A healthy heart and blood vessels help to ensure a long and full life. Years of poor diet, smoking, and lack of exercise take their toll on heart fitness, even though symptoms may not appear for many years.
Cardiovascular disease is the major public health problem for Australia. According to the National Heart Foundation, in 1998, cardiovascular disease (heart, stroke and vascular diseases) accounted for 40 per cent of all deaths.
Coronary heart disease (mainly heart attacks) is the leading single cause of death in Australia.
Two ways in which heart health can be assessed are through monitoring blood pressure and monitoring blood lipid (fat) levels, such as cholesterol levels. If either of these become high, it signals the need for a change in lifestyle, and possibly the need for medication, to regain good health. Regular checks are the only way of assessing high blood pressure and high cholesterol, as these conditions rarely give rise to symptoms.
Everybody has blood pressure. It is the pressure in the arteries, created as the heart pumps blood around the body. Blood pressure is determined by 2 measurements: systolic pressure and diastolic pressure. These measurements are expressed as systolic pressure (for example, 130) over diastolic pressure (for example, 85): 130/85. Correctly, it is written as 130/85 mmHg, which includes the units of measurement (mmHg = millimetres of mercury).
Normal blood pressure is generally less than 130/85. When blood pressure readings rise above 140/90 on a regular basis, this is called high blood pressure, or hypertension. The higher the blood pressure, the harder the heart has to work to push blood through the arteries. This eventually damages the heart and blood vessels, increasing the risk of heart attack or stroke.
Cholesterol is a type of fat found in the blood, and has several important functions in the body. Whereas some cholesterol comes from our diets, most is made by our bodies. Over time, too much cholesterol in the blood (a condition doctors call hypercholesterolaemia) can lead to a build-up inside the arteries, sometimes called ‘hardening of the arteries’ (atherosclerosis).
Although it is important to know the total level of cholesterol in the blood, it is also essential to measure the different kinds of cholesterol present. This is because there are some ‘good’ types of cholesterol (such as HDL, or high-density lipoprotein) and some ‘bad’ types (such as LDL, or low-density lipoprotein). A blood test for a full lipid profile provides this information.
The aim is to increase HDL (‘good’ cholesterol) and reduce LDL (‘bad’ cholesterol). This can be achieved through diet and other lifestyle changes, such as exercise and quitting smoking. If you have a family history of high cholesterol, or if diet and lifestyle changes don't help, your doctor may prescribe medications to reduce your cholesterol level.
Some people have high levels of another type of lipid (fat) in the blood, known as triglycerides. High triglyceride levels have been linked to the development of atherosclerosis, and therefore a higher risk of heart disease and stroke, particularly if they appear in conjunction with high cholesterol levels. Hyperlipidaemia is the general term doctors use to describe high blood lipid levels (high triglyceride levels and/or high cholesterol levels).
If you are overweight, losing weight is a highly effective way of reducing blood pressure and improving your cholesterol profile. Even a few kilograms can make a real difference. Decreasing the fat content of your diet is a very effective way of achieving weight loss. All fats should be reduced, but particularly saturated fats, as they tend to raise the ‘bad’ cholesterol level. Examples include coconut and palm oil, and also animal fats, such as fatty meats, butter, cream and cheese.
Substitute polyunsaturated (such as sunflower or safflower) or monounsaturated (such as canola or olive) oils and margarines for other fats, but aim to keep total fat intake moderate. Remember that all fats contribute equally to weight gain.
Eat plenty of fruit and vegetables and wholegrain bread and cereals. Grill, dry-fry, boil, steam, bake or microwave instead of frying and choose lean cuts of meat, and chicken without the skin. And reduce your intake of fast foods and sugary foods such as soft drinks. If you drink alcohol make sure it is a moderate amount.
For those who have high blood pressure, avoid drinking alcohol and adding salt to food during cooking or at the table. Choose low-salt or no-added salt brands, and limit salty foods such as cheeses and processed meats.
High blood pressure can be reduced, and lipid profile improved, by maintaining a reasonable level of fitness through exercising. Exercise will also help to reduce excess body weight.
It is vital that you consult your doctor before commencing an exercise programme. This is especially important for those with existing heart conditions, high blood pressure, diabetes, or those over 40 years of age.
Current thinking is to incorporate physical activity into each day, and to aim for at least 30 minutes of moderate-intensity activity on most days. This includes brisk walking, cycling, swimming and similar activities. You can do 2 or 3 shorter sessions that add up to a total of 30 minutes if you can't do it all at once. Where possible be active and do things yourself rather than use machines.
Smoking is dangerous for anyone, but even more so if you have high blood pressure or high cholesterol. Smokers are 70 per cent more likely to die from heart disease than non-smokers. Giving up smoking will reduce your risk of heart disease, even if you have smoked for a long time.
Last Reviewed: 14 March 2003