Heart Disease Conditions

CONTENT

Abnormal heart rhythms  Angina  Atrial Fibrillation  Cardiac arrest  Cardiomyopathy  Cardiovascular disease  Congenital heart disease  Diabetes  Heart attack  Heart failure  Heart valve disease  High blood pressure  High cholesterol  Women and heart disease

ABNORMAL HEART RHYTHMS
Your heart is a muscle that pumps blood around the body. For the pump to work, it needs an electrical supply. This is provided by a special group of heart cells called the sinus node, which is also known as your heart’s natural pacemaker.

The electrical signal produced by the sinus node makes your heart’s top chambers or atria contract and push blood through to the lower chambers or ventricles. When the impulses reach the ventricles, they contract to push the blood out of the heart and into the lungs and the rest of the body.

These electrical impulses cause your heart to beat between 60 to 100 beats per minute (bpm).

The normal electrical pattern of your heart, is known as sinus rhythm, and can be recorded doing an electrocardiogram (ECG). You can measure your own heart rate and feel your rhythm by taking your pulse.

It’s normal for your heart to beat at different rates during the day. For example it will be slower when you are sleeping, resting or doing activites that do not require a lot of effort but may be faster when you are physically active such as when you are gardening, walking briskly, or running. Your heart rate might also be faster if you are anxious or excited.

ANGINA
Angina is a pain or discomfort felt in the chest, and usually caused by coronary heart disease. However, in some cases the pain may affect some people in only the arm, neck, stomach or jaw.

What does angina feel like?
Angina often feels like a heaviness or tightness in your chest, but this may spread to your arms, neck, jaw, back or stomach as well. Some people describe the feeling of severe tightness, while others say it’s more of a dull ache.

Symptoms of experiencing shortness of breath have been reported too.

Angina is often brought on by physical activity, an emotional upset, cold weather or after a meal. Symptoms usually subside after a few minutes.

If your symptom pattern changes, you should speak to your doctor immediately. Can I prevent angina?

Unfortunately you can’t reverse coronary heart disease, but you can help prevent your angina and the condition from getting worse by keeping your heart healthy. It is important to:
stop smoking
control high blood pressure
reduce your cholesterol level
be physically active
achieve and maintain a healthy weight
control your blood glucose if you have diabetes
eat a healthy, balanced diet and only drink moderate amounts of alcohol.

Some medications can also be used to help prevent angina episodes.

How is angina diagnosed and treated?
Your doctor may be able to diagnose whether you have angina from the symptoms that you describe. Alternatively, they may want to carry out a health check or send you for some tests.

There is medication available too that can help control your symptoms, whereas some people require treatments such as angioplasty or heart bypass surgery. Living a healthy lifestyle is a very important part of your treatment too.

Everyday life with angina
Many people with angina have a good quality of life and continue with their normal daily activities. Your doctor or nurse will be able to advise you on your daily activity and any lifestyle changes you may need to make.

ATRIAL FIBRILLATION
An irregular pulse could be a sign that you have an abnormal heart rhythm. Atrial Fibrillation (AF) is one of the most common forms of an abnormal heart rhythm and a major cause of stroke.

That’s why it’s important to find out if you have it, because you can get effective treatment to reduce the risk of stroke.

Normally, your heart’s natural pacemaker sends out regular electrical impulses. AF happens when those impulses fire off from different places in the atria (the top chambers of the heart) in a disorganised way.

People with AF have an irregular and sometimes fast pulse. You can check to see if you might have AF simply by feeling your pulse.

Around 800,000 people in the UK have AF – roughly one in 100 – and mostly aged 55 and over.

What causes AF?
Causes include high blood pressure, heart valve disease, thyrotoxicosis (overactive thyroid gland) and excess alcohol consumption.

It’s also associated with coronary heart disease. But in many patients no underlying cause can be found. Sometimes the AF can be resolved once the underlying condition has been dealt with.

What are the symptoms of AF?
Symptoms can include palpitation (being aware of your heart beat), tiredness, shortness of breath, dizziness or feeling faint. However, some people only have mild symptoms, while other people have no symptoms at all.

How can AF be detected?
AF can be detected by feeling the pulse at your wrist. The pulse will feel irregular and beats may be variable in strength.

Some people don’t realise they have AF. It’s only discovered when they have a pulse check or ECG (a test which records the electrical activity of the heart).

Make sure you know your pulse – download your own Pulse Check Card.

If your pulse is irregular or if you’re concerned in any way about your pulse you should make an appointment to see your GP.

Is an irregular pulse always due to AF?
Occasional irregularities such as missed beats or extra beats are very common and usually nothing to worry about.

AF on the other hand is continuously irregular with no pattern to it at all.

What are the complications of AF?
It can increase the risk of a blood clot forming inside the chambers of the heart, which can lead to a stroke. AF increases stroke risk by around four to five times.

Although AF can greatly increase the risk of stroke, there are other factors that can contribute to a stroke. These include smoking, high cholesterol, high blood pressure, physical inactivity, being overweight and diabetes.

With appropriate treatment the risk of stroke, can be substantially reduced. An anticoagulant (blood thinner) drug called Warfarin is the most effective treatment to reduce the risk of stroke in people with AF.

What should you do if your pulse is irregular?
If your pulse is irregular or if you’re concerned in any way about your pulse you should make an appointment to see your doctor.

A quick guide to checking your pulse

1. Put one of your hands out so you’re looking at your palm.
2. Use the index/first finger and middle finger of your other hand and place the pads of these fingers on the inside of your wrist. You should place them at the base of your thumb near where the strap of a watch would sit.
3. Press lightly and feel the pulse. If you can’t feel anything press slightly harder or move your fingers around until you feel your pulse.
4. Once you’ve found your pulse, continue to feel it for about 20-30 seconds.Feel the rhythm of the pulse and check if it’s regular or irregular.

CARDIAC ARREST
A cardiac arrest happens when your heart stops pumping blood around the body. The most common cause of a cardiac arrest is a life threatening abnormal heart rhythm called ventricular fibrillation.

Ventricular fibrillation occurs when the electrical activity of the heart becomes so chaotic that the heart stops pumping and quivers or ‘fibrillates’ instead.

This is a cardiac arrest. It can sometimes be corrected by giving an electric shock through the chest wall, using a device called a defibrillator.

Some other reasons why you might have a cardiac arrest are:
if you lose a large amount of blood or fluid
lack of oxygen
your body being very hot or very cold
a blood clot in the lung or coronary arteries

A cardiac arrest is different from a heart attack.

A heart attack usually happens because you have coronary heart disease. If you have a heart attack, you do not always experience the life threatening rhythms that can lead to a cardiac arrest. A cardiac arrest does not always happen because you have a heart condition.

If you have a cardiac arrest, you lose consciousness almost at once.

There are also no other signs of life such as breathing or movement.

Cardiopulmonary resuscitation (CPR)
Unless someone starts cardiopulmonary resuscitation (CPR) the person may suffer permanent damage to the brain and other organs.

CPR means:
chest compression (pumping the heart by external cardiac massage), to keep the circulation going until the ambulance arrives and
rescue breathing (inflating the lungs by using mouth-to-mouth resuscitation),

Ambulance staff are trained in advanced resuscitation and all emergency ambulances carry a defibrillator.

CARDIOMYOPATHY
Cardiomyopathy is a disease of the heart muscle. It can run in families and can affect more than one member of a family. Some family members may not be affected at all.

There are three main types of cardiomyopathy:
Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy

What is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy (HCM) is an inherited (genetic) condition which means it can be passed on through families.

If you have HCM, the cells of your your heart muscle wall are affected and become thickened making the heart muscle stiff. This makes it harder for your heart to pump blood around your body.

