What causes heart disease?

What’s covered?

Several factors have a negative influence on the heart and blood vessels.

Heart disease is part of a wider group of diseases called cardiovascular diseases. These diseases affect the heart and its related organs, e.g., blood vessels. Common heart diseases include;

• Diseases related to the heart muscle, e.g., myocardial infarction, cardiomyopathy etc.

• Diseases related to heart valves e.g., valvular regurgitation, valvular atresia and valvular stenosis etc.

• Genetic defects, e.g., congenital heart disease including atrial septal defect, atrioventricular septal defect, Ebstein anomaly etc.

• Irregular heartbeat and other issues related to the pacemaker (e.g., cardiac arrhythmia)

• Diseases related to blood vessels, e.g., arteriosclerosis, atherosclerosis, coronary artery disease (commonly called the 'heart disease', peripheral artery disease, aortic disease, haemorrhages, clots etc.

These diseases have very similar causes, risk factors, treatment options and management protocols. Before looking for the causative factors, you need to know how important these diseases are.

Cardiovascular disease, a leading cause of mortality

Cardiovascular diseases are the leading cause of death worldwide and in the United Kingdom. According to a recent report published by the British Heart Foundation, 7.6 million people in the country are living with some circulatory or heart disease, and 160,000 are dying yearly (460 deaths per day). More than half of these heart patients are males.

The causes and risk factors of all these diseases are the same. Their importance and high rate of incidence demand public education about the reasons. If you want to learn about the causes of heart disease, you have landed right. Let's go through what causes your heart to go out of order.

What are the causes of heart disease?

The most common cause of heart disease is the development of plaque in the blood vessels supplying blood to the heart. The plague is a complex and waxy substance formed by minerals, fatty molecules, cholesterol etc. These plagues develop in the inner walls of the blood vessels, causing the vessels to become narrow.

Such a vessel becomes prone to rupture when exposed to other risk factors, e.g., hypertension. There are, however, too many risk factors involved. These risk factors will decide whether you will develop heart disease or not. Some risk factors, e.g., heredity, family history and age, are not under your control, while others, e.g., unhealthy eating habits, depression, smoking, physical inactivity, diabetes, blood pressure and obesity, are to some extent under your control.

The causes and risk factors of heart disease are countless, but we will discuss only the most common aspects faced by most of the population. Let's go through the role of various risk factors and causes.

Lifestyle factors

Lifestyle means the behavioural orientations, behaviours, interests, and opinions of an individual or a group. An unhealthy lifestyle increases your risk of heart disease and heart failure, particularly if you have a genetic predisposition. Some lifestyle factors causing heart disease are;

• Improper management of diabetes

• Improper stress management while working in a high-stress environment

• Excessive smoking and drinking

• Prolonged lack of proper sleep

• Poor diet and eating unhealthy foods, including salts, trans fats and sugars

• Lack of exercise due to a sedentary lifestyle

These issues are the most easily controllable factors. You can take the help of a doctor and a nutritionist to reduce the risk of coronary heart disease. A review published in the American Journal of Lifestyle Medicine has elaborated the role of physical activity, diet, weight, smoking etc., on heart health. You can read the recommended guideline by clicking here.

Depression

Depression major and other psychological issues also cause an increased risk of cardiovascular diseases. Various studies have explored the link between depression and heart disease. For example;

• A 2016 study published in the Frontiers in Psychiatry noted that stress and depression increase the risk of coronary artery disease by influencing various risk factors, e.g., smoking, hypertension and diabetes.

• Another review published in the Progress in the Cardiovascular Disease in 2013 identified that 20% of patients with cardiovascular disease also suffer from a major depressive disorder.

Depression induces a variety of negative changes in the body that increase the risk of heart diseases, e.g.,

• Consistent and heavy stress causes an increase in your blood pressure.

• Depression also causes an increase in the production of C-reactive protein (CRP), which is an inflammatory marker and is associated with heart diseases.

• Besides these, depression also causes various other issues that increase the risk of heart diseases, e.g.,

• Increased smoking and drinking

• Skipping of medications

• Lack of interest in the routine physical activities

• Lack of interest in the healthy foods

If you have symptoms of depression major, talk to a psychologist for recovery. If you want to know more about depression major in women, its causes, risk factors and management strategies, click here to read.

Diabetes

Researchers have found that the risk of cardiovascular diseases is higher in older adults with type 2 diabetes. A recent review published in Circulation Research noted that the risk of heart failure in people with diabetes is double that of non-diabetic people. Besides increased risk, people with type 2 diabetes also have poor disease outcomes.

Diabetes also increases the risk of a heart attack at a younger age, and diabetics are also likely to have multiple heart attacks. Higher glucose in the blood compromises the health of blood vessels as it causes an increased risk of plaque formation in the blood vessels.

So, having diabetes demands careful management to reduce the risk of heart and eye diseases. Quitting smoking, replacing high-sugar diets with low-sugar and high-fibre diets and maintaining a healthy weight are good options. The care is particularly essential if you have a familial history of heart disease and stroke.

Obesity

Obesity is due to the accumulation of excessive fats in the body. Various criteria are used to quantify body fat, including the body mass index (BMI). A BMI score of over 25 means you are overweight, and a score of over 30 means you are obese. It contributes to cardiovascular diseases in these ways;

It increases the risk of other causative factors, e.g., hypertension, hypercholesterolemia, hyperglycaemia etc. The increased risk of these issues causes an increased risk of cardiovascular diseases. According to a review published in the Diabetology and Metabolic Syndrome in 2019, obesity causes insulin resistance, reduces immune functions and causes an increased risk of atherosclerosis and cardiovascular disease.

