Hesperian Health Guides

Heart Disease and High Blood Pressure


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In this chapter:

What Is Heart Disease?

a woman feeling the pulse at her neck.
The heart works day and night to pump blood through the body. Put your fingers on the side of your neck or on your wrist to feel the steady beat of your heart.

Our bodies need a strong and healthy heart to pump blood through arteries and veins, the tubes that carry the blood from the heart to all parts of the body (arteries) and then back again (veins). If the arteries are blocked or brittle, not as much blood gets back to the heart, making it weak. And if the heart is too weak, it won’t pump the blood well and has to work too hard.

Because the blood carries oxygen and nutrients throughout the body, blood circulation and heart problems can affect the entire body. It is like a water system: if the pump works too hard, it may burn out; if it is too weak, not every household will get water; if the pipes are clogged, there is less water getting through; and in the homes that don’t get water, there will likely be more illness.

NWTND heart Page 1-2.png

Problems in the arteries and veins and problems with the valves inside the heart are all called heart disease. Common heart diseases (also called cardiovascular disease) include:

  • Hardening of the arteries (arteriolosclerosis): When the arteries that carry blood from the heart throughout the body become stiff, narrow, or blocked—often from too much unhealthy food—not enough blood will return to the heart.
  • Congestive heart failure: When the heart is not strong enough to pump the blood well, it is called heart failure. It harms the person because the blood does not get everywhere it is needed. With less blood flow to the body’s organs, the person gets tired more easily. Lack of good blood flow can cause swelling in the legs and fluids to build up in the lungs.
  • Heart attack: When blood flow is blocked inside the heart, the heart muscle is damaged and becomes too weak to work properly. This is an emergency.
  • Stroke: When blood flow to the brain becomes blocked or when a smaller tube, called a blood vessel, bursts inside the brain, the brain is damaged. This is an emergency.
  • Rheumatic heart disease: This is caused when rheumatic fever damages a child’s heart. Medicines or an operation can help.
  • Newborn heart problems: When a child is born with a hole or other defect in his heart, it may cause problems only surgery can fix. These are called heart defects.

Who is more likely to get heart disease?

Most kinds of heart disease develop for a long time before any signs appear. But because certain conditions often lead to heart disease, it is easy to predict that a person with 2 or more of these conditions is more likely to have heart problems in the next few years:

  • has blood pressure higher than 140/90 every time it is measured
  • weighs too much
a patient's family member speaking to a doctor.
He was always out of breath, but we never thought it was because of his heart.
A heart attack or stroke may seem to happen suddenly, but heart disease often starts when you are young and then gets worse over many years.
  • has diabetes
  • smokes tobacco
  • is a man older than 55 or a woman older than 65


Health workers can encourage people with these conditions to check their blood pressure and get tests for diabetes and cholesterol levels.

You can make heart problems less likely, and even improve heart problems you already have. Stop smoking, get treatment for diabetes, eat less salt and less processed “junk” foods, exercise more, and lower your stress. These changes will help your heart. Talk to your health worker and see Ways to Lower Blood Pressure and Help Your Heart.

How to check the heart and circulation system

A health worker measures how well your heart is working by:

  • Measuring blood pressure. This shows if your heart is working too hard to move blood around the body. When the blood pressure measurement is always high, this is a warning that you have or could develop heart disease or problems that can lead to a heart attack or a stroke.
  • Testing blood to measure cholesterol. Cholesterol is a waxy liquid made in the body. The body needs some, but too much is a sign of heart problems to come.


Other signs that may show a heart problem, especially if you feel them often, are:

  • Too fast, too slow, or always changing heartbeat (arrhythmia)
  • Pain in the chest (angina)
  • Trouble breathing or feeling short of breath
  • Swelling in your feet and legs
  • Trouble lying flat to sleep at night

Preventing heart disease

Most heart disease is caused by the foods we eat and how we live. We can control some of these choices, but many are not under our control. Are good housing or healthy foods available and affordable? Do jobs pay enough? Are there safe places to exercise and for children to play? Is there pollution or tobacco smoke everywhere? Does racism, poverty, harsh lives for women, or violence make our lives constantly stressful? This chapter describes how heart disease works, but it also shares ideas how individuals, families, and communities can prevent heart disease to live better and longer.

NWTND heart Page 4-1.png When children can play safely every day and have nutritious food to eat, they will have fewer health problems when they are older.


This page was updated:05 Jan 2024