Chronic diseases and heart disease: What's the link?

Coronary artery disease (CAD), also called coronary heart disease, has many risk factors. Some, such as family history, age and ethnicity, are beyond our control. Some require lifestyle changes. Yet other risk factors of heart disease can be medically managed, as in the case of chronic diseases.

The Department of Cardiology from National Heart Centre Singapore (NHCS), a member of the SingHealth group, explains how high blood pressure (hypertension), type 2 diabetes (diabetes mellitus) and high cholesterol are linked to heart disease.

Plus, find out what puts you at risk of getting these conditions, and what you can do to prevent them.

Chronic diseases that raise heart disease risk and how to prevent them

1. High blood cholesterol (hyperlipidaemia)

High blood cholesterol (hyperlipidaemia) is a symptomless condition, in that it hardly presents any symptoms. There are two main types of cholesterol in blood:

  • LDL (low density lipoprotein) – Commonly known as ‘bad’ cholesterol as it carries cholesterol to tissues, including the arteries.

  • HDL (high density lipoprotein) – Known as ‘good’ cholesterol as it takes cholesterol from the tissues to the liver, where it can be removed from the body.

When it comes to cholesterol, the key is to keep LDL cholesterol down, while raising HDL cholesterol. 

Accumulation of too much ‘bad’ cholesterol in your blood can lead to a build-up of plaque in artery walls, causing a narrowing and hardening of blood vessels (coronary atherosclerosis). This increases your likelihood of developing heart disease.

Risk factors of high blood cholesterol:

  • Poor diet – Consuming foods high in saturated fats, trans fats and cholesterol

  • Being overweight/obese

  • Leading a sedentary lifestyle

  • Heredity – If your family member have high cholesterol, you may also have it

Tips to lower your cholesterol naturally:

  1. Opt for ‘healthier’ fats such as mono-unsaturated fats (olive oil, canola oil, nuts like almonds and cashews, and avocados), polyunsaturated fats (vegetable oils like soybean oil, sunflower oil and corn oil), and omega-3 fats (salmon, sardines and mackerel).

  2. Choose fish, skinless poultry and lean meat when choosing meat, and low-fat or fat-free milk products.

  3. Consume more fibre-rich foods such as vegetables, fruits and whole grains.

  4. Exercise regularly – Aim to have 30 mins of moderate physical activity daily such as brisk walking, cycling or swimming. If you are unable to accommodate a long workout, spread it into smaller sessions throughout the day or week.

  5. Maintain a healthy weight

  6. Quit smoking (if you haven't)

  7. Limit alcohol intake to no more than two standard drinks a day for man and one standard drink a day for women.

2. High blood pressure (hypertension)

High blood pressure, also known as hypertension, refers to a blood pressure persistently above 140/90 mmHg. It is commonly known as a ‘silent killer’ as there are usually no symptoms. 

“High blood pressure is one of the major causes for coronary artery disease, as well as stroke and bleeding in the brain,” shares the Department of Cardiology from NHCS. 

If left untreated, high blood pressure may lead to long-term damage of organs such as the heart and blood vessels, leading to stroke, heart attack (myocardial infarction) or kidney failure (renal failure). That’s why you should get your blood pressure checked at least once a year.

Causes of high blood pressure (hypertension):

Most of the time, the cause is unknown. However, blood pressure is likely to rise if:

  • Blood volume is increased by too much salt intake, leading to water retention.

  • Blood vessels become more rigid due to build-up of fatty deposits in blood vessel walls (coronary atherosclerosis).

Risk factors:

  • Age

  • Pre-existing medical conditions such as kidney disease or hormonal imbalance

  • Heavy alcohol consumption

  • Smoking

  • Obesity

  • High blood cholesterol levels

Tips to control high blood pressure:

  • Stick to a healthy diet - Avoid foods high in cholesterol and saturated fats

  • Exercise at least five times a week to lower your high blood pressure. Brisk walking is one of the best and simplest forms of exercise.

  • Maintain a healthy body weight to reduce risk of high blood pressure.

  • Stop smoking (if you haven't).

  • Keep stress in check through regular exercise and adopting a balanced approach to work and family life

  • Take all your medications as prescribed.

3. Type 2 diabetes (diabetes mellitus)

Type 2 diabetes (diabetes mellitus) occurs when the body doesn’t make enough insulin or cannot properly use the insulin it produces. It’s the most common form of diabetes, with 90 to 95 per cent of all diabetes cases classified as type 2 diabetes. Studies have shown that having type 2 diabetes greatly increases your risk of heart disease.

The Department of Cardiology from NHCS shares that in Singapore, about 10 per cent of the population aged 18 to 69 has type 2 diabetes.

Risk factors of type 2 diabetes:

  • Have a family history of diabetes

  • Have a BMI value of 23 or higher

  • Are physically inactive

  • Have high blood pressure

  • Have high cholesterol or abnormal lipid levels

  • Were affected by gestational diabetes

  • Are aged 40 years and above

  • Have impaired glucose tolerance and/or impaired fasting glucose

If these factors apply to you, you should pay special attention to the signs and symptoms of diabetes, which include:

  • Low energy

  • Increased thirst and need to urinate

  • Unexplained weight loss

  • Blurred vision

  • Constant hunger

  • Itchy skin or ‘pins and needles’ sensations in the limbs

  • Slow healing of wounds

To prevent type 2 diabetes:

  1. Eat right – The My Healthy Plate is an easy way to follow to create nutritious and balanced meals. Typically, your meal should consist of fruit and vegetables, whole-grains and proteins. A diet rich in fruits and vegetables can also prevent many health problems such as heart disease and some cancers.

    In addition, remember to choose water instead of sweetened drinks, and to limit your alcohol intake to no more than one drink per day for women and two drinks per day for men.

  2. Stay active - You should engage in at least 150 minutes of moderate aerobic activity (like brisk walking and leisure cycling) per week, for at least 10 minutes each time, or 20 to 30 minutes of vigorous activity (like jogging/running and swimming continuous laps) three or more days per week. 

    However, be sure to check with your doctor before you start an exercise programme if you have a medical condition or have not exercised for a long time.

  3. Lead a well-balanced lifestyle - Achieve a healthy weight by balancing the food you eat with daily physical activity. Regular exercise not only helps you to keep fit but also helps you destress, which is important for your mental well-being! Too much stress could lead to a vicious cycle: when unable to cope well with stress, you could neglect your health by making unhealthy lifestyle choices such as binge-eating and not exercising. This could then make it harder for you to control your blood glucose levels, increasing your risk of developing diabetes.

    Also, try to get at least 7-9 hours of sleep every night. Sleep deprivation not only affects your ability to focus but has also been linked to chronic diseases such as high blood pressure and Type 2 diabetes. 

    Lastly, smoking puts you at higher risk of developing type 2 diabetes. If you are a smoker, make the decision to quit smoking today.

Ref: I23 (ed)