What is arrhythmia? Cardiologist explains
29 September 2026
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Heart disease remains one of the leading causes of mortality and morbidity worldwide. Thanks to constantly developing medical science, the management of heart disease has evolved, encompassing a broad range of treatments and therapies aimed at improving patient long term and short term outcomes. In daily clinical practice we often get asked about the way that patients can improve their cardiovascular health. This article investigates the various aspects of managing heart disease, including treatments, therapies, medication, rehabilitation, and support, supported by research evidence and references to clinical trials. We will also explain in more details more advanced heart disease treatments.
Heart has several main components and as such heart disease encompasses a variety of conditions affecting it`s structure. This includes coronary artery disease, heart failure, arrhythmias, and valvular heart disease. The management of heart disease involves a combination of prevention, lifestyle changes, medication, and surgical interventions.
A heart-healthy diet is crucial for managing and more importantly preventing heart disease in the first instance. The DASH diet, which stands for Dietary Approaches to Stop Hypertension follows choices of foods that are rich in potassium, magnesium, fibre and protein, low in saturated fat and salt. In addition to this Mediterranean diet have shown in clinical trials to be beneficial for heart health. For instance, according to a study published in 2014 in Circulation, Mediterranean Diet enriched with Olive Oil caused a significant reduction in the incidence of Atrial Fibrillation. (https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.113.006921) Interestingly, some foods like for example liquorice (licorice), which is derived from a plant glycyrrhiza glabra and is used as a sweetener and flavouring agent can cause significant increase of blood pressure. Authors of this study (https://ajcn.nutrition.org/action/showPdf?pii=S0002-9165%2824%2900019-4) concluded: ` ‘We found licorice to be more potent than previously known, with significant increases in BP, after a daily intake of only 100mg glycyrrhiza glabra. Thus, the safe limit of intake of this substance might need to be reconsidered.’
Ultra-processed foods, which include pastries, cakes, pre-prepared pizza, burgers and many more also cause high blood pressure, according to a meta-analysis published in June 2022 in American Journal of Hypertension. (https://academic.oup.com/ajh/article/35/10/892/6617679)
So to summarise heart-healthy diet is based on the consumption of fruits, vegetables, whole grains, and lean proteins while reducing the intake of saturated fats, cholesterol, and sodium.
Regular exercise strengthens the heart muscle, improves blood circulation, and helps maintain a healthy weight. The NHS website recommends for adults
between 19 and 64 years old: at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week with a spread of exercise evenly over 4 to 5 days a week, or every day. (https://www.nhs.uk/live-well/exercise) And similarly, the American Heart Association mentions to `get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week`.
According to clinical research even changing our daily habits can make a difference. For instance, according to a study published in `Atherosclerosis` journal in September 2023, climbing more than 5 flights of stairs a day reduces risk of atherosclerotic cardiovascular disease by 20%. (https://www.atherosclerosis-journal.com/article/S0021-9150(23)05221-8/fulltext) In addition to this, according to this study cycling to work can reduce risk of heart disease and dying. (https://www.bmj.com/content/357/bmj.j1456) The authors of this study concluded: ‘Cycle commuting was associated with a lower risk of cardiovascular disease, cancer and all cause mortality. Walking commuting was associated with a lower risk of cardiovascular disease independent of major measured confounding factors. Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions.’
