What is coronary heart disease?

The term ‘cardiovascular disease’ is a blanket term for all diseases related to the heart and blood vessels, and coronary heart disease (CHD) is a type of cardiovascular disease. Coronary heart disease happens when the blood vessels supplying the heart become narrowed or blocked. 

Also known as ischemic heart disease (IHD) and coronary artery disease (CAD), CHD is one of the leading causes of death in the UK. Coronary heart disease used to be the number one cause of death in the UK, but rates have lowered due to better awareness and treatment. Despite progress in treatment and prevention, CHD remains an incredibly common and dangerous disease that can affect anybody.

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How is Coronary Heart Disease treated?

Treatment for CHD can not only help to manage painful symptoms, but it can also improve the performance of your heart and reduce the risk of developing further issues. Effective treatment commonly involves a mixture of medication, healthy lifestyle changes and in some cases, surgery.

The first step towards getting treated for CHD will be to book an appointment with your GP. Once diagnosed, there are a variety of medicines you can use to treat your CHD, many of which are available via the Superdrug Online Doctor:

ACE inhibitors: blocks the activity of a hormone which causes the blood vessels to narrow, this then improves blood flow and lowers high blood pressure.

• Ramipril 

• Lisinopril 

• Perindopril 

• Enalapril

Angiotensin-receptor blockers (ARBs): works in a similar way to ACE inhibitors to improve blood flow and treat high blood pressure. Side effects may be less severe than ACE inhibitors.

• Candesartan 

• Losartan 

Calcium channel blockers: relaxes the muscles in your artery walls and causes them to become wider. This lowers blood pressure and allows blood to flow more easily.

• Amlodipine

• Felodipine 

• Lercanidipine

Beta blockers: used to treat high blood pressure by blocking the effects of a particular hormone in your body. This slows down the heartbeat and widens the blood vessels which improves blood flow.

• Atenolol 

• Bisoprolol

• Metoprolol 

Other medications

• Aspirin

• Glyceryl trinitrate sublingual tablets

• Glyceryl trinitrate aerosol sublingual spray

Please note that we will only provide these treatments if you have already been diagnosed with CHD and have been on treatment for three months or more.

Can you treat clogged arteries without surgery?

There are a few methods that are less invasive than surgery to treat clogged or narrowed arteries:

• Coronary angioplasty: a catheter is passed into an artery where a special balloon is gently inflated inside. This widens the artery and allows blood to flow more easily

• Stents: a mesh tube that holds the artery open and widens an artery. Normally used after a coronary angioplasty

Can plaque in arteries go away?

While the effects caused by atherosclerosis can be treated, there is no way to make the plaque go away without an endarterectomy, although diet and exercise can help. Unfortunately, once you find out you have plaque in your arteries, the most you can do is make sure it doesn’t get any worse. This can be done through a combination of medication to ease the symptoms, or a series of healthy lifestyle changes.

How to prevent Coronary Heart Disease

Because there is no way to ‘cure’ CHD or atherosclerosis, taking steps to prevent CHD is key to maintaining your heart’s future health. Here are a few ways you can prevent or minimise the risk of developing CHD:

• Eat a healthy diet: a low-fat, high-fibre diet is key, avoiding saturated fats and salt and focusing on fruit, vegetables and unsaturated fats

• Be physically active: exercising your heart is key to keeping it healthy, as well as maintaining a healthy weight

• Give up smoking: smoking puts pressure on the heart and can seriously damage its health. Read more on how to quit smoking

• Drink less: binge drinking or drinking over the recommended limits can seriously increase your risk of having a heart attack

• Maintain healthy blood pressure: this can be done by exercising regularly, eating healthily and - if necessary - taking medication

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What are the symptoms of coronary heart disease?

There can be many subtle symptoms for CHD which will differ from person to person. Due to the serious nature of CHD, the severe symptoms are much more common. The sooner you identify them, the sooner you can get treatment. Here are the three common symptoms for CHD:

Angina

Angina a severe chest pain caused by reduced blood flow to the heart due to blocked or narrowed arteries. This chest pain can feel tight, or as if there is a heavy weight on your chest. This feeling may spread to other parts of your upper body including the arms, jaw and back. On its own, Angina is not life-threatening, but it is an indicator of a much more serious condition, like CHD. It usually occurs during exercise and settles when resting, but if it continues for longer than 5 minutes you must call 999.

Heart failure

Heart failure is when the heart loses its ability to pump blood around the body effectively. The effects of CHD can cause the heart to become weak because the walls are weak or stiff. Heart failure does not mean your heart has stopped working, it just needs some assistance. 

Heart attack

A heart attack is caused by a sudden lack of blood to the heart, caused by a blocked artery. This can be fatal or cause permanent damage to the heart muscle. A heart attack is a serious medical emergency. If you think you are having a heart attack, call 999 immediately.

What does a heart attack feel like?

A heart attack will feel like your chest is being pressed or squeezed by a very heavy object. The pain or pressure may spread down your left arm or up into your jaw. Alongside this, you may feel:

• light-headed 

• dizzy

• nauseous

• cold and clammy

• hot and sweaty

• short of breath

Heart attack, or indigestion?

