Heart Disease: Risk Factors, Prevention, and More
Hypertensive Heart Disease
Hypertensive heart disease refers to heart conditions caused by high blood pressure.
The heart working under increased pressure causes some different heart disorders. Hypertensive heart disease includes heart failure, thickening of the heart muscle, coronary artery disease, and other conditions.
Hypertensive heart disease can cause serious health problems. It's the leading cause of death from high blood pressure.
In general, the heart problems associated with high blood pressure relate to the heart's arteries and muscles. The types of hypertensive heart disease include:
Narrowing of the arteriesCoronary arteries transport blood to your heart muscle. When high blood pressure causes the blood vessels to become narrow, blood flow to the heart can slow or stop. This condition is known as coronary heart disease (CHD), also called coronary artery disease.
CHD makes it difficult for your heart to function and supply the rest of your organs with blood. It can put you at risk for heart attack from a blood clot that gets stuck in one of the narrowed arteries and cuts off blood flow to your heart.
Thickening and enlargement of the heartHigh blood pressure makes it difficult for your heart to pump blood. Like other muscles in your body, regular hard work causes your heart muscles to thicken and grow.
This alters the way the heart functions. These changes usually happen in the main pumping chamber of the heart, the left ventricle. The condition is known as left ventricular hypertrophy (LVH).
CHD can cause LVH and vice versa. When you have CHD, your heart must work harder. With severe LVH, your heart can become enlarged, causing an obstruction of blood leaving the heart. This can then lead to symptoms of coronary artery disease.
ComplicationsBoth CHD and LVH can lead to:
Heart disease is the leading cause of death for both men and women in the United States. Over 695,000 Americans die from heart disease every year.
The main risk factor for hypertensive heart disease is high blood pressure. Your risk increases if:
You're more prone to heart disease if it runs in your family. Men are more likely to get heart disease than women who have not gone through menopause. Men and postmenopausal women are equally at risk. Your risk for heart disease will increase as you age, regardless of your sex.
Symptoms vary depending on the severity of the condition and progression of the disease. You may experience no symptoms, or your symptoms may include:
You need emergency care if your heart is suddenly beating rapidly or irregularly. Seek emergency care immediately or call 911 if you faint or have severe pain in your chest.
Regular physical exams will indicate whether you suffer from high blood pressure. If you do have high blood pressure, take extra care to look out for symptoms of heart disease.
Your doctor will review your medical history, conduct a physical exam, and run lab tests to check your kidneys, sodium, potassium, and blood count.
One or more of the following tests may be used to help determine the cause of your symptoms:
Treatment for hypertensive heart disease depends on the seriousness of your illness, your age, and your medical history.
MedicationMedications help your heart in a variety of ways. The main goals are to prevent your blood from clotting, improve the flow of your blood, and lower your cholesterol.
Examples of common heart disease medications include:
It's important to always take all medications exactly as prescribed.
Surgeries and devicesIn more extreme cases, you may need surgery to increase blood flow to your heart. If you need help regulating your heart's rate or rhythm, your doctor may surgically implant a battery-operated device called a pacemaker in your chest.
A pacemaker produces electrical stimulation that causes cardiac muscle to contract. Implantation of a pacemaker is important and beneficial when cardiac muscle electrical activity is too slow or absent.
Cardioverter-defibrillators (ICDs) are implantable devices that can be used to treat serious, life threatening cardiac arrhythmias.
Coronary artery bypass graft surgery (CABG) treats blocked coronary arteries. This is only done in severe CHD. A heart transplant or other heart-assisting devices may be necessary if your condition is especially severe.
Long-term outlookRecovering from hypertensive heart disease depends on the exact condition and its intensity. Lifestyle changes can help keep the condition from getting worse in some cases. In severe cases, medications and surgery may not be effective in controlling the disease.
Monitoring and preventing your blood pressure from getting too high is one of the most important ways to prevent hypertensive heart disease. Lowering your blood pressure and cholesterol by eating a healthy diet and monitoring stress levels are possibly the best ways to prevent heart problems.
Maintaining a healthy weight, getting adequate sleep, and exercising regularly are common lifestyle recommendations. Talk with your doctor about ways to improve your overall health.
How serious is hypertensive heart disease?Hypertensive heart disease is a serious condition that requires treatment. It increases your risk of death and puts you at risk of developing other cardiovascular diseases like heart failure, atrial fibrillation, and stroke, as well as chronic kidney disease.
How long does it take for hypertension to cause heart damage?Long-term high blood pressure ultimately leads to heart damage, and often heart failure. The length of time to develop heart damage varies for each person and depends on how uncontrolled your blood pressure is and what markers are used to determine LV damage. Treatment of high blood pressure can help prevent damage to the heart.
