Updated: Jan 17
Our cardiovascular system works best when we are young, at a normal body weight, staying hydrated, eating well, and exercising regularly. But stress, illness, and an unbalanced lifestyle trigger trouble signals and set the stage for oxidative stress. Uncorrected, this can cause chronic cellular damage.
Cardiovascular disease (CVD) is a collective term for diseases of the heart and blood vessels. The term commonly includes diseases such as coronary heart disease, heart failure, cardiomyopathy, congenital heart disease, peripheral vascular disease and stroke. Many of these conditions can be life-threatening.
Cardiovascular disease is one of Australia's largest health problems. Despite improvements over the last few decades, it remains one of the biggest burdens on our economy. CVD affects one in six Australians, (4.2 million people). CVD was the main cause for more than 575,800 hospitalisations in 2017 and was a major cause of death in Australia, with 43,477 deaths attributed to CVD in Australia in 2017. Many of these deaths were preventable. Cardiovascular disease kills one Australian every 12 minutes. CVD prevalence increases with age, 35% of Australians aged 55 - 65 report to be Living wIth long-term CVD increasing to 66% for Australians aged over 75 years.
Coronary heart disease
Coronary heart diseases the most common form of heart disease in Australia. The two major forms of coronary heart disease are heart attack (also known as acute myocardial infarction) and angina. A heart attack is caused when blood supply to the heart is blocked completely, often causing damage to the heart muscle and its function. Angina is a chronic condition where short episodes of chest pain occur periodically, caused by a temporary shortage of blood supply to the heart. Angina is not usually life-threatening, but can be associated with increased risk of heart attack.
Heart failure & cardiomyopathy
Heart failure is a life-threatening condition that occurs when the heart is unable to maintain a strong enough blood flow to meet the body’s needs. It usually develops over many years, although it can also occur more suddenly. Heart failure can result in chronic tiredness, reduced ability for physical activity and shortness of breath. Cardiomyopathy occurs when the heart muscle becomes thickened, enlarged or stiff which can reduce the effectiveness of the heart. Cardiomyopathy and heart failure commonly occur together.
Congenital heart disease and Peripheral vascular disease
Congenital heart disease is a broad term for any defect of the heart or central blood vessels that is present from birth. It can include abnormalities of the heart or heart valves, such as a hole between chambers of the heart, or narrowing of major blood vessels, or combinations of disorders. Peripheral heart disease refers to disease of large arteries that supply blood to the peripheries and can be caused by blockage of arteries due to cholesterol or fatty substances, or caused by widening of the arteries such as the aorta, which in severe cases can lead to rupture of the arterial wall.
Stroke is a type of cerebrovascular disease and occurs when an artery supplying blood to
the brain either suddenly becomes blocked or begins to bleed. This may result in part of the brain dying, leading to sudden impairment of one or more capacities, such as speaking, thinking and/or movement.
Major risk factors associated with CVD that cannot be modified include advancing age (as you get older your risk of CVD increases), genetic predisposition, gender (men are at a higher risk of heart disease than women, until woman hit menopause when it may be equal) and ethnicity).. Modifiable risk factors include behavioural factors such as smoking, insufficient physical activity, poor diet, excessive alcohol consumption and biomedical factors such as high blood pressure, high blood cholesterol and obesity.
Most heart disease risk factors can be changed, and there’s plenty you can do about them.
Being smoke free is one of the best ways to protect your heart. Smoking affects the vessels that supply blood to your heart and other parts of your body. It reduces the amount of oxygen in your blood and damages blood vessel walls. Smoking contributes to atherosclerosis. Atherosclerosis occurs when there is narrowing and clogging of the arteries which reduces blood supply, and the amount of oxygen available, throughout the body.
High blood pressure
Blood pressure is the pressure of your blood on the walls of your arteries as your heart pumps it around your body. Your blood pressure naturally goes up and down all the time, adjusting to your heart’s needs depending on what you are doing. High blood pressure is when your blood pressure is persistently higher than normal. Blood pressure that’s high over a long time is one of the main risk factors for heart disease. Your blood pressure may be strongly influenced by age, family history, eating patterns, alcohol intake, weight and amount of physical activity.
