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THURSDAY
20th November 2003
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Health at 50+ - Your health

Heart disease
by Dr Gill Jenkins

Understand it
Avoid it
Treat it
Other cardiac disease

Understand it!

Heart disease is a very general term which can be used for all sorts of problems, but the commonest problem with the heart in the over 50's is coronary heart disease (ischaemic heart disease).

Coronary heart disease is where the fine blood vessels which go around the heart, feeding blood with nutrients and oxygen to the muscular tissue, are damaged. These blood vessels may be partially blocked by fat and debris, which have accumulated over many years, even starting in childhood. The muscle of the heart is no longer getting the oxygen it needs and starves.

You will get angina type pain, or breathlessness and swelling as the heart fails in its job as a pump. Eventually the vessels will block and you will have a heart attack, with permanent damage to the muscle.

Avoid it!

The four important steps to avoid ischaemic heart disease are:

  1. Stop smoking. Better still, never start.
  2. Exercise regularly, at least twice a week.
  3. Have a healthy diet, keeping your weight sensible, keeping your cholesterol low, and your blood pressure down.
  4. Ask your doctor to check your cholesterol levels and blood pressure and then take his general advice as well as any medication you may need.
Treat it!

If you already have angina there are treatments available in many forms, including tablets, sprays, patches and injections, to ease it. None of these will clear the blockages once formed but they may allow you to lead a normal life. If you are otherwise fit, your doctor may feel it is worthwhile sending you for tests to see if surgery would help. These tests include special scans and x-rays to see which blood vessels are affected.

Once this is known, you might have an operation to clear the blocked vessels. This may be done through a telescope put in through the groin, whilst you are awake. Either the blockage is stretched with a little inflatable balloon or a tube ('stent') is pushed through to hold it open. If many of your coronary blood vessels are affected you may have by-pass surgery, where less essential blood vessels from elsewhere in the body are 'borrowed' to by-pass the affected vessels.

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Other cardiac disease

As well as the blood vessels around it, other parts of the heart can become diseased, especially as we move into the second half of our lives.

  • The valves between the different chambers of the heart can stiffen or leak, making the heart a less efficient pump.
  • The major vessels taking blood to and from the heart chambers can develop weaknesses and suddenly leak.
  • Hypertension, or high blood pressure, is linked to heart disease.
  • Irregular heartbeats (arrhythmias) can cause heart failure, angina and can even be fatal.
  • Diseases of the muscle itself, such as diabetic cardiomyopathy, and also the membranes surrounding the heart, can require treatment.
See your doctor!

Heart disease is now well understood. If you are getting chest pains, breathlessness or palpitations, don't put up with it quietly. See your doctor and live longer!

Links and Organisations

Three BBC HEALTH sites with more information on heart disease:
Ask The Doctor: High Blood Pressure
Men's Health: Heart Disease
Women's Health: Heart Disease

British Heart Foundation
www.bhf.org.uk/
Information, news, research, local contacts and publications.

Wessex Cardiac Unit Web Site
www.heartbeat.co.uk
Descriptions of the disease, and treatments.



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Disclaimer

All content within BBCi HEALTH is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of the BBCi HEALTH website. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you're in any way concerned about your health.



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