Heart disease and stroke

Heart disease and stroke are both types of cardiovascular disease. The cardiovascular system, also called the circulatory system, is made up of the heart and all the blood vessels that pump and move blood around the body. The health of your cardiovascular system is, to a large extent, shaped by your lifestyle.

Although age and genetic factors play a part, much cardiovascular disease would be preventable if more people ate healthy food, were more physically active, maintained a healthy weight and blood pressure, and avoided smoking. Cardiovascular disease is one of the leading causes of death worldwide, and in some countries it has accounted for as much as nearly one third (30 per cent) of all deaths.

Types of cardiovascular disease#

Cardiovascular disease covers a number of conditions, many of which are related to lifestyle, including:

• Coronary heart disease – which can cause either angina or a heart attack (acute myocardial infarction).
• Stroke – caused either by a blockage from a blood clot (an ischaemic stroke) or by the rupture of a blood vessel and bleeding (a haemorrhagic stroke).
• Peripheral vascular disease – obstruction of the large blood vessels that supply blood to the arms and legs.

Some cardiovascular conditions are not related to lifestyle, including:

• Acute rheumatic fever and rheumatic heart disease – caused by an untreated infection with group A streptococcus bacteria.
• Congenital heart disease – conditions present from birth that affect the structure of the heart, such as its valves.

Causes of coronary heart disease and stroke#

By far the biggest cause of death from cardiovascular disease is the progressive blocking of blood vessels, which leads to coronary heart disease and stroke. Healthy blood vessels are flexible, but with age and unhealthy lifestyle choices they can become thickened and stiff, which restricts blood flow around the body.

This process is known as arteriosclerosis and is commonly called ‘hardening of the arteries’. Atherosclerosis is a form of arteriosclerosis that involves a build-up of fatty substances and cellular waste (plaques). These plaques can partially or totally block blood vessels, or a plaque can break open and trigger a blood clot that blocks blood flow.

Atherosclerosis can occur anywhere in the body#

• When it occurs in the vessels leading to your arms and legs, it can cause peripheral vascular disease (PVD).
• When it occurs in the arteries that supply the heart muscle (coronary heart disease, or CHD), it can trigger angina or a heart attack.
• When it occurs in the arteries supplying the brain, the arteries narrow with plaques, and a blood clot can form and block the blood supply to the brain (a thrombotic stroke).

In other cases, a blood clot may travel from elsewhere in the body, such as the heart, and lodge in a narrowed artery (an embolic stroke). Thrombotic stroke and embolic stroke are both causes of the most common type of stroke, ischaemic stroke. Haemorrhagic stroke, which is less common, occurs when a blood vessel in the brain breaks and bleeds.

Although blocked blood vessels can cause both coronary heart disease and some types of stroke, stroke is not the same as heart disease.

Reduce the risk of coronary heart disease and stroke#

You can reduce your risk of cardiovascular disease by making healthy lifestyle choices, such as:

• Avoid smoking – smoking is a major risk factor, with nicotine directly narrowing your blood vessels.
• Eat healthy foods – and especially limit highly processed foods.
• Exercise and move more – speak to your doctor about activity that is suitable for your needs.
• Maintain a healthy weight – exercising and eating healthy food will make this easier.
• Manage stress – try muscle relaxation, breathing techniques or visualisation.

Visit your doctor to discuss lifestyle choices that will lower your risk of cardiovascular disease. You can also ask for advice about regular check-ups to look for early signs of related conditions, such as depression, diabetes, high blood pressure and high cholesterol.

Key points#

• Heart disease and stroke are both forms of cardiovascular disease, and much of it is linked to lifestyle.
• Arteriosclerosis (‘hardening of the arteries’) and atherosclerosis can block blood vessels anywhere in the body.
• Thrombotic and embolic strokes are both causes of ischaemic stroke, the most common type; haemorrhagic stroke, which is less common, occurs when a blood vessel in the brain breaks and bleeds.
• Not smoking, eating well, staying active and maintaining a healthy weight all help reduce your risk.
• Visit your doctor to discuss lifestyle changes and check-ups that can reduce your risk of cardiovascular disease.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).