Of the factors influencing heart disease the easiest and most effective target for preventive medicine is lifestyle. Its management is an important start point in conjunction with other risk factors such as blood pressure and serum cholesterol levels.
Three aspects of lifestyle which require consideration are:
- Smoking – risk of recurrent heart disease is reduced by as much as 50% in the first year of smoking cessation and has a sustainable effect on mortality for up to a decade.
- Diet – diets low in saturated fat have shown significant reductions in coronary mortality and improvement in survival.
- Exercise – an exercise programme is associated with a significant reduction in coronary mortality
Reductions in heart disease mortality and morbidity through alterations in lifestyle are clearly documented in scientific and epidemiological studies worldwide.
Many studies have identified risk factors that should be targeted for the most effective reduction.
- Finland. Decline of Ischaemic Heart Disease, by 55% in men and 68% in women, attributed to fall in smoking, blood pressure and serum levels. Almost half the decline associated with decreased serum cholesterol concentration.
- New Zealand. 38-51% of the observed decrease in mortality could be accounted for by the calculated changes in serum cholesterol concentration.
- Japan. Increases in mortality from IHD were related to a decline in nutritionally balanced diets and a greater consumption of fast foods.
- Australia. A decrease in mortality was linked to improved nutrition and reduced smoking.
- The Framingham Study. An improvement in the profile of cardiovascular risk factors contributed to a 60% decrease in mortality from cardiovascular disease.
Lifestyle clearly has a significant effect on the risk of heart disease but should always be considered in conjunction with other factors. However while some risk factors are subjective, new developments in diagnostics offer healthcare professionals a definitive and absolute means of assessment.
Diagnostic tests can identify at risk individuals and be used to consistently and regularly monitor improvements in lifestyle.
The £10,000 million Coronary Heart Disease burden:
- It costs the UK healthcare system £1,600 million a year. One percent of this spent on prevention, hospital-care accounts for 54% and drugs another 32%.
- It costs the UK economy £8,500 million a year due to death, illness and the informal care of people with the disease.
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