Can heart damage from hypertension be reversed?A 2016 study found that after 6 months of treatment, a person had succeeded in reversing heart damage caused by hypertension. That said, it's not always possible to reverse heart damage caused by high blood pressure. Following a well-development treatment plan can help you manage symptoms and prevent disease progression.
In A First, Microplastic Particles Have Been Linked To Heart Disease
Microplastics are everywhere in the environment—and in our bodies. The build-up of these tiny plastic particles in blood vessels is linked to a greater risk of heart attack, stroke, and death, according to a new study.
When plaque builds up in arteries—a disease called atherosclerosis—the thicker vessel walls reduce blood flow to parts of the body, raising the risk of strokes, angina, and heart attack. The plaques are typically a mixture of cholesterol, fatty substances, waste from cells, calcium, and a blood clotting protein called fibrin. The new study now focuses on some 300 people with atherosclerosis, some of whom also had tiny plastic particles—microplastics and nanoplastics—embedded in plaques in their carotid artery, a major blood vessel in the neck that provides blood to the brain. The people with plastic-containing plaques were more than four times more likely to have a heart attack or stroke or to die from any cause over the next three years, according to the research published on March 7 in the New England Journal of Medicine.
Researchers have long known that the chemicals in plastics can leach out and cause health problems, such as interfering with hormones or other parts of the endocrine system.
"But this is the first time we've seen a human health effect attributed to the particles themselves," says Philip Landrigan, a pediatrician and public health epidemiologist at Boston College who was not involved in the study but has spent much of his career studying toxic chemicals' effects on human health. Landrigan helped spearhead the lead poisoning research that led the U.S. Government to remove lead from gasoline and paint.
"Until now, the mantra has always been, Well, the particles are there, but we don't know anything about what they're doing. This paper changes that." Landrigan expects this study will spur more research into what other organs plastic may be damaging, such as the brain, kidneys, and reproductive organs.
The arrows in these microscope images point at microplastic particles—characterized by jagged edges—that were detected inside a macrophage cell (left) and free floating in plaque removed from patients' carotid arteries (right).
Micrograph by Marfella, et al., 2024 (Top) (Left) and Micrograph by Marfella, et al., 2024 (Bottom) (Right)
Giuseppe Paolisso, a cardiologist at the University of Campania Luigi Vanvitelli in Italy and one of the study's authors, says they could not determine how the tiny plastics got into blood vessels. They can enter the body in many ways, including breathing them in from the air and consuming them from the food and water supply.
"What we can say is that our data could sound a warning in our daily lives that we should try to reduce the use of plastics and use more glass," Paolisso says.
A large amount of research has already shown that microplastic and nanoplastic particles are "essentially everywhere we look in the body," says Kenneth Spaeth, an occupational medicine doctor at Northwell Health in New York who was not involved in the study. "Given what these particles are composed of, it has long been suspected that they are playing a role in affecting our health." The findings therefore aren't necessarily too surprising, he says, but they are important.
Most current data scientists have on the effects of microplastics and nanoplastics in the body come from animal studies, says Aaron Aday, a cardiologist and vascular medicine specialist at Vanderbilt University. "We knew these microplastics and nanoplastics could get into the bloodstream and into certain organs, but this research is a pretty big leap in terms of finding them in plaque in individuals who had significant disease," he says. "This is certainly a landmark study in linking them to human disease."
Linking microplastics to heart diseaseThe study involved 304 adults who underwent a surgery called carotid endarterectomy, in which surgeons clean out plaque that built up in the carotid artery. Plaque build-up in this artery can increase the risk of stroke when a piece of the plaque breaks off and blocks a smaller artery, preventing blood flow.
After removing the plaque, the researchers analyzed it for plastics, although they did not distinguish between how much microplastic particles—about the width of a grain of rice—versus nanoplastics, about one tenth the diameter of a human hair, they found in the plaques.
They identified polyethylene, the most produced plastic in the world, in 58 percent of the patients. They found polyvinyl chloride—more commonly known as PVC—in 12 percent.
When the researchers looked at the tiny plastic particles under an electron microscope, they found foreign particles with jagged edges inside macrophages in the plaques. Macrophages are white blood cells that surround and kill microorganisms and other foreign bodies by consuming them.
The researchers then followed 257 of the patients for between two and three years to see how many had heart attacks or strokes or died from any cause. The patients with microplastics and nanoplastics in their plaque were about 4.5 times more likely to have a heart attack, stroke, or death in the next several years.
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The unexpected health benefits of Ozempic and MounjaroThe researchers cannot say whether or how the micro- and nanoplastics contribute to heart attacks or stroke, but one possibility is that the tiny particles cause inflammation as macrophages converge to rid the body of the foreign particles, Paolisso says. As inflammation in the plaque increases, pieces might more easily break off and enter the bloodstream.
The inflammation hypothesis is reasonable since it's known that macrophages contribute to plaque development and that inflammation is important in cardiovascular disease, Aday says.
