Prioritising heart health: Understanding heart attack risk and prevention

In this detailed guide to heart attack risk and prevention, revered consultant cardiologist and general medicine specialist Dr Khalid Khan offers expert insight on the most important factors which can increase a person’s risk of coronary artery disease and details the most effective lifestyle changes patients can make to lower their individual risk. The leading specialist also offers guidance on when to see a doctor about any chest pain or angina-like symptoms.

Why do heart attacks occur?

A heart attack is what we as doctors call a myocardial infarction, or MI for short. A heart attack occurs when there is a blockage in one of the arteries, the tubes which supply the heart with blood. When a blockage suddenly appears, it interferes with the heart’s blood supply meaning it doesn’t receive oxygen, i.e. “the food” that it needs. This means the heart suffers as a result and some parts of the muscle can sustain damage.

This disruption to the heart’s normal blood supply may cause the patient to experience symptoms of chest pain that may spread to the arms, back, neck or jaw, breathlessness, sweatiness or nausea. It is vital that anyone suffering a suspected heart attack gets emergency help immediately to try and improve the heart’s blood supply and remove the blockage.

Which factors increase a person’s risk of suffering a heart attack?

Patients who develop coronary artery disease, a furring up and blockage of the arteries, can go on to suffer a heart attack. There are a number of different factors which can increase a person’s risk of heart attack, including:

• a family history
• lifestyle factors, most notably smoking but also an unhealthy diet and lack of exercise
• diabetes
• high blood pressure
• high cholesterol
• obesity

Fortunately, nearly all of these factors are reversible or treatable meaning there are a number of measures we can take to substantially reduce a person’s risk of having a heart attack.

What are some of the warning signs of an elevated risk of heart attack?

Many patients who suffer a heart attack don’t experience any warning symptoms beforehand and therefore, being aware of your risk factor profile is key.

We are able to estimate an individual person’s risk of suffering a heart attack by looking at several factors such as their height, weight, blood pressure, cholesterol and diabetes status, as well as any family history. Additionally, some tests, such as a CT coronary angiogram, can examine the presence and extent of coronary artery disease to give more clues about how likely a person may be to suffer a heart attack.

Around a quarter of patients may experience some warning symptoms before suffering a heart attack, such as angina, chest pain or chest discomfort, that occurs out of the blue, happens with greater frequency or when at rest. These symptoms may be alarm bells for somebody who may go on to suffer a heart attack in the future.

Any patients concerned about chest pain symptoms should seek medical advice as soon as they can so that they can be promptly assessed and any risk factors can be addressed with appropriate treatment to hopefully prevent a heart attack from occurring.

When should you see a doctor about concerns about your heart health?

Knowing when to see a doctor in relation to your heart health is vital and there are two categories of patients who I would advise to seek out medical attention:

Firstly, patients who don’t have any symptoms of heart problems but have a family history or are affected by some of the relevant risk factors should be regularly assessed by their GP or another healthcare professional to evaluate their heart health.

This may involve looking at blood pressure, diabetes status, cholesterol and weight as well as exercise and smoking habits. According to these risk factors, we can determine a person’s risk of having a heart attack and what interventions, including both lifestyle and perhaps medication, can be undertaken to reduce this risk. Seeking out informed advice and implementing changes helps to lower the likelihood of adverse events such as a heart attack or a stroke in a way that does not interfere with quality of life and may allow you to live and longer and fuller life.

Secondly, patients who have developed chest discomfort or symptoms of angina should always seek medical attention. These symptoms may feel like a heaviness, tightness or pressure in your chest when you’re exerting yourself or under stress. If you’ve noticed any discomfort in the chest, you should see your GP or a healthcare professional as soon as possible so that your symptoms can be evaluated and you can be referred on for treatment if necessary.

If you are experiencing significant chest pain, heaviness or pressure, you should seek urgent medical attention. In this case, you may feel quite unwell and the discomfort may last for ten or fifteen minutes without going away. If you are very concerned about your symptoms, it’s important to seek emergency help by calling an ambulance who can take you to hospital where you can will be assessed and specialists can investigate if an urgent intervention is needed.

What are the most impactful lifestyle modifications which help to improve heart health?

Aside from medication, it’s important to know that there are a number of steps people can take to reduce their risk of heart disease and complications like angina and heart attack.

First of all, stopping smoking substantially reduces a person’s heart attack risk and so if you do smoke, this is a key area of importance. In fact, the risk of a heart attack drops off within a couple of years of stopping smoking so quitting is a very impactful lifestyle change to make.

Additionally, controlling your blood pressure is very important. Aside from medication, reducing your salt intake, increasing the amount of exercise you do and losing weight can all really help with reducing your blood pressure.

Likewise, keeping your cholesterol low is essential. Medication can certainly help with this but this should accompany a sensible and healthy diet, which puts less bad cholesterol and more good cholesterol into your blood stream, meaning that there is less of the raw material which can over time result in a gradual blockage of the heart arteries.

For patients who are diabetic, a sensible diet and weight loss can help their diabetes status on top of any medication they may take. For people in a pre-diabetic state, healthy lifestyle changes can have quite an important impact in preventing the progression of the condition.

If you are concerned about your heart health and wish to schedule a consultation with Dr Khan, you can do so by visiting his Top Doctors profile.