The heart is a muscle that's about the size of your fist. It beats around 100,000 times a day to pump blood around the body. In fact, the human heart beats more than 2.5 billion times during the average lifetime and 5.6 litres or so of blood circulates around the body three times a minute. In one day, all that blood is estimated to have travelled a total of 12,000 miles (i).
If you have a problem with your heart or your circulation, the general condition is called cardiovascular disease. This is an umbrella term for conditions including heart disease, stroke, cardiomyopathy (disease of the heart muscle), atrial fibrillation (irregular heart rhythm) and heart failure. Together, says the British Heart Foundation (BHF), these diseases currently cause more a quarter of all deaths in the UK (around 170,000 every year) (ii).
Single biggest killer
The most common type of heart disease is coronary heart disease. This is a major cause of death both in the UK and worldwide, says the NHS (iii), with 73,000 people dying from coronary heart disease in the UK annually (iv). The cause of coronary heart disease is a build-up of fatty substances in the coronary artery walls – a process known as atherosclerosis. This can cause restricted blood supply to your heart, causing chest pains known as angina. If your coronary artery becomes completely blocked, the result can be a heart attack (myocardial infarction).
According to the BHF, most deaths from coronary heart disease are caused by heart attacks, and here in the UK there are more than 100,000 hospital admissions for heart attacks every year – that’s one every five minutes (ii). And while a heart attack is often seen as strictly a male problem, 35,000 women are admitted to hospital after having a heart attack each year in the UK – an average of 98 women a day (v).
Another condition that can affect people with coronary heart disease is heart failure. This is when the heart is too weak to operate properly, which can cause a build-up of fluid in the lungs and lead to breathing difficulties.
Are you at risk?
There are several risk factors that increase your likelihood of developing cardiovascular disease. The main ones include the following:
According to the NHS an estimated 25,000 deaths each year from coronary heart disease can currently be attributed to smoking, with smokers almost twice as likely to have a heart attack than non-smokers (vi). This is because the chemicals in cigarette smoke can damage and narrow your arteries, with two in particular (nicotine and carbon monoxide) putting your heart under strain by making it pump faster. Giving up smoking may help to reduce the strain on your heart, plus it can reduce other risk factors such as high cholesterol, high blood pressure and having diabetes (see below).
High blood pressure
Like smoking, having high blood pressure (hypertension) can put a strain on your heart. Blood Pressure UK figures suggest 30 per cent of women and 32 per cent of men in the UK have high blood pressure, with approximately a third of people with high blood pressure not realising they have it (vii). Understanding the impact of high blood pressure on heart disease can be the first step to overcoming the condition.
The health charity Heart UK claims more than half of adults in the UK have high blood cholesterol levels of 5mmol/L or more (iv). High cholesterol is another main risk factor for cardiovascular disease because too much cholesterol in the blood can cause your arteries to narrow and may increase your risk of developing a blood clot. Click here for more information on high cholesterol.
Not exercising regularly could mean you’ll have high blood pressure, high cholesterol levels and be overweight – all of which are risk factors for cardiovascular disease (viii). Exercise gets your heart working and keeps it healthy, plus it can help to reduce your blood pressure and cholesterol – and it’s also an ideal way of managing your weight. However, according to the UK government around one in three men and one in two women are not currently active enough for good health (ix).
The latest statistics from Diabetes UK suggest 4.6 million people are living with diabetes in the UK (x). However, people with diabetes have a greater risk of developing heart disease than others who don’t have diabetes. That’s because having high blood glucose levels can damage the walls of your arteries. Keeping your blood glucose levels at a normal level can help to protect your heart health as much as possible.
If you're overweight or obese, you have a higher risk of developing cardiovascular disease than someone whose weight is normal because being overweight or obese raises your risk of developing diabetes and high blood pressure. The latest statistics from the Health Survey for England show that 28.7 per cent of adults in England are living with obesity, while a further 35.6 per cent are overweight but not obese (xi).
If cardiovascular disease runs in your family, your risk may be higher. You are considered to have a family history of cardiovascular disease if your father or brother was diagnosed with cardiovascular disease before they reached the age of 55, or your mother or sister before they reached 65. Your ethnic background may also put you at a higher risk – for instance, people who originate from South Asia and who live in the UK may have a higher risk of developing coronary heart disease compared with the rest of the population.
The older you get, the higher your risk becomes of developing cardiovascular disease.
How to have a heart-healthy lifestyle
Thankfully, many of the main risk factors of cardiovascular disease can be prevented by making the following lifestyle changes:
Giving up smoking is the single most important step you can take to protect your heart health. If you're having difficulties giving up, find out about stop smoking aids that could help, such as patches, gum and lozenges.
Eat more fruit and veg
Try to eat at least five portions of fruit and veg a day to provide your body with the vitamins, minerals and antioxidants that are thought to help protect the cardiovascular system. Fruit and veg also contain fibre, which may help keep your cholesterol levels down.