"If these particles are causing more inflammation in the plaque, then perhaps the plaques are more vulnerable to causing problems in the future," he says, but it's too early to say for sure if that's happening.
It's also not clear how much harm might arise from chemicals in the plastics versus the physical particles themselves. Many different kinds of chemicals make up these plastics, including endocrine disruptors—chemicals that interfere with the natural hormones the body produces—and inflammation triggers, Spaeth says.
Given the many different potentially toxic chemicals in plastics, they could have any number of effects in our bodies, he says. Unlike pharmaceuticals, which are tested in clinical trials, it's not ethical to test environmental exposures like microplastics in humans in randomized controlled trials, Spaeth says. "Unfortunately, we are all part of a living experiment where we all could be studied."
While individuals can't do much to control their widespread exposure to plastics in the environment, they can adopt lifestyle habits known to reduce cardiovascular risk, such as regular physical activity, a healthy diet, and not smoking.
It's not clear how much environmental pollutants are contributing to cardiovascular disease and other disease overall, but "things like diet, exercise and lifestyle probably have a bigger impact than worrying about how many plastic water bottles you have in your house," Spaeth says.
Plastic, plastic everywherePlastic waste has more than doubled just since 2000, and the vast majority of that—around 80 percent—ends up in landfills, where it breaks down into tiny particles that infiltrate the water and soil, eventually entering our food chain.
"No component of plastics contributes more to plastic waste and micro- and nanoplastics than single-use plastic," Landrigan says. Single-use plastics, such as water bottles, grocery bags, product packaging, and plastic straws, plates and cutlery, make up about 40 percent of the plastic made every year.
"I don't think it's possible in today's world for people to get rid of all plastics, but they can certainly reduce their exposure," Landrigan says. Ways to do that include drinking out of steel cups or bottles instead of plastic ones and not microwaving food in plastic containers, since heat speeds up the breakdown of plastics, he says.
People can also reduce their overall plastic footprint, such as not using plastic bags at stores. The average American generates 487 pounds of plastic waste each year, according to the Organization for Economic Co-operation and Development.
"Individuals can do a little bit, but the heavy lifting is going to have to be at the policy level because plastics are so widespread," Landrigan says. The United Nations has been negotiating the world's first-ever plastics pollution treaty since 2022 and will be meeting later this month to finalize it. This New England Journal of Medicine study should increase the urgency of those negotiations, Landrigan says.
While Spaeth acknowledges that the study findings are "a bit scary and daunting," he's optimistic about how this kind of research leads to change. The history of public health has consistently shown that, as scientific evidence mounts and demonstrates that a particular human activity harms health, it eventually reaches a tipping point to motivate policy change, he says.
"There was a time when we were completely oblivious to the health effects of air pollution and didn't think about it, and over a decade's time, the science got really strong," Spaeth says. "Then we started efforts to make our air cleaner, and real, measurable benefits have resulted from that." Another example, he says, is asbestos, which was finally completely banned last month.
"I think the political will to take on [plastics] will also grow," Spaeth says. Hopefully this will lead to more studies so researchers get a better handle on the risks plastics pose, he says, "and that will help us shape policy."
How To Improve Circulation
Although circulation is largely an automatic process, there are some ways to improve circulation. Examples include increasing activity levels, maintaining a moderate weight, eating oily fish, and more.
As the blood circulates the body, it delivers oxygen-rich blood to the brain and other tissues and removes waste products. It also brings oxygen-poor blood from the brain and body back to the lungs for reoxygenation.
This article discusses several research-backed ways to improve circulation.
For people looking to improve their circulation, there are some first steps to take. These include:
There are also various other ways a person can help to improve their circulation.
Maintaining a moderate weight helps promote good circulation. Carrying excess body weight may negatively affect circulation.
Although everyone needs some fat to remain healthy, too much can lead to a buildup of fat in the arteries. Visceral fat, which sits around the internal organs, can prevent the body from using insulin correctly, leading to arterial damage.
Increase physical activityRegular cardiovascular exercise, such as jogging, supports the circulatory system's health and improves circulation.
Research from 2018 notes that regular cardiovascular exercise is associated with improved cardiovascular performance and lower blood pressure. This is because this type of exercise improves the body's ability to take in and use oxygen. It also improves the capacity of blood vessels to dilate, which helps them work more efficiently, allowing the muscles to receive oxygen more easily.
Exercise can improve circulation and make daily activities less tiring.
Learn about 20 cardio exercises to try at home.
Practice yogaYoga is a low impact form of exercise that is easy to modify for beginners. It involves bending, stretching, and twisting. These movements can help compress and decompress a person's veins, improving circulation.
Yoga postures can improve flexibility, balance, and heart health.
A simple yoga position for beginners to try is the downward-facing dog. This helps improve circulation by putting the hips and heart above the head, allowing gravity to increase blood flow toward the head.
