How your blood supply connects everything

Heart disease is connected with many other illnesses. Senior Cardiac Nurse Emily McGrath discovers how one condition can lead to another, and we hear how Barrie Gough adapted after suffering a stroke and atrial fibrillation.

Barrie Gough

When Barrie Gough (pictured above) had a stroke aged 59 it came without warning. “I didn’t experience any kind of pain, just a strange feeling,” he says. “I mentioned it to my wife, who went to get me a drink, and realised I had lost the use of my right arm.”

A few months later, Barrie was told he had atrial fibrillation (AF), a heart rhythm disturbance. Barrie will never know for sure whether he already had AF before his stroke, but it’s known to be a major risk factor for it. This is because your heart doesn’t beat normally when you have AF, so blood clots can form inside it. If one blood clot travels to the brain, it can block a blood vessel and cause a stroke.

How and why different conditions are connected

All of our organs need a normally functioning heart and circulatory system to supply them with blood that carries oxygen and nutrients. So when things go wrong with this system, things can go wrong in other organs too.

Your circulatory system includes your arteries, veins and the blood flowing through them. ‘Circulatory diseases’ is a term for a wide range of problems affecting this system. Examples include stroke, peripheral artery disease, deep vein thrombosis and vascular dementia (‘vascular’ means it is caused by problems with blood vessels, in this case in the brain).

When things go wrong with your heart and circulatory system, things can go wrong in other organs too

Our Medical Director, Professor Sir Nilesh Samani, explains: “Heart and circulatory conditions are connected in more than one way. Firstly, they share many of the same risk factors. For example, diabetes and high blood pressure are both risk factors for coronary heart disease, stroke and vascular dementia. The conditions themselves can also raise your risk of other conditions: if you have AF then you are at an increased risk of stroke, for example, and if you have a stroke you are at increased risk of vascular dementia.”

When an artery supplying the heart becomes blocked, this leads to a heart attack. When an artery supplying the brain is blocked or bursts, this leads to a stroke. Having a stroke can also lead to dementia, in particular vascular dementia (the second most common type of dementia, after Alzheimer’s). A third of people who survive a stroke go on to develop some form of dementia within five years. 

Professor Mark Kearney

How diabetes increases your risk of other conditions

Mark Kearney (pictured above) is the BHF Professor of Cardiovascular and Diabetes Research at the University of Leeds. He describes diabetes as “a magnet for other risk factors”. This is because people with diabetes commonly have high cholesterol and high blood pressure, and diabetes causes uncontrolled blood sugar levels and changes to the walls of your blood vessels (including the arteries supplying your heart and brain).

People with diabetes commonly have high cholesterol and high blood pressure

All of these factors combine to increase your risk of coronary heart disease, stroke and dementia. Atherosclerosis – the hardening of arteries that can lead to heart attack, stroke and limb amputation – happens both earlier and with greater severity to people with diabetes. Professor Kearney’s work has shown us more about how this happens.

“Of people with heart and circulatory disease, around a third will have diabetes and a third will have pre-diabetes [when your blood sugar level is higher than normal, but not yet diabetes],” says Professor Kearney. “Of the patients I see who have had heart attacks and now have a diagnosis of heart failure, around 35 per cent have diabetes, and many of them have had a stroke. A lot of people with both diabetes and heart disease have a bad memory too – and diabetes is linked to an increased risk of dementia.

“It is common to see patients with multiple conditions, and most of these are linked by blood vessels. If the blood vessels aren’t working very well, it affects everything.”

BHF-funded research to find the answers

Professor Kearney is studying how diabetes damages blood vessels, and developing ways to avoid it. This research tells us more about links between diabetes and heart and circulatory diseases, but he has also studied how to best treat people with these conditions with medicines.

I think a lot of people don’t realise the range of things that we fund

Professor Sir Nilesh Samani

Professor Samani explains: “We have always funded research into all forms of heart and circulatory disease and their risk factors. I think a lot of people don’t realise the range of things that we fund.”

Our research has already helped make many breakthroughs, from finding the genes that cause some heart conditions, to better management of high blood pressure and reducing the risk of stroke.

Professor Kearney explains: “When I think back over my career, things have changed so much. People used to die from heart attacks all the time and if they survived, recovery was very slow. Now they come in and in many cases they have a stent, go home and do well. BHF research has made these improvements possible, and led to innovation in other treatments such as pacemakers.”

Barrie Gough and his wife on their wedding day and gardening together

Barrie tries to live a healthy life now, gardening and walking with his wife, and making the most of family time.

Making positive changes to reduce risk

In Barrie’s case, four months after his stroke, the feeling in his right arm had returned and he was able to lead a normal life again. Fifteen years on, he feels grateful that the stroke hasn’t had a lasting effect on his life and he can still spend quality time with his family.

Leading a healthy lifestyle will help with all of the risk factors that we know about, as well as some we don’t even understand yet

Professor Mark Kearney

Professor Kearney says: “Leading a healthy lifestyle will help with all of the risk factors that we know about, as well as some we don’t even understand yet. Staying active and eating a balanced diet improves blood vessel function and blood pressure, as well as reducing cholesterol. We know that if someone is overweight, even losing a little bit of weight will make a huge difference to their risk factors.”

Leading a healthy life is something Barrie now embraces every day, and he enjoys going walking with his wife. ‘‘I feel lucky that my life is back to normal and I haven’t let it have a detrimental effect on me,” says Barrie. “I still play football with my grandkids. We keep ourselves fit, eat healthily and don’t overindulge in drinking alcohol. I make sure that I take my medication to reduce my risk of having any more problems, and have regular blood tests for the warfarin. We try to live a sensible life with no excess.

“I thank God that I am still here living my life.”

How your circulatory system connects everything

Your circulatory system is a 60,000-mile network of blood vessels with your heart at the centre, delivering the blood that keeps your organs working.

  • Adults with diabetes are two to three times more likely to develop heart and circulatory disease.
  • Heart and circulatory diseases are the cause of death in about two-thirds of people with diabetes.
  • People with heart failure are two to three times more likely to have a stroke.

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