol.