Cardiovascular disease
Coronary heart disease
The heartMuscular organ that pumps blood around the body. is a muscular pump. Like all muscles, it needs oxygenGaseous element making up about 20% of the air, which is needed by living organisms for respiration. for aerobic respirationRespiration that requires oxygen. so that it can contract. The coronary arteryOne of the arteries that supplies the heart muscle with oxygen and glucose so that it can continually respire and therefore contract. supply blood, and therefore oxygen, to the heart muscle.
The coronary arteries may become blocked by a build-up of fatty material, caused by certain kinds of 'bad' cholesterolA type of lipid (fatty substance).. As the fatty material increases, one or more coronary arteries narrow, and can become blocked.
If a blockage builds up, the amount of oxygen reaching the heart muscle is reduced. A person will develop chest pain, and if left untreated, a heart attack is the result. heart attackWhen the supply of blood to the heart is suddenly blocked. result in damage to, or death of the heart muscle. Part of the heart muscle, or the whole heart, will die.
Ways of treating cardiovascular disease
Drugs and surgery can help to control coronary heart diseaseA form of heart disease in which one or more of the coronary arteries become blocked, depriving the heart muscle of oxygen..
Statins
Statins are drugs that help to lower cholesterol in the blood. They do this by lowering its production in the liverThe large organ, beside the stomach, which has many functions, including processing substances absorbed by the digestive system and a role in the storage of the body's carbohydrate..
Statins are prescribed for people with heart disease or who have a high risk of developing it. They need to be taken long-term. Cholesterol levels will rise again if a person stops taking them.
Some studies have raised concerns regarding the side effects of statin use, while others believe they can bring additional positive benefits.
Statins are not suitable for everyone - they should not be prescribed for people with liver disease, or pregnant or breastfeeding women.
Some patients taking statins experience side effects such as headaches and memory loss. There have been reports of statins being linked with type 2 diabetesA serious disease in which the body is unable to regulate blood sugar. and liver damage.
Other people argue that statins should be used more widely. They may protect against other conditions such as Alzheimer's disease A disease in which the brain degenerates and short term memory is lost., but further research is needed.
Stents
Coronary arteries that are blocked or have become narrow can be stretched open and have a stentA device, consisting of a wire mesh tube, used to keep a narrowed or blocked coronary artery open. inserted to restore and maintain blood flow.
The stent is inserted into a coronary artery in a catheterA thin tube that can be inserted into a body cavity, duct, or vessel to treat diseases of perform a surgical procedure.
Stents can be used in instances where drugs are less effective, and offer a longer term solution. Stents are made from metal alloyAn alloy is a mixture of two or more elements, at least one of which is a metal. and do not lead to an immune response in the patient.
Over 90,000 operations are carried out each year. Risk factors depend on the patient's:
- age
- general health
- whether they have had a heart attack
The operation is safe as it does not involve surgery, but there is a risk of bleeding, heart attack or strokeDamage to the brain caused by bleeding or blood clots in the brain's blood vessels..
Heart transplants
A heart transplantsAn operation to replace a damaged heart with a healthy heart from a donor. is required in cases of heart failureA condition where the heart is failing to pump sufficient blood around the body at the appropriate pressure.. Coronary heart disease can lead to heart failure. The heart fails to pump sufficient blood and organA group of different tissues that work together to carry out a particular function, eg heart and lungs. are starved of oxygenGaseous element making up about 20% of the air, which is needed by living organisms for respiration.. There are different degrees of severity of heart failure.
A donorA person or organism providing an organ or tissue for transplant. heart is transplanted. In rare cases, a heart is transplanted along with lungs.
A consultant assesses the patient's condition. If other treatments are not managing the heart condition, a transplant may be recommended. The patient will be put on a waiting list. A transplant puts major strain on the body, and the benefits and risks will be evaluated, including whether the patient's condition is sufficiently severe and other health factors.
There is a shortage of donor hearts in the UK. Only around 200 transplants are carried out each year in a small number of hospitals.
Artificial hearts are plastic devices used occasionally to keep patients alive whilst waiting for a heart transplant. They can also be used to allow a patient's heart to rest to help it recover.
After the transplant, the patient will:
- need time to heal, recover and build up strength
- have to take drugs called immunosuppressant drugA type of drug that prevents a patient's immune system from rejecting a transplant. for the rest of their life - this prevents the person's immune system from rejecting the donor heart
- have an increased risk of infection because of these drugs
Learn more about non-communicable diseases with Dr Alex Lathbridge.
Listen to the full series on BBC Sounds.
In this podcast, learn the key facts about non-communicable diseases. Listen to the full series on BBC Sounds.