Medicines for Cardiovascular disease

What it is

Cardiovascular disease (CVD) is a general term for a group of conditions that affect the heart and blood vessels. It is one of the main causes of ill health and death, but importantly, much of it is preventable, and the risk can be substantially reduced. Most cardiovascular disease is associated with a process called atherosclerosis — a build-up of fatty deposits in the walls of the arteries, which narrows and damages them and can reduce or block the blood flow. The main types of cardiovascular disease include: coronary heart disease (affecting the arteries that supply the heart, which can cause angina and heart attacks); stroke and transient ischaemic attacks (TIAs, "mini-strokes", affecting the blood supply to the brain); peripheral arterial disease (affecting the arteries supplying the limbs); and aortic disease (affecting the body’s main artery). These share many of the same underlying causes and risk factors. Key risk factors for cardiovascular disease include: high blood pressure, high cholesterol, smoking, diabetes, being overweight, physical inactivity, an unhealthy diet, drinking too much alcohol, and a family history, as well as increasing age and certain ethnic backgrounds. Some of these risk factors cannot be changed (such as age or family history), but many can be — and this is the encouraging and important point: reducing the modifiable risk factors substantially lowers the risk of cardiovascular disease, and much of it is preventable. Cardiovascular disease may not cause symptoms until a problem occurs (such as a heart attack or stroke), which is why identifying and managing risk factors is so important, including through health checks. Treatment and prevention involve a healthy lifestyle and, where needed, medicines (such as those to lower blood pressure or cholesterol) and other treatments, tailored to the individual’s risk. The key messages are that cardiovascular disease is common but largely preventable, that reducing risk factors through a healthy lifestyle (and treatment where needed) substantially lowers the risk, and that knowing and managing your risk — including through health checks — is worthwhile.

How it is treated

Cardiovascular disease is largely preventable, and its management centres on reducing risk factors through a healthy lifestyle and, where needed, medicines, tailored to the individual’s level of risk. A cornerstone is a healthy lifestyle, which both reduces the risk of developing cardiovascular disease and helps manage it: not smoking (and stopping smoking, which is one of the most important steps); eating a healthy, balanced diet (with plenty of fruit, vegetables, wholegrains, and less saturated fat, salt, and sugar); being physically active; keeping to a healthy weight; drinking within recommended alcohol limits (or less); and managing stress. Alongside this, managing specific risk factors is important: controlling high blood pressure, managing high cholesterol, managing diabetes well, and treating other relevant conditions — through lifestyle and, where appropriate, medicines. Because cardiovascular risk depends on the combination of factors, doctors assess a person’s overall cardiovascular risk (for example through health checks, which are offered to adults in certain age ranges, and which check blood pressure, cholesterol, and other factors), and use this to guide advice and treatment — for example, medicines to lower cholesterol (such as statins) or blood pressure may be recommended for those at higher risk, and other medicines for those with established cardiovascular disease. For people who already have cardiovascular disease (such as after a heart attack or stroke), treatment focuses on managing the condition, reducing the risk of further events (with lifestyle measures and medicines), and rehabilitation. Because much cardiovascular disease is silent until a problem occurs, and because reducing risk factors makes a real difference, the key messages are to know and manage your risk — including taking up health checks when offered — and to adopt a heart-healthy lifestyle, with treatment where needed. The reassuring and empowering message is that much cardiovascular disease is preventable, that a healthy lifestyle substantially reduces the risk, and that identifying and managing risk factors (with treatment where appropriate) protects heart and circulatory health.