What is dilated cardiomyopathy?
When dilated cardiomyopathy (DCM) is diagnosed it might be that there is no-one else in your family has the condition. However it can be inherited too.

In DCM, the heart muscle wall becomes thin and floppy, and is described as being dilated. This makes the heart weak and it is difficult for it to pump blood around the body effficeintly.

DCM can occur in some women in the late stages of pregnancy or shortly after birth. Excessive amounts of alcohol can also cause the condition.

What is arrhythmogenic right ventricular cardiomyopathy?
Arrhythmogenic right ventricular cardiomyopathy (ARVC) usually affects the right side of your heart. It is an inherited condition which means that it can be passed on through families.

In ARVC, the heart muscle cells are gradully replaced with fatty tissue. When this happens, your heart becomes weak and unable to pump blood around the body effectively. It usually takes many years for this to happen so most people are not diagnosed until later in life.

What else do I need to know?
Although cardiomyopathy cannot be cured, there are many effective treatments that can help you to lead a normal life. In a few cases, there is a risk of sudden arrhythmic death (SADS). You should discuss this with your doctor who will be able to advise you about treatments available to you.

Because cardiomyopathies can be inherited, you should speak to your GP about screening for your family.

CARDIOVASCULAR DISEASE
Coronary heart disease (CHD) is caused by a gradual build up of fatty deposits in the walls of your coronary arteries, which can then cause them to narrow. The medical term for this condition is atherosclerosis and the fatty material is known as atheroma.

Over time, the artery may become so narrow that it can’t deliver enough oxygen to your heart, especially when you’re exerting yourself. This can lead to angina – a pain or discomfort in your chest.

If a piece of this fatty material breaks away from the artery wall it can cause a clot to form, which will then starve your heart of blood and oxygen. This is known as a heart attack.

What causes cardiovascular disease?
The following things can increase your risk:
Smoking
High blood pressure
High blood cholesterol
Physical inactivity
Being overweight or obese
Diabetes
Family history
Age – the older you are the more likely you are to develop CVD.

What can I do if I’m worried about developing cardiovascular disease?
You should visit your GP or practice nurse who can assess your risk by carrying out a health check.

Your GP or practice nurse will want to:
talk to you about your lifestyle
take your weight, height and waist measurements
take your blood pressure
have your blood tested for cholesterol
ask questions about your family history.

After your check, your GP or practice nurse may give advice to help you make changes to your lifestyle to reduce your risk of heart disease. You can find out more about heart health checks in our booklet Keep your heart healthy.

How can I prevent heart disease?
Making small changes to your lifestyle can reduce your risk of developing CVD. If you already have the condition the following can help to keep your heart healthy and reduce the risk of future problems:
Stopping smoking
Controlling high blood pressure
Reducing your cholesterol level
Being physically active
Achieving and maintaining a healthy weight
Controlling your blood glucose if you have diabetes
Eating a healthy, balanced diet and only drinking moderate amounts of alcohol.

CONGENITAL HEART DISEASE
Congenital heart disease affects about 1 in every 145 births. For more than half of these babies, the condition is a minor problem which either doesn’t need any treatment, or can be successfully corrected with surgery after they are born.

Other conditions are more serious and sadly, some children with congenital heart disease do not survive. However, thanks to advances in early diagnosis and treatment, most children will grow up to become adults and lead full and active lives.

There are many different types of congenital heart disease. For example, the heart’s valves may not be properly formed or there could be holes between the chambers of the heart.

What causes congenital heart disease?
In most cases, something has gone wrong in the early development of the foetus. Some heart conditions are due to faulty genes or chromosomes. Often, we don’t understand why the baby’s heart hasn’t developed normally.

How is the condition discovered?
Many heart problems are picked up when the mother has an ultrasound scan during pregnancy, but sometimes they are not detected until after the baby has been born.

Some conditions may not be discovered until the child is older or even an adult.