Cholesterol is a fatty substance that is carried around the body in the blood. The body produces most cholesterol naturally, and it is found in some foods. Lipoproteins carry cholesterol in the blood. The lower the density of the lipoproteins the more fats it contains. High density lipoprotein is called the ‘good cholesterol’ because it helps to keep cholesterol from building up in the arteries. Low density lipoprotein is called the ‘bad cholesterol’ because it is the main source of cholesterol build-up and blockage in the arteries. Triglycerides are another form of fat in the blood that can also raise the risk of heart disease.
Treatments vary widely and can include lifestyle changes, medication and surgery.
There is now a wide range of medicines to treat CVD and its risk factors. Common medicines may include low-dose aspirin and warfarin to help prevent your blood clotting, beta-blockers to prevent angina and treat high blood pressure, cholesterol lowering statins may reduce your risk of further problems. Most medicines will need to be taken for the long term.
Surgery includes angioplasty (a tube is fed up to an artery in your heart and a small balloon is inflated in a narrowed part of the artery to improve blood flow to the heart muscle, after angioplasty is performed, a stent is usually put into your artery, expanded, and left in place to keep your artery open) and coronary artery bypass graft surgery (a blood vessel is taken from your chest, leg or forearm and grafted to your coronary artery to let blood 'detour' past a narrowing in this artery, improving blood flow to your heart muscle). An implantable cardiac defibrillators can be put into your chest and connected to your heart to monitor and correct your heartbeat. It can either stop an arrhythmia by pacing your heart, or in more serious situations, it can give your heart a controlled electric shock to try to return it to its normal rhythm.
The latest advancements in cardiovascular science tell us that if we want to change our cardiovascular health in a profound way, we have to look at it from an all-encompassing point of view—we have to look at its most foundational components. The entire vascular network of the body is regulated and repaired by redox chemical reactions that not only maintain balance, but that are vital to survival itself.
Endothelial cells are responsible for nutrient intake, oxygen transport, immune cell assimilation, and toxin defense and they rely on redox signaling molecules and redox reactions to do this. The sensitive endothelial cells experience injury and stress, just as all other cells in the body. The ability of these cells to self-repair from exposure to toxins, mechanical injury, exposure to pro-inflammatory cellular “waste” products, and infiltration from “bad cholesterol” is sparked by redox signaling molecules.. Redox signaling molecules send input to cellular receptors that control the auto-regulation of blood pressure, heart rate, and vascular tone. .
Oxidative stress causes a shift in the redox potential, and the cell is unable to maintain balance. The result is cell death, cell dysfunction, or cellular defensive adjustments. Cell death requires replacement. In youth, the body easily adjusts. With age, this cellular renewal slows down and sometimes results in scar formation. This is the beginning of arterial plaque, or hardening of the artery.
People who suffer from high blood pressure have been shown to have higher levels of the byproducts of oxidative stress as well as an inability to produce adequate levels of intracellular antioxidants, which help to neutralize the unstable molecules that cause oxidative stress. Oxidative stress in the cardiac muscle cells causes a chemical imbalance inside the cells and a breakdown in the mitochondria’s ability to create energy via electron chain transport system. This buildup and oxidative stress, coupled with a lack of ATP being produced by the muscle cell, causes weakness in contraction ability. Cells can actually die from exhaustion as well. Some cells weaken so much that they dilate, resulting in congestive heart failure.
Recovery from stroke requires redox balance. Redox signaling molecules render brain cells capable of redesigning both themselves and the interconnections necessary for them to perform critical functions. Redox chemistry is critical in signaling the replication of neighboring cells to replace damaged ones. Partially damaged cells seek to restore mitochondrial actions to rebuild the integrity of the cell membrane and allow nutrients in and waste out.
Solutions to cardiovascular disease can be found in balancing the diet with fewer sugars and more complex carbohydrates. Additionally, maintaining proper weight and having daily exercise along with supplementing redox signaling molecules can create a balanced physiology and prevent the damage to the vessels from oxidative stress.