Cut down on sugar
Eating too many sugary foods can make you put on weight, which can raise your blood pressure. There’s also strong evidence that sugar can caused raised blood sugar and insulin levels, which in the long term could lead to diabetes and heart disease. Try having fruit with low-fat yoghurt or fromage frais instead of sugary desserts.
Eat less saturated fat
If you have high levels of saturated (or animal) fat in your diet, it could affect your cholesterol levels. So cut down on fatty meats, cheese, butter, cakes, biscuits and processed snacks, and try to cook with small amounts of vegetable oils such as rapeseed, olive, corn and sunflower oils.
Choose oily fish
Fish such as salmon, mackerel, trout, sardines, pilchards and fresh (not tinned) tuna contain high levels of omega-3 fatty acids that may help prevent dangerous clots developing in your blood. Try to eat at least one portion of oily fish a week (or take a good-quality fish oil supplement if you’re not fond of eating fish).
Reduce your salt intake
Eating too much salt is thought to raise blood pressure, so avoid adding it to food and avoid eating too many processed foods that are high in salt as well as salty snacks. Aim for no more than 6g of salt a day (that's around one teaspoonful).
Drink alcohol in moderation
According to Alcohol Change UK 24 per cent of adults in England and Scotland regularly drink more than the amount recommended in the Chief Medical Officers’ guidelines for low-risk drinking (xii). Drinking too much alcohol may increase your risk of heart disease and stroke because it can increase your blood pressure and cholesterol levels. The recommended guidelines for alcohol intake for both men and women state no more than 14 units a week spread over at least three days. A unit is the equivalent of half a pint of ordinary strength beer, lager or cider, or a single pub measure of spirits (a small 125ml glass of wine contains 1.5 units).
Stay physically active
If you have a sedentary lifestyle, it’s important to start building more exercise into your daily routine – for your heart’s sake. See Exercise and your heart (below) for more information.
Manage your weight
Being overweight can increase your risk of having high blood pressure, high cholesterol and type 2 diabetes, not to mention the extra strain it can put on your heart. The good news is that adopting a healthy lifestyle that includes eating healthily and staying physically active can really help keep your weight down.
Stress may not be a direct risk factor for cardiovascular disease, but it can cause problems with your heart in several ways – for instance, you may smoke, drink too much alcohol or overeat when faced with stressful situations. Stress can also trigger angina, says the NHS (xiii). When life is stressful, try to find ways to relax more often. If you can’t avoid stress, try to avoid smoking as well as drinking more than normal. Instead, try using techniques for managing stress such as deep breathing, meditation or yoga – or whatever helps to make you feel calmer and more relaxed – and try to stay as active as possible.
Exercise and your heart
According to the British Heart Foundation, around five million deaths worldwide are attributed to physical inactivity, and in the UK it causes one in 10 premature deaths from coronary heart disease (xiv). Your heart is, after all, a muscle – and like any other muscle, it needs to be exercised to keep it healthy. Staying physically active can help your heart in a number of ways. It can help reduce your blood pressure and cholesterol levels, and if you have diabetes it can help you to control your condition. It can help to keep your weight down and reduce your stress and anxiety levels.
Plus if you already have a heart condition such as coronary heart disease or you’ve recently had a heart attack or heart surgery, being active on a regular basis can help prevent problems with your heart in the future.
How much exercise?
Experts suggest aiming for 30 minutes of moderate pulse-raising exercise on five or more days of the week (in other words, at least 150 minutes of physical activity per week). And if you can't do 30 minutes all at the same time, you can break it down into two 15-minute sessions or even three 10-minute sessions – in fact the latest recommendations on physical activity by the UK Chief Medical Officers suggest being active for just a few minutes at a time is good for you too (xv). But if you’re new to exercise or you haven’t been very active lately, remember to check with your GP before you start, especially if you have any existing medical conditions or you’re very unfit.
What type of exercise?
The best type of exercise where your heart is concerned is activity that makes your heart and lungs work harder, such as brisk walking, cycling, aerobics, dancing and even climbing the stairs. As well as these types of moderate-intensity physical activity, your heart can also benefit if you improve your flexibility, mobility and strength. Try exercises such as yoga, Pilates or t'ai chi as well as digging the garden and housework such as vacuuming and sweeping.
The NHS also recommends activities for balance and co-ordination if you’re aged 65 or older, such as yoga, t’ai chi and dancing. In addition to your 150 minutes of exercise each week, it’s a good idea to build more exercise into your daily routine so that you’re more active in general. This means doing things like walking wherever possible instead of using your car or taking the bus, and using stairs instead of taking the lift or the escalator.
Try building up your activity levels gradually, and you’ll find as you get fitter you’ll be able to do more exercise. It also helps to do something that you enjoy rather than forcing yourself to do something you don’t like, and if you vary your activities instead of doing the same thing over and over again, it could help to keep you motivated.
