Within the body, the blood supply acts as a transport system for nutrients and waste products, and is reliant upon both the heart and blood vessels to be healthy to keep functioning as it should. Anything that causes a blood vessel to be narrower than normal can cause problems, and if this continues €“ for example, because of fatty deposits caused by excess cholesterol in the blood €“ the vessel walls become less flexible and more prone to damage. This condition is known as atherosclerosis and leads to coronary heart disease (CHD), in which the blood supply to the heart itself is compromised. Ultimately, this can lead to further problems such as angina, stroke or heart attack.

Nobody is immune from developing CHD, but there are certain factors that increase the likelihood:

• Age €“ the risk of CHD increases sharply with advancing age
• Gender €“ men are at higher risk than women
• Family history
• Ethnicity €“ people of South Asian origin are at increased risk.

There are also several modifiable risk factors, which unlike the above, people can do something about. These include:

• Smoking
• High fat diet
• Obesity
• Lack of exercise
• Poorly controlled diabetes or high blood pressure
• Stress.

Many healthy living measures already described in this module will benefit heart health, as will quitting smoking and reducing alcohol intake. It is also important to try and reduce the amount of low density lipoprotein (LDL) cholesterol and increase the amount of high density lipoprotein (HDL) cholesterol in the diet, as the former encourages fat deposits to accumulate in the arteries whereas the latter transports cholesterol to the liver, which can get rid of it from the body. Food supplements containing fatty acids or plant sterols can be beneficial for this.