What treatment is available?
Treatment depends on the type and severity of the condition. Some children won’t require any treatment, while others may need medication or heart surgery. There are also other new techniques and procedures that, in some cases, can be done instead of surgery.

Support for parents and families
Finding out that your child has a congenital heart condition can be very distressing, but there are health professionals and groups who can support you through this time.

If your child is being treated at a specialist centre or hospital, ask if there is a cardiac liaison nurse or social worker you could speak to. They can provide you with practical help and reassurance, and direct you to other useful organisations for further support. Your cardiac liaison nurse will often stay in touch and be available to answer your questions even after your child has been discharged from hospital.

DIABETES
High glucose levels in the blood affect the walls of the arteries, making them more likely to develop fatty deposits (atheroma).

Diabetes increases the damage done by some of the major risk factors for coronary heart disease – smoking, high blood pressure and high blood cholesterol.

Type one diabetes
Your body cannot make insulin. This type usually affects children and young adults.

Type two diabetes
Your body can’t produce enough insulin or it doesn’t work properly. Type two diabetes is more common and tends to develop gradually as people get older – usually after the age of 40. It’s closely linked with:
being overweight
being physically inactive or,
a family history of diabetes.

Almost two million adults have been diagnosed with diabetes in the UK, and this number is rising. And worryingly, type two diabetes is now being diagnosed in younger people.

Some ethnic groups have a much higher rate of diabetes – particularly people of African Caribbean and South Asian origin.

What can I do?
If you don’t have diabetes, you can greatly reduce your risk of developing it by controlling your weight and doing regular physical activity.

If you do have diabetes, it’s very important to make sure that you control your blood sugar, blood pressure and cholesterol. This will help to reduce your risk of cardiovascular disease. You can also:
do more physical activity
eat a healthy, balanced diet
control your weight and body shape, and
give up smoking.

If you are diagnosed with diabetes, you may also need to take medication such as statins (a cholesterol-lowering medicine) to help protect your heart.

HEART ATTACK

Most heart attacks are caused by coronary heart disease, which is when your coronary arteries narrow due to a gradual build-up of atheroma (fatty material) within their walls. If the atheroma becomes unstable, a piece may break off and lead to a blood clot forming. This clot can block the coronary artery, starving your heart of blood and oxygen and causing damage to your heart muscle – this is a heart attack. It is also called acute coronary syndrome, myocardial infarction or coronary thrombosis.

A heart attack is life threatening. If you think you or anyone else is having a heart attack, you should phone for an ambulance immediately.

You are more likely to survive a heart attack if you phone straight away.

What is the difference between a heart attack and cardiac arrest?
Cardiac arrest is totally different from a heart attack. A cardiac arrest happens when your heart stops pumping blood around the body. As a result you will be unconscious and won’t be breathing normally. Immediate cardiopulmonary resuscitation (CPR) and defibrillation is needed to have any chance of survival.

One of the causes of cardiac arrest is a heart attack. Other causes include electrocution or choking.

If you witness a cardiac arrest, you can increase the persons chances of survival by phoning and giving immediate CPR.

What are the symptoms of a heart attack?
The symptoms of a heart attack vary from one person to another. They can range from a severe pain in the centre of the chest, to having mild chest discomfort that makes you feel generally unwell.

The symptoms can include:
central chest pain; a dull pain, ache or ‘heavy’ feeling in your chest; or a mild discomfort in your chest that makes you feel generally unwell. The pain or discomfort may feel like a bad episode of indigestion
this pain or discomfort may spread to the arms, neck, jaw, back or stomach
as well as having chest pain or discomfort you can feel light-headed or dizzy and short of breath
You may also feel nauseous or vomit

Do not phone your GP if you think you or someone else is having a heart attack, you must call for an ambulance.

The sooner you get emergency treatment, the greater your chances of survival and the more of your heart muscle can be saved.

Should I take an aspirin if I think I am having a heart attack?
The first thing to do if you think you’re having a heart attack is to call immediately for an ambulance.

