Cardiovascular diseases (CVDs) such as coronary heart disease, stroke, high blood pressure, and vascular dementia, are among the leading causes of morbidity and mortality worldwide. In the UK, they present a significant public health challenge, affecting millions of people annually.
Here, we look into the most common types of CVD, exploring their causes, symptoms, treatment options, and management.
Prevalence of cardiovascular diseases in the UK
Cardiovascular diseases account for nearly 25% of all deaths in the UK, according to the British Heart Foundation. Approximately 7.6 million people live with CVD in the UK; around 4 million men, and 3.6 million women. NHS England estimates that over 1.4 million people are registered with coronary heart disease, and stroke affects approximately 1.3 million people across the UK. High blood pressure is even more prevalent, with 14.4 million adults diagnosed and many more likely undiagnosed.
The NHS invests heavily in treating and managing CVDs, with the conditions contributing to millions of hospital visits annually. In 2019/20, over 500,000 hospital admissions in England were related to CVDs.
Coronary Heart Disease (CHD)
What is CHD?
CHD occurs when the coronary arteries supplying blood to the heart become narrowed or blocked due to a buildup of fatty deposits, a condition known as atherosclerosis. This can lead to angina (chest pain) and heart attacks.
Causes
- Lifestyle factors: Smoking, poor diet, physical inactivity, and excessive alcohol consumption
- Health conditions: High cholesterol, diabetes, and high blood pressure
- Genetic predisposition: A family history of CHD increases the risk
Symptoms
- Chest pain or discomfort (angina)
- Shortness of breath
- Heart palpitations
- Fatigue or dizziness
- Symptoms of a heart attack: severe chest pain, sweating, and nausea
Treatment options
- Lifestyle modifications:
- Healthy diet (e.g., low saturated fats, high fibre)
- Regular physical activity
- Quitting smoking
- Medications:
- Statins to lower cholesterol
- Antiplatelets like aspirin to reduce clot formation
- Beta-blockers and ACE inhibitors to manage heart function
- Surgical interventions:
- Coronary angioplasty and stenting
- Coronary artery bypass grafting (CABG)
Complications
Untreated CHD can lead to heart attacks, heart failure, and sudden cardiac arrest.
Stroke
What is a stroke?
A stroke occurs when the blood supply to part of the brain is cut off, either due to a blockage (ischemic stroke) or bleeding (hemorrhagic stroke).
Causes
- Risk factors: High blood pressure, atrial fibrillation, smoking, high cholesterol, and obesity
- Transient Ischemic Attack (TIA): A “mini-stroke” that indicates higher stroke risk
Symptoms (FAST rule)
- Face: Drooping or asymmetry
- Arms: Weakness or inability to raise one arm
- Speech: Slurred or incoherent speech
- Time: Immediate medical attention is crucial
Treatment Options
- Emergency treatment:
- Thrombolysis (clot-dissolving drugs) for ischemic strokes
- Mechanical thrombectomy to remove clots
- Surgery for hemorrhagic strokes to control bleeding
- Rehabilitation:
- Physiotherapy, occupational therapy, and speech therapy
- Medications like anticoagulants and statins to prevent recurrence
Complications
Strokes can cause long-term disabilities, including paralysis, speech difficulties, and cognitive impairments.
High Blood Pressure (Hypertension)
What is hypertension?
Hypertension occurs when the force of blood against artery walls is consistently too high, increasing the risk of other cardiovascular diseases.
Causes
- Primary hypertension: No identifiable cause; linked to lifestyle and genetics
- Secondary hypertension: Caused by underlying conditions like kidney disease or hormonal disorders
Symptoms
Often called the “silent killer,” hypertension usually has no symptoms but can cause headaches, blurred vision, and shortness of breath in severe cases.
Treatment options
- Lifestyle adjustments:
- Reducing salt intake
- Maintaining a healthy weight
- Regular exercise
- Limiting alcohol consumption
- Medications:
- ACE inhibitors, calcium channel blockers, diuretics, and beta-blockers
Complications
Untreated hypertension can lead to strokes, heart attacks, kidney damage, and vascular dementia.
Vascular Dementia
What is vascular dementia?
Vascular dementia results from reduced blood flow to the brain, often caused by strokes or small vessel disease.
Causes
- Strokes and transient ischemic attacks
- Narrowed or damaged blood vessels in the brain
- Conditions like high blood pressure and diabetes
Symptoms
- Memory loss and confusion
- Difficulty with problem-solving or concentration
- Changes in mood or behavior
Treatment options
- Managing underlying conditions:
- Controlling blood pressure, cholesterol, and diabetes
- Stroke prevention strategies
- Cognitive support:
- Therapies to support memory and cognitive function
- Lifestyle changes:
- Balanced diet and physical activity
Complications
Vascular dementia worsens over time, potentially leading to severe cognitive and functional impairments.
Managing Cardiovascular Diseases
Effective management involves a combination of medical treatments, lifestyle adjustments, and regular monitoring. NHS services play a critical role in this process, offering:
- Regular health checks for high-risk patients
- Medication reviews and adjustments
- Access to rehabilitation programs, such as cardiac rehab after a heart attack or stroke
Support systems
- Patient support groups (e.g., Stroke Association, BHF)
- NHS helplines and resources for managing long-term conditions
- Community-based lifestyle programs
The NHS response to CVD
The NHS has prioritised CVD prevention and management through its Long Term Plan, aiming to prevent 150,000 heart attacks, strokes, and cases of dementia by 2029. Key initiatives include:
- Expanding access to preventive treatments like statins
- Integrating digital health technologies for early detection and monitoring
- Enhanced training for healthcare professionals
Take care of your heart
Cardiovascular diseases represent a significant burden on individuals and healthcare systems in the UK. Understanding these conditions, recognising the symptoms, and adopting preventive measures are vital steps toward reducing their impact. Through the combined efforts of your GP, medical advancements, and awareness of your condition and how to manage it, the outlook for managing and preventing a CVD continues to improve.
If you are experiencing any of the symptoms mentioned above, please contact your Primary Care 24 GP practice.
