Heart health (cardiovascular health)

Coronary artery disease (CAD) is the most common form of heart disease, and is caused by narrowing of the arteries, which increases the risk of a heart attack or stroke occurring.

High levels of LDL-cholesterol (‘bad’ cholesterol) are a key factor in the development of CAD because they can lead to the accumulation of fatty deposits in artery walls (atherosclerosis), making the arteries narrower and stiffer. Low levels of HDL-cholesterol (‘good’ cholesterol) may also be involved. Cholesterol levels in the blood depend on dietary factors (e.g. the amount of saturated fat and cholesterol consumed) and the amount of cholesterol manufactured by the body (which may involve genetic factors).

Other factors that may contribute to the development of CAD include:

• High blood pressure  (which may be a consequence of medical problems, but is more often due to lifestyle issues, including being obese, being physically inactive, and eating a high salt diet).
• High triglyceride levels (high levels of fat in the blood) 
• High levels of a compound called homocysteine 
• Being overweight 
• Smoking 
• Getting older 
• Being diabetic 
• Having a personal or family history of heart problems 
• Leading an inactive lifestyle

Congestive heart failure, a condition in which the heart weakens and becomes unable to effectively perform its functions, is a serious consequence of CAD. As heart function declines, fluid accumulates in the abdomen, legs, and lungs, causing the characteristic symptoms of fatigue, oedema and breathlessness.

• A healthy diet and lifestyle are essential to a healthy heart. Work with your healthcare professional to develop a plan to achieve and maintain a healthy cardiovascular system, body weight, and blood sugar balance, as all of these contribute to your heart health.
• When assessing your heart health, your healthcare professional will consider your cholesterol level and blood pressure in the context of other risk factors such as your family history, body weight, level of physical activity and whether you are diabetic or smoke cigarettes. 
• Adhere to your doctor’s instructions. Talk to your doctor before taking any natural health supplements or changing your diet or lifestyle; such changes may mean that your medicine or its dosage needs to be monitored.
• Reduce the quantity of cholesterol and saturated and trans fats in your diet by avoiding animal fats (meat and full-fat dairy products) and sources of hidden fat such as pastries and pies.  
• At the same time, increase the amount of fish  in your diet (but not deep-fried fish) , and eat more fruit, vegetables and whole grains. 
• A diet high in soluble fibre is highly recommended in order to promote the excretion of cholesterol. Good sources include legumes, oats and psyllium.   
• Eating moderate amounts of foods that contain monounsaturated fats may support the management of healthy normal cholesterol levels. Important foods to include in your diet include nuts (especially walnuts), seeds and olive oil.   
• Stick to a diet that’s low in salt  by decreasing your consumption of processed meats (e.g. bacon, ham and salami), packaged foods, and junk foods. Buy low salt alternatives of any tinned foods, sauces or other packaged foods that you use, and don’t add salt to your meals.
• Including low-fat dairy products in your diet may be beneficial for your blood pressure, perhaps due to the calcium they contain. Aim for three serves per day. 
• Also include foods in your diet that have antioxidant and heart-protecting properties, such as garlic, green tea and tomatoes (a source of the antioxidant lycopene).
• Drink alcohol only in moderation, and favour antioxidant-rich red wine.
• Quit smoking. Cigarette smoking significantly increases the risk of developing cardiovascular disease and other health problems, and can exacerbate the negative effects of high cholesterol and blood pressure levels.     
• Regular aerobic exercise can help to maintain a healthy heart. As little as 30 minutes of moderate exercise (for example, brisk walking) per day may help to improve your cardiovascular health, but seek the advice of your healthcare professional before commencing a new exercise programme.
• Practice techniques to lower your stress levels and improve your ability to cope under pressure. Yoga, meditation, hypnotherapy, tai chi and qi gong may all be particularly beneficial .
• Do not consume large quantities of liquorice confectionary or the herb liquorice (Glycyrrhiza glabra), as it may increase blood pressure in some people.

• Heart problems are serious and require professional treatment and monitoring. Do not make any changes to your medication use, supplements, diet or lifestyle without prior consultation with your healthcare professional.