The symptoms of a heart attack can often be mistaken for indigestion and although it may sound like a strange mix-up to make, it happens quite often and can lead to people not getting the help they need. The main differences between symptoms are:

• Indigestion tends to occur after eating, whereas a heart attack can happen at any time

• Indigestion can be relieved by ant-acid medication, a heart attack cannot

• A heart attack is less likely to cause burping or bloating, whereas indigestion will

If you have a tight chest, shortness of breath and feel lightheaded, call 999 immediately.

What are the early signs of Coronary Heart Disease?

By knowing the early signs of CHD, you can spot it before it develops and start implementing some healthy lifestyle changes to stop it progressing.

Common early signs you could have CHD include:

• Discomfort in the chest

• Shortness of breath (especially when not exercising)

• Irregular heartbeat when you didn’t have one before

• High blood pressure

• Having a relative who has also had CHD

These early signs could be indicators of many other conditions, as well as the result of smoking, an unhealthy diet or lack of exercise.

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What causes Coronary Heart Disease?

While lifestyle factors will differ from person to person, CHD is caused by a narrowing or complete blocking of the arteries that lead to the heart. This is usually caused by plaques lining the artery walls known as Atherosclerosis.

Plaque in arteries

The plaques that narrow or completely close arteries are the result of different substances in the blood that can build up over time. These include: calcium, fat, cholesterol, and fibrin, which is used to clot blood. As plaque builds up, cells in your artery walls will multiply, which can worsen the blocking even more.

Atherosclerosis

This is when plaques, or atheroma, form in the walls of the arteries and continue to grow. This can lead to hardening of the artery walls leading to increased blood pressure and further increasing your risk of getting a heart attack later on in life.

Coronary heart disease risk factors

There are a number of risk factors that can increase your chance of developing CHD. Some can be avoided by making healthier lifestyle choices, while others are caused by underlying conditions that can be more difficult to treat. It is important to be aware of these risk factors so that you can reduce your risk of developing CHD. 

How does smoking cause Coronary Heart Disease?

Smoking is a major risk factor for CHD, and smokers are 2 to 4 times more likely to develop heart diseases than non-smokers. There are a number of chemicals in cigarettes that can have a harmful effect on your heart. Nicotine and carbon monoxide inhaled into the body put a strain on the heart, which beats faster in response to them. Other chemicals in cigarettes can also damage the lining of your arteries, increase your blood pressure, and can cause a buildup of sticky plaque. Smoking also increases the risk of blood clots, which can lead to a heart attack or stroke.

How does high cholesterol cause Coronary Heart Disease?

Cholesterol can build up in your arteries which increases your risk of developing CHD. Cholesterol is a fat made by the liver from the saturated fats you eat. While a little cholesterol is essential to a healthy diet, too much will put a strain on your heart. High levels of cholesterol can be caused by an unhealthy diet, or by an underlying genetic condition.

How does high blood pressure cause Coronary Heart Disease?

High blood pressure can put a strain on your heart as it requires more effort to pump blood around your body. This increased pressure puts stress on the walls of your arteries, which can make them weaker or even damage the lining. Weakened or damaged arteries are more likely to become narrower and more likely to get blocked by a buildup of plaque..

How does obesity cause Coronary Heart Disease?

Obesity is caused by a combination of lack of exercise and an unhealthy diet. Both of these things can lead to a buildup of fat in the arteries, which lines the artery walls, blocking them and making you more likely to develop CHD.

How does diabetes cause Coronary Heart Disease?

A high level of blood sugar leads to diabetes, which more than doubles the risk of developing CHD. Diabetes causes the lining of your blood vessels to become thicker, which increases the chances of plaque buildup in the arteries.

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How is Coronary Heart Disease diagnosed?

A diagnosis of CHD is a crucial first step to getting effective treatment. Usually, diagnosis consists of two parts. The first is a ‘Risk Assessment’ so that your GP can work out how likely it is that you have CHD. This could involve blood tests, cholesterol tests, a blood pressure check and  questions about your family’s medical history and your lifestyle.

If the results of your Risk Assessment suggest that you are at high risk of CHD, and if you have symptoms your GP may refer you for  further testing to confirm your diagnosis. There are a variety of tests that are used to do this, including:

• Electrocardiogram (ECG)

• Exercise stress tests

• X-rays

• Coronary angiography (using chemical dye to identify blocked arteries)

• Radionuclide tests (a scan used to diagnose blood and heart disease)

• MRI scans

• Other blood tests

How are blocked arteries diagnosed?

Visit your GP for a Risk Assessment, just as you would with CHD. Your blood pressure, cholesterol levels and lifestyle will all be taken into account to diagnose blocked arteries. Your GP will also judge the risk of you having a stroke or heart attack.

How can I check if my arteries are clogged?

It is difficult to tell if your arteries are clogged or not because they are inside your body. Most people will only find out that they have clogged arteries after they get symptoms. You can test your cholesterol using an at-home kit. If your test results come back high, consider visiting your GP to find out if this is a symptom of CHD.

Can an ECG detect a blocked artery?

An Electrocardiogram (ECG) is a test that measures the electrical activity of the heart, heart rate and the regularity of the heartbeat. These measurements can identify an irregular heart rate, whether you are having a heart attack or have had one in the past or whether one side of your heart is pumping more efficiently than the other. 

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