Our expert shares the facts around cardiovascular disease.
By Claire Coleman
Cardiovascular (CV) — or heart and circulatory — disease causes more than a quarter of all deaths in the UK. That’s more than 150,000 deaths each year, an average of one death every three minutes.
We asked Dr Vikas Kapil, clinical senior lecturer and honorary consultant in cardiovascular medicine at Queen Mary University of London, to bust some of the biggest myths around vascular disease.
Myth 1: Cardiovascular disease basically means a heart attack or a stroke
Although a heart attack and stroke are the most well-known, and among the most serious, forms of cardiovascular disease, there are many ways in which the cardiovascular system can malfunction. The most common conditions are ones related to the furring up (clogging) of the arteries.
‘Clogging in arteries that supply the heart muscle is known as coronary heart disease. This can cause chest pain, usually with physical activity (angina), or can present as a heart attack. This happens when one of these arteries suddenly gets blocked and the heart muscle doesn’t get enough oxygen,’ explains Dr Kapil.
‘If there’s a blockage in an artery that leads to the brain, this can cause a stroke. A blockage that restricts blood flow to the legs can cause pain, and problems with walking — this is known as peripheral artery disease.’
Myth 2: Heart disease is an old man’s disease
This might be the perception, but the fact is that you don’t have to be old, or a man, to suffer from vascular issues.
‘Coronary heart disease is the most common cause of premature (under the age of 65) death in the world,’ says Dr Kapil.
‘It’s the biggest killer there is, and twice as many women die prematurely from coronary heart disease than from breast cancer. It’s a fallacy to suggest that women don’t get heart disease, but the fact that chest pain in women is frequently not assumed to be related to the heart can mean they may not be diagnosed as early as men.’
Myth 3: Only people who are overweight have cardiovascular problems
‘This is just not true,’ says Dr Kapil. ‘Vascular disease is a multifactorial issue and we know that weight is one of many important risk factors, but diet, smoking and genetics are also important. You simply can’t say that slim people never get heart disease or that everyone overweight will.’
Myth 4: If you’ve been smoking for 20/30/40 years there’s no point giving up now
Being a smoker majorly increases your risk of vascular disease, but according to Dr Kapil, it’s never too late to stop — and improve your risk profile.
‘Several studies have looked at smoking cessation and there is very good evidence that benefits start to accrue quite quickly,’ he says.
‘Within several years of giving up, your risk [of CV disease] will be substantially lower than if you had continued to smoke, although it may still be a little bit higher compared to non-smokers. Put very simply, there is overwhelming evidence that stopping smoking at any point is beneficial.’
Myth 5: You can use diet alone to manage your levels of cholesterol
‘The cholesterol in your blood doesn’t just come from what you eat,’ says Dr Kapil.
‘A significant proportion is produced by the liver, and you may have high levels because your body naturally produces a lot of cholesterol. People can be meticulous about their diet but still have high levels of cholesterol and in those instances. The only way to tackle those levels, if the patient is deemed to be at his risk of a heart attack or stroke, is through medication.’
Myth 6: You should avoid statins at all costs
Statins are drugs that work by slowing down production of cholesterol in the liver, resulting in lower levels of cholesterol in the blood. This reduces the risk of arteries getting blocked with fatty material, called plaque, and therefore a reduced risk of vascular diseases.
Like all drugs, statins can have side effects, but correctly prescribed they can be beneficial, as Dr Kapil explains.
‘Statins are not a substitute for a healthy lifestyle, but in appropriate people they can have significant benefit. If you’ve had a heart attack or are known to have heart disease, statins can reduce your risk of further heart attacks or dying by about 30-35 per cent.
‘The more complicated question is whether people who do not have heart or vascular disease should be taking statins as a preventative measure. I think in these cases, you need to look closely at the total risk, taking in account all risk factors such as age, family history, cholesterol and blood pressure levels, and make a decision based on that.’