Patient’s lifestyles can impact whether they contract CHD and community pharmacists are ideally placed to give good advice. Read on to find out which are the main contributing factors.
Several lifestyle factors contribute to CHD, and are another area in which pharmacists and their staff can have an impact:
- Smoking is a significant risk factor for developing CHD. Nicotine and carbon monoxide both stimulate the heart to work harder, and other chemicals in cigarette smoke can damage the lining of the coronary arteries, leading to the formation of scar tissue that can contribute to atherosclerosis. Quitting smoking is one of the most important lifestyle changes someone can make with regards to their health, and the services and support provided by pharmacies have been shown to make a considerable difference to success rates. The website http://www.nhs.uk/smokefree is a good starting point for anyone looking to stop smoking.
- Being overweight or obese increases the risk of CHD due to the fact that it causes an increase in blood pressure, cholesterol levels, and the risk of developing Type 2 diabetes. Getting to a healthy weight and maintaining it is not easy but is a hugely important thing to do. Lifestyle measures are the first line of attack, with medication usually reserved for those with a body mass index of 30 or more who have demonstrated a commitment to reducing their weight through diet and exercise, and surgery generally only performed in cases of life-threatening obesity when other measures have not worked.
- Adopting a healthy diet is something everyone knows they should do, but doesn’t necessarily achieve, and pharmacists and their staff are ideally placed to offer advice and information. People trying to reduce their risk of CHD may think that they need to cut out all fat, but while a low fat, high fibre diet is a good approach, it should feature unsaturated fats as these have been shown to increase high density lipoprotein (HDL or ‘good’) cholesterol. Good sources are oily fish, avocadoes, nuts, seeds and sunflower, rapeseed, olive and vegetable oils. Saturated fats, which should be avoided, are generally found in processed foods such as sausages, cakes, pastry and biscuits, but also butter, cream, cheese and coconut oil. Cutting back on sugar and salt is also a sensible idea, as these increase the risk of diabetes and hypertension respectively.
- Exercise goes hand in hand with healthy eating, increasing the efficiency of the circulatory system, which in turn can help keep BP low. People who do regular physical activity have been shown to have a 35 per cent risk of developing CHD. Adults should aim to do at least 150 minutes of moderate intensity activity a week plus some muscle strengthening exercises. Ideas can be found at http://www.nhs.uk/Livewell/fitness/Pages/whybeactive.aspx
What is available to patients in terms of pharmacy services depends to a certain degree on where in the country they are. For example, those living in England aged 40 to 74 years who are not already on a disease register can have their blood pressure, blood glucose and cholesterol levels and body mass index measured as part of the NHS Health Check, which is offered by many pharmacies. Quit smoking services are provided on a national basis by pharmacies across Scotland; south of the border, provision is widespread but patchy.
Join us tomorrow as we look at medication versus management of CHD together with links to useful resources.