To do the downward-facing dog, a person should follow these steps:
Learn more basic yoga poses.
Eat oily fishThe omega-3 fatty acids in oily fish promote cardiovascular and brain health, according to the American Heart Association (AHA). This can also lead to improved circulation.
Oily fish include:
Vegetarians and vegans can opt for kale, which provides a small quantity of omega-3 fatty acids.
Supplements containing omega-3 fatty acids are another option for people who do not eat fish.
Learn about omega-3 supplements.
Drink teaThe antioxidants in tea promote cardiovascular health and may improve circulation. This is true for both black tea and green tea.
A 2017 study found that black tea improves blood vessel health. Healthy blood vessels help improve circulation.
Another study from 2021 found that green tea consumption is associated with a reduced risk of cardiovascular health issues.
Keep iron levels balancedIron is an essential mineral for the circulatory system. The body needs it to make hemoglobin, which is one of the major components of red blood cells and is responsible for carrying oxygen around the body.
Eating foods rich in iron, such as red meat or spinach, helps the body get enough of this essential mineral. However, maintaining a healthy balance is also necessary, as too much iron may negatively affect cardiovascular health.
A 2016 study found a link between insufficient iron in the body and iron-restricted erythropoiesis with anemia. However, too much iron can lead to tissue iron overload and other conditions.
Wear compression socksCompression socks apply pressure to the calves and lower legs, forcing blood in that part of the leg to flow upward. They help create a continuous flow of blood throughout the circulatory system.
A healthcare professional may prescribe them for conditions such as varicose veins and lymphedema. They may also improve circulation.
Stop smokingAccording to the American Cancer Society, circulation improves and lung function increases within 2 weeks to 3 months of quitting smoking.
Just 1–12 months after quitting, tiny hair-like structures within the lungs, called cilia, begin to regain function and move mucus out of the lungs.
In addition, 1–2 years after stopping smoking, the risk of heart attack drops drastically.
Learn more about what happens after quitting smoking.
MassageResearch from 2020 found that certain types of massage can help improve circulation in the body. One particular type of massage that has been proven to aid in circulation is effleurage.
Effleurage is often part of the beginning of a massage treatment. It is a light friction technique that involves long, storing movements done with the fingers or a flat hand.
Individuals can speak with a physiotherapist or massage therapist about massage to improve circulation.
Read about other types of massage.
The health of a person's circulatory system determines how well the blood circulates the body. There are various factors that can affect this circulation.
Blood pressureBlood pressure is the pressure that the blood places on the walls of the blood vessels as it circulates. Blood pressure measurements include readings of systolic pressure and diastolic pressure. Systolic pressure is the pressure when the heart is beating, and diastolic pressure is the pressure between heartbeats.
According to the American Heart Association (AHA), a normal resting blood pressure in an adult is less than 120 millimeters of mercury (mm Hg) systolic and less than 80 mm Hg diastolic. The abbreviation for this is 120/80 mm Hg.
People with very low blood pressure may experience poor circulation and other related symptoms. However, having a lower blood pressure measurement is not usually a cause for concern in people with a healthy cardiovascular system.
Blood healthThe blood carries oxygen and nutrients to the cells and removes waste. It performs these functions most effectively when it is healthy.
Healthy blood has the right balance of red blood cells, which carry oxygen, white blood cells, and platelets. The body makes all of these components in the bone marrow. An imbalance in these components may affect blood circulation.
Heart healthThe heart is the muscle responsible for pumping the blood around the body. The stronger and healthier a person's heart is, the better their circulation.
Blood vessel healthHealthy veins and arteries are easier for blood to pass through. Excessively high cholesterol levels can injure and block blood vessels.
Poor circulation may be a symptom of other underlying health conditions. These conditions include:
Exercise and other measures to promote cardiovascular health may reduce the poor circulation that these conditions cause.
Learn more about poor circulation and its causes.
If blood flow slows to a certain part of a person's body, they may experience symptoms of poor circulation.
These symptoms mainly occur in the arms or legs but can affect other parts of the body. They include:
Anyone who experiences the symptoms of poor circulation should speak with a healthcare professional. They can help diagnose the problem and suggest treatment for any underlying conditions.
In addition, they may recommend eating a nutritious diet, exercising regularly, and quitting smoking to improve circulation.
There are various ways a person can improve the circulation in their body. These include regular exercise, increasing their intake of omega-3 fatty acids, maintaining a moderate weight, and quitting or avoiding smoking.
There are various conditions and factors that can affect circulation, such as obesity, diabetes, heart disease, and Raynaud's syndrome. Treating these underlying conditions may help to improve circulation.
If a person is experiencing symptoms of poor circulation, such as tingling, swelling, fatigue, and skin changes, they should speak with a healthcare professional.
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