You should then sit and rest while you wait for the ambulance to arrive.

If you are not allergic to aspirin and have some next to you, or if there is someone with you who can fetch them for you, chew an aspirin. However, if they are not nearby, the person with you should not go hunting for aspirin, they should stay with you.

Do not get up and wander around the house looking for an aspirin. This may put unnecessary strain on your heart.

How is a heart attack diagnosed?

HEART FAILURE
Having heart failure means that for some reason, your heart is not pumping blood around the body as well as it used to. The most common reason is that your heart muscle has been damaged, for example, after a heart attack.

It can be very frightening to hear that you or a person close to you, has heart failure.

For many people heart failure can be a debilitating condition where normal everyday tasks such as having a shower or bath, doing the shopping or simply playing with the children takes enormous energy and leaves them breathless and exhausted.

That’s because when heart muscle is damaged, it cannot heal itself. So once your heart ‘breaks’, it stays that way.

What causes heart failure?
There are lots of reasons why you might be diagnosed with heart failure. It can be sudden or it can happen slowly over months or even years. Some causes of heart failure are:
a heart attack
high blood pressure
problems with the valves in your heart
cardiomyopathies – diseases of the heart muscle
too much alcohol
congenital conditions – ones you are born with.

How will heart failure affect me?
Not everyone experiences the same symptoms and everyone copes in different ways. You might feel out of breath if you are physically active, or for some people even when they are at rest. You may also have swollen feet and ankles and feel very tired. You might have to think about how you will cope with work or if you need to change your job.

Everyone is different so it’s important to speak to your GP and your heart failure nurse about what is best for you.

How is heart failure diagnosed and treated?
Your doctor will ask you questions about your medical history and talk to you about what has caused your heart failure. The reason for your condition will make a difference to how your symptoms are controlled. You may need to have tests which include blood tests, an electrocardiogram (ECG) and an echocardiogram.

While there isn’t a cure for heart failure at the moment, the treatment to control symptoms has improved dramatically. With treatment and the right medicines many people live full and active lives. Your doctor will prescribe drugs that will help control your blood pressure and help the pumping action of your heart.

They will also give you advice about making changes to your lifestyle such as cutting down on salt, staying active and stopping smoking, that will help you do all the things that you enjoy, improve your condition and live a normal life.

HEART VALVE DISEASE
Your heart is a muscle which pumps blood to your lungs and around the rest of your body. There are four chambers to your heart which are separated by valves to make sure that the blood flows in one direction through the heart.

The two large blood vessels that leave the heart also have valves to make sure that the blood does not go back into the heart once it has been pumped out.

What causes heart valve disease?
The main causes of heart valve disease are:
being born with an abnormal valve or valves (congenital heart disease)
having had rheumatic fever
cardiomyopathy – a disease of the heart muscle
damage to the heart muscle from a heart attack
getting older
a previous infection with endocarditis.

What happens to heart valves?
A diseased or damaged valve can affect the flow of blood in two ways:
If the valve does not open fully, it will obstruct the flow of blood. This is called valve stenosis or narrowing.
If the valve does not close properly, it will allow blood to leak backwards. This is called valve incompetence or regurgitation or a leaky valve.

Both of these will put extra strain on the heart and if you have stenosis, the valve can restrict the flow of blood making your heart pump harder to force the blood past the narrowing. If you have incompetence, a leaking valve may mean that your heart has to do extra work to pump the required volume of blood through the heart.

What are the symptoms of heart valve disease?
You may not experience any symptoms but if you so some of the common symptoms are:
being out of breath
swelling of the ankles and feet
being unusually tired

How is heart valve disease diagnosed?
You may be visiting your doctor because you are experiencing some of the symptoms listed above. Or you may not have any symptoms but your doctor has said that they can hear a murmur (an unusual sound) when they listen to your heart. A murmur does not always mean that there is a problem with your heart as people with normal hearts may also have murmurs.

