Your health with Pharmacist Advice

Disease State Management - Heart Disease

DEFINITION

Heart Disease is a term used to describe diseases affecting the ability of the heart to function adequately within the circulatory system(1).

DESCRIPTION

The circulatory system can be divided into two main systems: the pulmonary system, consisting of the heart and lungs and the systemic or peripheral system, consisting of the network of veins and arteries throughout the rest of the body.(2) The term Heart Disease generally refers to diseases affecting the pulmonary circulation. These include heart attack, high blood pressure (hypertension), arrhythmia, atherosclerosis (clogging of the arteries), aneurysm, endocarditis, congestive heart failure, angina and heart valve disease. Diseases affecting the peripheral circulation are described in the Circulation (Diseases Of) topic.

Heart Disease is not an inevitable result of ageing.

Heart Disease is largely preventable if the numerous associated risk factors are reduced. These include:

  • Smoking. Smokers have more than twice the risk of Heart Attack than non-
          smokers.
  • Smokers also have more severe or fatal Heart Attacks than non-smokers(3).
  • High cholesterol. High blood cholesterol leads to atherosclerosis, the leading
          cause of Heart Attack(4).
  • High blood pressure (hypertension). This increases the heart's workload,
          causing it to enlarge and weaken.
  • Obesity. Being overweight increases the heart's workload and raises blood
          pressure and cholesterol.
  • Sedentary lifestyle (lack of exercise)(5).
  • Diabetes mellitus. Around two-thirds of diabetics die from heart disease.(6)
  • High homocysteine levels. Homocysteine is an amino acid in the blood that is
          associated with Heart Disease.(7)
  • Other factors include stress, hormonal medications such as the oral
          contraceptive pill or HRT(8) and heavy alcohol use.

Risk factors that cannot be altered include increasing age, gender (men have a higher risk of Heart Disease than women), congenital heart defects and hereditary factors (having a parent with Heart Disease).(9)

SIGNS AND SYMPTOMS

Symptoms may include shortness of breath, hypertension, fatigue, moist cough, chest pain, and swollen neck veins, legs and ankles.(10) Heart Disease can often progress to an advanced stage before the patient notices symptoms. More than one type of cardiovascular disorder can occur in the same person, or several problems and symptoms can be related to a single underlying cause. Therefore, a person with Heart Disease may have a number of differing symptoms depending on individual problems.

HEALTH MANAGEMENT

As with all conditions your Doctor should be consulted. Your Doctor will diagnose and treat this condition.

  • If your Doctor suspects Heart Disease, a full investigation with a variety of
          laboratory tests will be required. These may include blood tests, an
          electrocardiogram, an echocardiogram and chest X-rays.
  • Ask your Doctor how to reduce your risk factors. See the Heart Disease -
          Prevention topic for more information.
  • Severe Heart Disease may progress to Heart Failure. Careful management by a
          Doctor specialising in Heart Disease (a Cardiologist) is essential.

PHARMACIST

Ask your Pharmacist for advice.


1) Quit smoking. Ask your Pharmacist about the range of anti-smoking products to help reduce cravings.


2) The contraceptive pill and certain types of HRT (Hormone Replacement Therapy) may increase the risk of Heart Disease(11),(12). Women who have other risk factors for Heart Disease may wish to discuss their contraceptive and HRT needs with their Doctor.


3) Ask your Pharmacist for advice about obesity and weight management.


4) A blood pressure monitor can be obtained to enable you to check your blood pressure regularly at home.


5) Cholesterol testing is available at many Pharmacies. Ask your Pharmacist to explain your Cholesterol levels to you.


6) Exercise regularly. Thirty minutes per day of moderate exercise is recommended. See the Exercising for Health topic for further information. Before starting any exercise programme, have a complete medical check-up.

DIET HINTS

Always follow the dietary advice given to you by your Doctor or Dietitian. See the Heart Diet for further information.

VITAMINS/MINERALS/HERBS

  • Nutritional supplements are only to be used if the dietary vitamin intake is
          inadequate.
  • Some studies have shown Coenzyme Q10 to be effective in improving heart
          function(13) and reducing high blood pressure(14).
  • Fish oil, which contains omega-3 fatty acids has been shown to reduce blood
          pressure.(15) (16) (17)
  • Garlic is thought to reduce cholesterol levels and lower blood pressure(18).
          Patients taking anticoagulants (blood thinning drugs) should NOT take garlic
          supplements.