Diabetes increases the demand for blood supply to the organs, leading to higher blood pressure. In simpler words, your body needs more blood pressure to pump the blood in an obese body.

Obesity is linked with increased levels of bad cholesterol (LDL) and lower levels of good cholesterol (HDL). According to Obesityaction.org, every 10 pounds of extra weight causes 10mg of additional cholesterol production in the body daily. Recall that the normal total cholesterol level should be less than 200 mg/dL. Total cholesterol above this level is called hypercholesterolemia and increases your exposure to heart disease and stroke.

So, it is important to lose weight to gain health and reduce the risk of heart disease.

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Physical inactivity

Physical inactivity is not a risk factor in itself, but it increases the risk of other factors, e.g., type 2 diabetes, hypercholesterolemia, hypertension and obesity etc. Regular exercise makes your muscles stronger, including the heart muscles. Several studies have confirmed this relationship.

For example, a 2019 review published in the Frontiers in Cardiovascular Medicine found that exercise improved cardiac functioning by increasing mitochondrial function, enhancing and restoring vascular supply and causing the release of myokines, the chemicals released from the skeletal muscles that augment the cardiovascular process.

Smoking

Smoking is also a major risk factor for cardiovascular diseases, and according to CDC, every one out of four deaths caused by cardiovascular disease is attributed to smoking. Its smoke has carbon monoxide and nicotine, which cause your heart to beat faster, thus putting extra strain on the heart muscles.

The chemicals in the smoke, e.g., tar, arsenic, formaldehyde, acrolein etc., are respiratory toxins and make the blood thicker, making it more prone to clotting. Some chemicals, e.g., carbon monoxide and nicotine in cigarette smoke, cause damage to the inner lining of the coronary arteries. Smoking poses a considerable risk to your overall health, so, you need to reduce this habit to eliminate it.

Exposure to smoke from secondary smoking is also dangerous. According to CDC, exposure to secondary smoke increases the risk of stroke by 20-30% and heart disease by 25-30% and is associated with thousands of deaths worldwide.

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Heart infections

Endocarditis is the general term for the infections of heart muscles and valves. The chances are rare; however, sometimes, the germs, e.g., parasites, bacteria and viruses, can gain entry into the heart, causing endocarditis. Fungal infections can also develop. For example;

• Parasitic heart infections, e.g., American trypanosomiasis (Chagas' disease), trichinellosis, toxoplasmosis etc.

• Bacterial infections, e.g., infective endocarditis

• Viral infections, e.g., various forms of pericarditis, myocarditis and endocarditis.

• Fungal infections, e.g., fungal endocarditis (a rare condition)

These germs travel through the bloodstream to reach the heart. However, the body's natural immune system will catch up and clear the infection. You need to consult the doctor for proper treatment if the immune system is insufficient.

You will need emergency care in case of severe infections that disrupt the blood flow.

Diseases of heart valves

Valves are present between the various chambers of the heart and between heart chambers and blood vessels. However, these valves can also get ill due to issues, e.g., congenital diseases, infections, endocarditis, thematic fever and connective tissue diseases.

The common examples are valvular stenosis, regurgitation and atresia. These diseases cause retention of blood in the heart or vessels, high blood pressure and various other issues.

Diagnosis of heart diseases

How can you diagnose and detect cardiovascular disease? Well, it is not your job in the first place. A cardiologist's job is to diagnose and treat heart disease. However, on your part, you need to keep an eye on the signs and symptoms of heart disease and report anything immediately to your doctor.

The diagnosis of heart disease is done through risk assessment and diagnostic tests. A doctor does the risk assessment, which involves the investigation of family and medical history, monitoring of blood parameters, e.g., blood glucose and cholesterol, evaluating lifestyle risk factors, etc.

For further diagnosis, the GP or a cardiologist can take the help of diagnostic tests, e.g., CT scan, MRI scan, blood tests, coronary angiography, echo-cardiogram, X-rays, electrocardiogram etc. These tests will provide the doctor with a picture of your heart health. However, the treatment is always more expensive than the prevention. So, it would help if you focus more on prevention.

Prevention and Control

The prevention of heart disease is a complicated process and needs the reversal of all risk factors. However, a well-designed plan and persistent execution under the guidance of experts can make things simpler. In a nutshell, you should focus on the following;

• Proper diabetes management

• Regular monitoring of blood pressure

• Reduce smoking and alcohol consumption

• Maintain a healthy weight

• Make yourself physically active and fit

• Eat a healthy and balanced diet, including all essential nutrients free from trans fats and LDL.

In case of severe issues, the doctor may recommend you to use prescription drugs. In case of severe blockage of blood vessels, the doctors may go for coronary artery bypass surgery. The recovery and rehabilitation needs a proper program including medications, education, motivation and emotional support. You can enroll yourself in any cardiac rehabilitation programs your nearest healthcare centre offers.

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Bottom-line

Heart diseases are very common, and their incidence is increasing rapidly. The causes of heart diseases are extremely variable and range from non-preventable congenital causes to preventable lifestyle factors. However, following a healthy lifestyle and reducing exposure to the risk factors can reduce the risk and chances of heart disease and sudden cardiac arrest.

You need to monitor the signs of heart disease, e.g., chest pain etc., and report to your doctor as soon as possible.

Given the difficulties in the treatment, regularly monitoring your cardiovascular health through blood tests is better. Our Heart Disease Risk Blood Test does this job by detecting the levels of various key parameters, e.g., LDL, HDL, triglycerides, total cholesterol, hs-CRP etc., in the blood. Click here to get your test kit.

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