Your doctor may suggest that you have further tests to see how well your heart is working. The most common test is an echocardiogram which uses sounds waves to look at the structure of your heart. It is similar to an ultrasound scan used to look at babies before they are born.

How is heart valve disease treated?
You may not need any treatment at all but your doctor may ask you to come back in a year’s time or if your symptoms get worse. Most valve problems however can be treated using medicines or by surgery. Your treatment will depend on the cause of your problem and the effect that it is having on your heart.

HIGH BLOOD PRESSURE
High blood pressure is just one of the risk factors for developing heart disease, along with cholesterol, diabetes and other lifestyle factors. Many people in the UK are walking around, undiagnosed, with high blood pressure.

The only way to know whether you have high blood pressure is to have it measured.

We recommend that everyone over 40 gets their blood pressure taken by a nurse or doctor as part of a risk assessment for heart and circulatory disease.

What is blood pressure?
Put simply, blood pressure is the pressure of blood in your arteries – the tubes that carry your blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to get the blood round your body.

The pressure of blood flowing through your arteries varies due to your heart pumping. When your heart pumps blood out of your heart into your arteries, the pressure in your arteries will be at its highest. When your heart is relaxing before it pumps again the pressure in your arteries will be at its lowest.

What do the numbers mean?
When we do get our blood pressure tested, the numbers our doctor or nurse gives us when taking our blood pressure can mean little to us.

Every blood pressure reading consists of two numbers or levels. They are shown as one number on top of the other and measured in mmHg, which means millimetres of mercury. If your reading is 120/80mmHg, you might hear your doctor or nurse saying your blood pressure is “120 over 80”.

	The first (or top) number represents the highest level your blood pressure reaches when your heart beats and pumps blood into your arteries – your systolic blood pressure. An example might be 130mmHg.
	The second (or bottom) numbert represents the lowest level your blood pressure reaches as your heart relaxes between beats – your diastolic blood pressure. An example might be 75mmHg.

You should have your blood pressure measured so that you know what your target is. Normally your target is to have a blood pressure below 140/85mmHg.

However, if you have heart or circulatory disease, including being told you have coronary heart disease, angina, heart attack or stroke, have diabetes or kidney disease, then your blood pressure should be below 130/80mmHg.

What is high blood pressure?
High blood pressure – or hypertension – means that your blood pressure is constantly higher than the levels above. High blood pressure is not usually something that you can feel or notice, but over time your heart may become abnormally large and beat less effectively.

Having high blood pressure increases your chance of having a heart attack or stroke. If left untreated it puts extra strain on your heart muscle which can lead to heart failure.

There isn’t always an explanation for the cause of high blood pressure, but these can play a part:
not doing enough physical activity
being overweight or obese
too much salt in your diet
drinking too much alcohol
not eating enough fruit and vegetables or,
having a family history of high blood pressure.

Even if you don’t have high blood pressure, making simple lifestyle changes may help prevent you developing it in the future.

What can I do to reduce my blood pressure?
If your doctor or nurse says you have high blood pressure, he/she is likely to encourage you to make some lifestyle changes to help reduce it. This may include increasing your physical activity, losing weight, reducing the salt in your diet, cutting down on alcohol and eating a balanced, healthy diet.

If your blood pressure is very high or these lifestyle changes do not reduce it enough, your doctor is likely to prescribe you medication to control it and to reduce your risk of having a heart attack or stroke.

HIGH CHOLESTEROL
Cholesterol is a fatty substance found in the blood. It’s mainly made in the body. Cholesterol plays an essential role in how every cell in the body works. However, too much cholesterol in the blood can increase your risk of cardiovascular disease.

LDL cholesterol and HDL cholesterol
Cholesterol is carried around the body by proteins. These combinations of cholesterol and proteins are called lipoproteins. There are two main types of lipoproteins:
LDL (low-density lipoprotein) is the harmful type of cholesterol
HDL (high-density lipoprotein) is a protective type of cholesterol

Having too much harmful cholesterol in your blood can increase your risk of getting cardiovascular disease. The risk is particularly high if you have a high level of LDL cholesterol and a low level of HDL cholesterol.

