A large part of your heart disease risk is in your own hands. Not smoking, staying active, eating well and keeping an eye on your blood pressure make a real difference. Below is what actually causes a heart attack, the warning signs worth taking seriously, and the everyday habits that lower your risk. This is general information, not a substitute for medical advice. If you have symptoms or you are unsure, call your GP or 999.
How a heart attack actually happens
Contrary to what many people think, an artery does not slowly clog up like a blocked pipe. In an acute heart attack, a plaque in the wall of a coronary artery tears open. Platelets rush to the spot, a clot forms very quickly, and the vessel closes off completely. The section of heart muscle behind it is suddenly starved of oxygen, and it can start to be damaged within about half an hour to an hour. That is exactly why acting fast saves lives.
Some hardening of the arteries is a normal part of getting older. You cannot fully prevent it, but you can slow it down a great deal, and that is where most of the gains are.
The warning signs you should not ignore
The classic symptom is pressure or pain in the chest, often described as a tight band, along with breathlessness and pain spreading to the arm, shoulder blades, back or jaw. Typically it comes on with exertion or strong emotion and eases with rest, though not always. In an acute attack the symptoms often appear at rest, with a pale or grey appearance and sweating.
The picture can differ between men and women. Women also have their own risk factors, such as high blood pressure or gestational diabetes during pregnancy, and an early menopause. If something does not feel right, do not wait it out.
High blood pressure: the silent killer
High blood pressure often causes no symptoms for years, sometimes for two or three decades. In the meantime it puts constant strain on your heart and blood vessels, and it is a leading cause of both heart attacks and heart failure. For the heart, high blood pressure is simply extra resistance to push against. At some point it can no longer keep up, and it starts to fail. Because you cannot feel it, the only way to know is to have it measured now and then, especially if you carry extra weight or it runs in the family.
How to lower your risk
Prevention comes down to concrete habits you can actually keep up. The ones that matter most:
- Do not smoke. This is by far the biggest single win for your heart.
- Move enough. The rough guideline is around 6 hours of moderate or 3 hours of vigorous activity a week, mixing cardio and strength work.
- Eat well and varied. A Mediterranean pattern works well: unsaturated fats, plenty of fibre, vegetables, fruit, pulses and a small handful of nuts (around 30g) a day.
- Go easy on alcohol and keep an eye on your blood pressure and blood sugar.
One more honest point on building muscle with anabolic steroids: a big biceps does nothing for your heart, and the strain these drugs put on it is real. Chasing size that way is not worth the risk to the one muscle you cannot replace.
The difference between a heart attack and heart failure
These are often confused. A heart attack is an acute, sudden blockage of a blood vessel. Heart failure is a longer-term condition where the heart no longer pumps or fills as it should, leading to breathlessness, fatigue and fluid retention. Uncontrolled high blood pressure is a major driver of both, which is another reason it is worth taking seriously long before you feel anything.
Frequently asked questions
What are the warning signs of a heart attack?
Pressure or pain in the chest, a tight band feeling, breathlessness, and pain spreading to the arm, back or jaw. In an acute attack this often comes on at rest, with a pale appearance and sweating. If you are not sure, call 999.
Are the symptoms different for men and women?
Often, yes. In men the picture is more often the classic one, while women relatively more often have symptoms towards the jaw, a tight band feeling or breathlessness. Take symptoms seriously in anyone.
What can I do myself to prevent heart disease?
Not smoking is the single most important thing. On top of that, stay active, follow a Mediterranean-style diet you can keep up, go easy on alcohol, and keep an eye on your blood pressure and blood sugar.
Why is high blood pressure so dangerous if I cannot feel it?
High blood pressure usually causes no symptoms for years, but it quietly strains your heart and blood vessels the whole time and is a leading risk factor for both heart attack and heart failure. That is why having it measured now and then is sensible.
What is the difference between a heart attack and heart failure?
A heart attack is a sudden, acute blockage of a blood vessel. Heart failure is a longer-term condition where the heart does not pump or fill properly, causing breathlessness, fatigue and fluid retention.
Can you prevent hardening of the arteries?
You cannot prevent it completely, as some degree is a normal part of ageing. You can slow it down considerably with a healthy lifestyle, not smoking and keeping your blood pressure under control.
