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About cardiovascular disease According to the Victor Chang Cardiac Institute, “heart disease, which is a type of cardiovascular disease, is any condition that affects the normal functioning of the heart” and this may include “heart defects from birth such as a hole in the heart, disease affecting the heart muscle, blockages of the arteries to the heart, problems with the function of the heart valves or heart rhythm problems”.3 Heart Research Australia explains that while “the term ‘heart disease’ is often used interchangeably with the term ‘cardiovascular disease’ (CVD), the latter generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain or stroke”.4 you do something about it by modifying those lifestyle factors ... medications ... may treat symptoms, but they won’t treat the underlying factors. That’s \\\\\\\[an area\\\\\\\] where pharmacists and pharmacy assistants can play a huge role.” CARDIOVASCULAR HEALTH 55 with “good quality” options “that are high in dietary fibre and won’t raise blood glucose levels rapidly”. “Low glycaemic index carbohydrates are important,” he said. In terms of managing blood pressure, Dr Barclay points to strategies such as weight reduction – losing “around 7.5 per cent of your current weight” if you’re overweight – and making sure “you don’t consume too much salt”. “These days there’s probably more salt in processed foods than what people are adding to their meals at the table,” he said. “So, be aware of the amount of sodium in foods and aim to have less than 2300mg a day – that’s the upper limit.” “We mustn’t forget that it’s not just about salt or sodium. Having plenty of potassium in your diet \\\\\\\[is important\\\\\\\] ... because it balances \\\\\\\[the sodium\\\\\\\]. It’s actually the ratio of sodium to potassium that’s a stronger risk factor. So, have more potassium than sodium. And of course, most potassium comes from lots of fruit and vegetables in particular. That’s one of the reasons why we tell people to eat fresh fruit and vegetables,” he explained. To put it simply, while it’s not the only factor we need to consider in terms of heart disease risk, and while it may not impact men and women overly differently (both men and women need to look at similar dietary choices), diet is one of the important considerations to make when looking after your heart health. Apart from having a good healthy diet in general, with more unsaturated fats and less saturated and trans fats; and good carbohydrates, Dr Barclay advises that having more omega-3 fats is important. “Australians don’t get enough \\\\\\\[omega-3 fats\\\\\\\],” he said. “We don’t eat enough seafood.” He recommends eating, “preferably”, fatty fish, two or three times a week. “\\\\\\\[This is\\\\\\\] all going to help,” Dr Barclay said. Speaking about the role of diet in the prevention and management of heart disease, and about how to lower one’s risk of CVD, Mr Quigley says the advice should focus on “a couple of simple things” and pointing out that these changes that might be made, may help. Looking at processed food, he suggested asking a person what they While there are lifestyle factors that are within our control – that we can do something about in terms of reducing our risk of heart disease, Heart Research Australia points out that some risks are outside our control, including: • Age. “As you get older, your risk of heart disease increases.” • Gender. “Men are at higher risk of heart disease. Women’s risk grows and may be equal to men after menopause.” • Ethnic background. “People of some origins have higher risk. Aboriginal and Torres Strait Islander people have more risk because of lifestyle factors.” • Family history. “If someone in your family has cardiovascular disease, speak to your doctor about your risk.”6 Heart Research Australia lists the conditions that involve the heart or the circulation of blood through the blood vessels: • Coronary heart disease • Heart attack • Heart failure • Stroke • Arrhythmias • Aneurysm • Septal defect • Peripheral vascular disease • Rheumatic heart disease • Congenital heart disease.5 “Cardiovascular disease is just a general phrase that involves a number of disease states,” Community Pharmacist and Master Herbalist Gerald Quigley said. “And so many of them \\\\\\\[the disease states\\\\\\\] are implicated in lifestyle factors. “So, lifestyle factors are \\\\\\\[among the main\\\\\\\] contributing causes of cardiovascular disease development.” These lifestyle factors, he adds, include “elevated cholesterol, elevated triglycerides, elevated blood pressure, weight gain, all of these things”. While these lifestyle factors in terms of contributing to CVD are well known, Mr Quigley says a concerning issue is that “most of these things are being ignored – the messages aren’t getting through”. “So, cigarette smoking, eating too much saturated fat, eating too much processed food, having too much tea and coffee, too much alcohol, lack of exercise, not eating enough fibre in your diet – all those things have been shown to potentiate the disease process,” he said. “And once it sets in, then unless The role of diet “Cardiovascular disease as a category – so, heart disease, stroke and other vascular disease – is still the leading cause of death in Australia,” said Accredited Practising Dietitian and spokesperson for Dietitians Australia, Alan Barclay. “It’s important that we try and reduce that risk as much as possible, for everybody’s sake.” According to Dr Barclay, diet plays an important role in the development of heart disease due to the “biomarkers of risk” that are affected by diet, including cholesterol, triglycerides, blood pressure and blood glucose levels. When it comes to cholesterol, he adds, it’s important to include “the right type and amount of fat” in the diet, and eat less trans and saturated fats, “which are generally found in processed and fatty meats and some highly processed food like pastries ... in particular sausage rolls, pies and that sort of thing”. “\\\\\\\[In terms of\\\\\\\] triglycerides, that’s where excessive alcohol consumption comes in ... so moderate alcohol is important from that perspective,” Dr Barclay said. When it comes to foods containing carbohydrates, Dr Barclay advises that good carbohydrates choices should be made – replacing refined carbohydrates TO PAGE 56 RETAIL PHARMACY ASSISTANTS • APR 2021