Triglycerides
Triglycerides are another type of fatty substance in the blood. They’re found in foods such as dairy products, meat and cooking oils. They can also be produced in the body, either by the body’s fat stores or in the liver.

People who are very overweight, eat a lot of fatty and sugary foods, or drink too much alcohol are more likely to have a high triglyceride level. People with high triglyceride levels have a greater risk of developing cardiovascular disease than people with lower levels.

What causes high cholesterol?
A common cause of high blood cholesterol levels is eating too much saturated fat.

However, some people have high blood cholesterol even though they eat a healthy diet. For example, they may have inherited a condition called familial hyperlipidaemia (FH).

The cholesterol which is found in some foods such as eggs, liver, kidneys and some types of seafood eg. prawns, does not usually make a great contribution to the level of cholesterol in your blood. It’s much more important that you eat foods that are low in saturated fat.

How can I reduce my cholesterol level?
Cut down on saturated fats
To help reduce your cholesterol level, you need to cut down on saturated fats and instead use unsaturated fats such as olive, rapeseed or sunflower oilds and spreads. You should also reduce the total amount of fat you eat.

Eat oily fish regularly
Oily fish provides the richest source of a particular type of polyunsaturated fat known as omega-3. Omega-3 from oily fish can help to lower blood triglyceride levels, helps prevent the blood from clotting, and can also help to regulate the heart rhythm.

Eat a high-fibre diet
Foods that are high in soluble fibre such as oats, beans, pulses, lentils, nuts, fruits and vegetables, can help lower cholesterol. Do regular physical activity

This can help increase your HDL cholesterol (the ‘protective’ type of cholesterol).

Will eating sterol-enriched foods help reduce my cholesterol level?
There is evidence to show that substances called plant sterols and stanols may help reduce cholesterol levels when 2g per day is regularly consumed. They are added to certain foods including margarines, spreads, soft cheeses and yoghurts. However, if you have been told by your doctor that you need to reduce your cholesterol levels, you can do this through changing your diet without using special products.

If you decide to use these products you should follow the manufacturer’s instrcutions on the amounts needed to provide you with 2g a day. And remember they are not a substitute for a heart healthy diet or a replacement for cholesterol lowering drugs.

I’ve heard that eating too many eggs can raise your cholesterol – how many can I eat?
For most people there is currently no limit on the number of eggs that you can eat in a week. However, because the recommendation has changed over the years, it’s often a common source of confusion.

In the past a restriction on eggs was recommended because we thought that foods high in cholesterol (including liver, kidneys and shellfish, as well as eggs) could have an impact on cholesterol levels in the body.

However, as research in this area has developed, so has our understanding of how foods that contain cholesterol affect people’s heart health.

For most people, the amount of saturated fat they eat has much more of an impact on their cholesterol than eating foods that contain cholesterol, like eggs and shellfish. So unless you have been advised otherwise by your doctor or dietician, if you like eggs, they can be included as part of a balanced and varied diet.

Will I need to take medication?
Whether you need to take cholesterol-lowering drugs or not depends not just on your total cholesterol, HDL and LDL levels, but also on your overall risk of cardiovascular disease.

Cholesterol-lowering medicines such as statins are prescribed for people who are at greatest overall risk of suffering from cardiovascular disease.

WOMEN AND HEART DISEASE
If you thought the single biggest killer of women was the big C, and especially breast cancer, you wouldn’t be alone. But you would be wrong. Heart disease kills three times more women than breast cancer. The good news is you can protect yourself, and learn to recognise the symptoms. Help us raise awareness – tell your friends about women and heart disease. It’s an enduring myth that heart disease affects men more than women, but the truth is, heart disease kills 1 in 3 women, as well as 1 in 3 men.