Undeniably, smoking tobacco is a major risk factor for heart disease. Quitting smoking can significantly reduce the risk of developing heart disease and improve overall heart health. Recent data also suggest that inhaling e-cigarettes leads to negative changes in vascular endothelial function. (https://pubmed.ncbi.nlm.nih.gov/36316290/)
Statins are commonly prescribed medication to lower cholesterol levels, reducing the risk of heart attacks and strokes. Clinical trials, such as the ` Intensive Lipid Lowering with Atorvastatin in Patients with Stable Coronary Disease` trial, have demonstrated the efficacy of statins in preventing cardiovascular events in high-risk individuals. (https://www.nejm.org/doi/full/10.1056/NEJMoa050461) Another study published in 2019 in Lancet demonstrated that `A 50% reduction of non-HDL cholesterol concentrations was associated with reduced risk of a cardiovascular disease event by the age of 75 years, and this risk reduction was greater the earlier cholesterol concentrations were reduced.` (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913519)
Antihypertensives, medications to control blood pressure
Commonly used medications used in management of high blood pressure include calcium channel blockers (Amlodipine or Felodipine), ACE inhibitors (Ramipril or Lisinopril), angiotensin II reception blockers (Candesartan and Irbesartan), diuretics (Furosemide or Bumetanide) and beta-blockers (Atenolol or Bisoprolol).
Antiplatelets and Anticoagulants
Drugs like antiplatelets (aspirin, clopidogrel, ticagrelor or prasugrel) and direct oral anticoagulants (edoxaban, apixaban, rivaroxaban or dabigatran) are used to prevent blood clots, reducing the risk of heart attacks and strokes. The use of dual antiplatelet therapy (DAPT) is particularly effective post-percutaneous coronary intervention (PCI), which most often means intracoronary stent implantation. In addition to this DOACs are used to reduce a risk of stroke in patients with atrial fibrillation. For instance, in this trial Edoxaban was shown to be noninferior to warfarin in prevention of stroke or systemic embolism and was linked to significantly lower bleeding risk and death from heart related causes. (https://www.nejm.org/doi/full/10.1056/NEJMoa1310907)
PCI, commonly known as angioplasty or intracoronary stenting, involves the use of a balloon to open narrowed or blocked coronary arteries. Stents are often placed to keep the arteries open. This treatment is used for coronary artery disease or also known as ischaemic heart disease. This heart disease presents as angina, chest pains mainly on exertion or a heart attack. A heart attack occurs when a coronary artery, an artery in a heart, becomes blocked or narrowed, causing inadequate blood flow to the heart muscle. This blockage is typically caused by furring up of the coronary arteries, buildup of fatty deposits along the inner walls of the arteries. When such a buildup ruptures, a blood clot may form, completely obstructing the artery and cutting off blood flow to the part of the heart muscle it supplies. Both angina and heart attack types are explained in details in our section `Heart conditions`.
CABG is an open heart surgery, which usually requires a few days in hospital stay. This procedure improves blood flow to the heart by redirecting blood around blocked arteries. Bypass surgery is typically recommended for individuals with significant fatty deposits in all three major coronary arteries or in the main artery supplying the heart (left main stem). Additionally, patients with coronary artery disease who also have diabetes are considered for bypass surgery under these conditions. (https://www.nejm.org/doi/full/10.1056/NEJMoa1211585)
Heart Transplantation
For patients with end-stage heart failure, a heart transplant may be necessary. Advances in immunosuppressive therapy have improved the survival rates of transplant recipients.
Cardiac rehabilitation is a comprehensive program designed to improve cardiovascular health after a heart event, which includes a heart attack or heart surgery. Heart health rehabilitation includes supervised exercise, education on heart-healthy living, and counselling to reduce stress. Studies, such as the HF-ACTION trial, which was published in 2009 in JAMA journal concluded: ‘In the protocol-specified primary analysis, exercise training resulted in nonsignificant reductions in the primary end point of all-cause mortality or hospitalization and in key secondary clinical end points. After adjustment for highly prognostic predictors of the primary end point, exercise training was associated with modest significant reductions for both all-cause mortality or hospitalization and cardiovascular mortality or heart failure hospitalization.’ (https://jamanetwork.com/journals/jama/fullarticle/183708)
A comprehensive heart disease management plan is essential for optimising treatment and improving patient outcomes. This plan typically includes regular monitoring of heart health, medication adherence, lifestyle modifications, and regular follow-ups with healthcare providers. Patients who have been through a significant heart event often stay under a long term follow up of a consultant cardiologist. Follow ups usually involve reassessments of symptoms, echocardiogram, ECGs and risk factors modification.
