Cardiovascular Disease Guide

What is cardiovascular disease?

Cardiovascular disease is an umbrella term for diseases that affect the heart and blood vessels. This includes conditions such as:

• Strokes and TIAs (transient ischaemic attacks): When the blood supply to part of the brain is blocked (a stroke) or temporarily disrupted (TIA).
• Coronary heart disease: Including heart attacks (where the heart’s blood supply is blocked) and angina (reduced blood supply to the heart).
• Peripheral arterial disease: Arteries in the arms and/or legs become narrowed/blocked.
• Aortic disease: Where the aorta (the biggest artery in the body) is weak or damaged – this includes aortic aneurysms where the aorta wall weakens and bulges.

Around the world, cardiovascular disease is responsible for 17.9 million deaths a year – more than any other health condition.¹ However, many of the risk factors that increase the risk of cardiovascular disease are linked to lifestyle. 

Symptoms of cardiovascular disease

As cardiovascular diseases are all different, the symptoms vary depending on the specific condition.

Strokes and TIAs ²

Strokes and TIAs happen when the blood supply to the brain is disrupted. This can be due to a clot/narrowing of the blood vessels or due to a weakness in the blood vessel wall bursting (known as a burst aneurysm). 

TIAs are temporary, so are diagnosed if symptoms completely resolve within 24 hours. Strokes are a more permanent disruption with lasting symptoms. Both strokes and TIAs require urgent medical care.

Symptoms depend on which area of the brain is affected, but general stroke or TIA symptoms include: ²

• Muscle weakness or sensation changes - often just one side of the body or face
• Dizziness
• Headache
• Confusion and/or reduced consciousness 
• Visual changes
• Speech issues or difficulty understanding speech
• Issues with balance and/or coordination 

Coronary heart disease

Coronary heart disease happens when the blood vessels that supply the heart muscle become narrowed due to build up of fatty material. This reduces how much blood gets to the heart. 

Angina is when the blood supply is reduced but not blocked entirely. This usually results in chest pain and tightness – often when stressed or during exercise/other physical exertion.³

If blood vessels become entirely blocked, this can lead to a heart attack. Symptoms to look out for include: ⁴

• Chest pain or tightness
• Neck, shoulder, jaw, or arm pain
• Shortness of breath
• Sweating
• Nausea and vomiting
• Abnormal heartbeat

These symptoms require emergency medical treatment. 

Peripheral arterial disease ⁵

If the arteries in the legs (and sometimes the arms) become narrower due to build up of fatty deposits, the blood supply is reduced.

This results in intermittent muscle pain (aching or burning), cramping, and tiredness in the leg(s), often after walking. In the early stages, the pain is usually improved after a few minutes’ rest. 

If the blood supply is further reduced, pain may happen at rest along with:

• Pale skin, hair loss, and poor wound healing in the affected area
• Weak or absent pulses in the feet/wrists
• The affected area feeling cold
• Reduced sensation and strength in the affected area

These symptoms can happen gradually or suddenly and may affect one or multiple limbs. 

Aortic disease ⁶

Although many people with an aortic aneurysm don’t experience any symptoms, a large aneurysm may lead to a pulsating sensation in the abdomen or ongoing back pain.

Most aneurysms don’t rupture, but if they do, this can lead to sudden, severe abdominal pain and loss of consciousness. Rupture leads to massive blood loss, so it’s important to call 999 immediately. 

Diagnosis of cardiovascular disease

Strokes and TIAs ²

A doctor will assess your symptoms and how long they’ve lasted to determine whether you have had a stroke or not. Brain scans, such as a CT or an MRI, are also used to see what area of the brain has been affected and whether symptoms are caused by a blockage or a bleed.

Coronary heart disease ⁴

If a heart attack is suspected, a healthcare professional will check your heart activity with an ECG. This, along with blood tests, can help doctors to see whether you’ve had a heart attack or not.

An ECG can also be used in a non-urgent situation to check how well your heart is working, and to diagnose you with angina if you’re also experiencing symptoms. 

Peripheral arterial disease ⁵

People experiencing symptoms of peripheral arterial disease are usually diagnosed based on a physical examination by their GP and an investigation called an ankle brachial pressure index (ABPI). 

ABPI calculates the ratio between your normal blood pressure in different limbs using a special ultrasound machine. A low ratio suggests peripheral arterial disease.

Aortic disease ⁶

Aortic aneurysms are usually picked up by screening programmes using ultrasound scans. Men over 65 are routinely screened as they’re most at risk. Your GP may also suggest screening if they feel you’re at high risk for another reason. 

Prognosis of cardiovascular disease

Disease prognosis depends on how severe your condition is, the risk factors you have, and treatment. 

Your GP may decide to use a risk scoring tool to identify your individual risk for developing cardiovascular disease in the future. This well help them to see whether:

• You would benefit from starting any preventative medications 
• Your treatment for any other conditions could be improved
• There are any lifestyle changes you can make to reduce your risk

Treatment of cardiovascular disease

Treatment varies depending on the specific condition, but many of the treatments share common principles.⁸

In an acute situation where blood flow is blocked, surgery or medication may be used to remove the blockage. If a blood vessel has burst, surgery is needed to repair the damage. Treatment after this will depend on whether there are any lasting effects. 

If blood flow is reduced but it’s not urgent, often treatment is to monitor the situation, relieve any symptoms, and treat any risk factors that may makes things worse (such as high blood cholesterol, high blood pressure, uncontrolled blood sugars, and being overweight). 

These risk factors can be treated through lifestyle changes or using medications like statins (to lower your cholesterol levels) and anti-hypertensive medications (to lower your blood pressure).