Natural remedies for a healthy heart
A healthy lifestyle is the best way to keep your heart in good condition. But there are several nutritional supplements you could consider taking too, including the following:
Many studies have investigated whether or not the omega-3 fatty acids found in oily fish can protect the heart from disease, with a review of randomised clinical trials finding that people taking omega-3 fish oil supplements had lower risks of heart attack and other cardiovascular disease events compared with those who were given a placebo (dummy pill) (xvi). Experts also believe sudden cardiac death is rare in populations with a high intake of omega-3 fatty acids. Fish oils are widely considered to reduce inflammation, including within the blood vessels, and there’s also evidence they may help to reduce the level of triglycerides, a type of fat found in the blood that can lead to artery damage and ultimately heart disease (xvii). Fish oils may also be beneficial for heart health as they may raise levels of ‘good’ (HDL) cholesterol (xviii).
If you’re a vegetarian or vegan you can still benefit from an omega-3 supplement, thanks to the availability of products that contain the natural triglyceride (TG) form of omega-3, which is sourced from plant organisms called microalgae rather than fish.
Also known as ubiquinone, CoQ10 is a powerful antioxidant that’s in every cell in the body, with high concentrations found in the muscles of the heart. And while there’s been a lot of interest in how CoQ10 may help treat congestive heart failure (xix), there’s also evidence that it may help lower high blood pressure (xx). Studies also suggest it may help people recovering from a heart attack (xxi), while some researchers believe CoQ10 as a therapy for cardiovascular disorders such as chronic heart failure appears to be safe and well tolerated (xxii).
You may also want to consider a supplement that provides both omega-3 fatty acids and CoQ10.
Several of the B vitamins are needed to keep the heart muscle healthy including vitamin B1, deficiencies in which may lead to congestive heart failure (xxiii). Studies also suggest that three particular B vitamins – namely vitamin B6, B12 and folic acid – help to reduce levels of homocysteine in the body (homocysteine is a substance produced in the body that’s believed to be linked to heart attacks and strokes as it may increase atherosclerosis – or hardening of the arteries) (xxiv).
This mineral is required by the body for muscle relaxation and is thought to be important for the regular functioning of heart muscle. Taking magnesium supplements regularly may also help to treat high blood pressure (xxv).
Substances found in plants called stanols and sterols – including beta-sitosterol – may be good for heart health because they’re thought to help to lower cholesterol in people with mildly or moderately raised levels. Numerous studies suggest stanols and sterols are effective at reducing ‘bad’ (LDL) cholesterol (xxvi), with some research also suggesting they may help people already taking cholesterol-lowering medicines called statins to improve their cholesterol even further (xxvii).
Several studies confirm garlic may help with heart health by reducing cholesterol (xxviii). In one analysis of 16 trials, researchers suggest garlic may reduce total cholesterol by 12 percent compared with a placebo after just four weeks of supplementation (xxvix). If you take any other prescription medicines, especially anticoagulants (medicines that thin your blood), checking with your doctor or pharmacist before taking garlic supplements.
An antioxidant compound found in a freshwater microalgae, astaxanthin may be useful for heart health as it may help maintain healthy cholesterol and blood pressure. It’s also found in the fish and seafood that eat the algae – in fact astaxanthin is the red pigment that gives salmon, lobster and others their distinctive red/pink colour.
Indeed astaxanthin has been reported in clinical studies to prevent LDL (‘bad’) cholesterol oxidation and to increase HDL (‘good’) cholesterol levels (xxx). One small-scale study with overweight participants, for instance, shows taking astaxanthin capsules for 12 weeks may help lower LDL cholesterol levels significantly compared to a placebo (xxxi). Another found that taking astaxanthin supplements – again for 12 weeks – significantly increased levels of HDL cholesterol (xxxii).
The evidence for astaxanthin’s effect on blood pressure is less strong as that for cholesterol, simply because the studies that confirm it are based on animals rather than human volunteers. However there is one human study that suggests astaxanthin may help improve blood pressure in people with type 2 diabetes (xxxiii).
Experts elsewhere, on the other hand, believe astaxanthin may be a potential therapeutic agent in the treatment of cardiovascular disease because it has anti-inflammatory properties (xxxiv).
To add more astaxanthin to your diet simply eat plenty of fish and seafood such as salmon, lobster, crab, rainbow trout and crawfish. It may, however, be difficult for you to get a large enough dose of astaxanthin to achieve any health benefits through diet alone. That’s because researchers are typically using daily doses of around 4 - 16mg, whereas a portion of wild salmon contains less than 4mg. The easiest way to get a good amount of astaxanthin may be to take a quality supplement (it’s also a solution for those who don’t like eating fish or seafood).
Pomegranate contains vitamin C, potassium and is a rich source of antioxidants called polyphenols. It has primarily been of interest to medical researchers as a heart-healthy fruit, and there’s evidence to suggest that pomegranate juice may have anti-hypertensive properties (xxxv).
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Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.