Heart disease doctors are called cardiologists. Dr Bart Olechowski is a consultant cardiologist, working in Hampshire, United Kingdom both as an NHS consultant and as a private heart specialist. Specialised care from a cardiologist is crucial for the effective management of heart disease. Cardiologists are trained to diagnose and treat various heart conditions, providing personalized treatment plans based on the latest research and clinical guidelines. The collaboration between primary care physicians and cardiologists ensures comprehensive care for heart disease patients. Dr Bart is an consultant interventional cardiologist, which means that he specialises in treatment of angina, heart attacks and implantation of intracoronary stents.
Emotional and psychological support is vital for heart disease patients, which include cardiac rehabilitation programmes but also family support. Support groups, counselling, and educational resources can help patients cope with the challenges of living with heart disease. Patients after a heart attack often are offered a programme, which allows them to accept their condition and gain confidence through exercise and education.
To emphasise further the importance of preventive measures, well balanced heart disease diet focuses on reducing the intake of unhealthy fats, sodium, and added sugars while increasing the consumption of nutrient-rich foods. Foods high in omega-3 fatty acids, such as fatty fish, and foods rich in antioxidants, like berries and leafy greens, are beneficial for heart health. The PREDIMED trial, which was published in the New England Journal of Medicine in 2018, highlighted the cardiovascular benefits of the Mediterranean diet, particularly in reducing the incidence of major cardiovascular events. The authors concluded: ‘In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.’ (https://www.nejm.org/doi/full/10.1056/NEJMoa1800389)
Advanced heart disease treatments have evolved significantly over the past few decades thanks to a wealth of research in cardiovascular field and improvement in technology. Current advances heaty disease treatments offer hope of positive outcomes for patients with severe cardiovascular conditions. These advanced therapies encompass a range of surgical, medical, and minimally invasive techniques designed to address complex heart diseases that were once deemed untreatable or carried high risk of dying.
Minimally invasive heart valve surgery, including transcatheter aortic valve implantation (TAVI), has revolutionised the treatment of aortic valve disease. TAVI allows for the replacement of a diseased aortic valve without open-heart surgery, making it an option for high-risk patients who are not suitable candidates for traditional valve replacement surgery. The procedure involves threading a catheter through an artery (most commonly used femoral artery) and positioning a new valve within the diseased one. TAVI has been shown to improve survival and quality of life in patients with severe aortic stenosis. (https://jamanetwork.com/journals/jama/fullarticle/2792251)
For patients with end-stage heart failure, advancements in mechanical circulatory support devices, such as left ventricular assist devices (LVADs), have been life-changing. LVADs are implantable mechanical pumps that help the weakened heart pump blood more effectively. Initially used as a bridge to heart transplantation, LVADs are now also used as a long-term solution for patients who are not candidates for transplant. These devices have dramatically improved the survival and quality of life for patients with end-stage heart failure.
Advanced heart disease treatments not only currently can extend patients` lives but also enhance the quality of their lives, providing a brighter future for those affected by severe cardiovascular conditions.
The article above provides a comprehensive overview of managing heart disease, integrating the latest research and clinical evidence to offer insights into effective treatments and therapies. By adhering to these guidelines, patients can achieve better health outcomes and lead a healthier life. Managing heart disease requires an overall balanced heart disease treatment, integrating heart disease doctor guided therapies, medication, rehabilitation and support. Advanced heart disease treatments have significantly improved the prognosis for heart disease patients. Continued research and clinical trials are essential for developing new treatments and improving existing ones. By following a comprehensive heart disease management plan and working closely with healthcare providers, patients can lead healthier, more fulfilling lives.
Consultant Interventional Cardiologist in Hampshire, UK.
Dr Bart Olechowski is an experienced Consultant Interventional Cardiologist based in Hampshire, UK. As a specialist in his field, Dr Olechowski leads with expertise, offering premier cardiovascular care.
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