To visit the main BHF website click the logo below		Did You Know? Around 4,600 babies are born each year with congenital heart disease in the UK More A ACE inhibitor A drug that is important in the regulation of blood pressure. ACE stands for angiotensin-converting enzyme. Age standardised death rate This is a summary measure of the death rate that a population would have if it had a standard age structure. It is useful as it allows a comparison between death rates in populations with very different age structures. Aneurysm A balloon like bulge in the wall of an artery that may burst and cause a haemorrhage. Angina Angina is the most common form of CHD. It is characterised by a heaviness or tightness in the centre of the chest which may spread to the arms, necks, jaw, face, back or stomach. Angina occurs when the arteries become so narrow that not enough oxygen-containing blood can reach the heart muscle when its demands are high – such as during exercise. Angioplasty Angioplasty is a treatment to improve the blood supply through an artery. A catheter (a fine, hollow tube) with a small inflatable balloon at its tip is inserted into a vein in the groin and passed through to the narrowed artery. The balloon is then gently inflated so that it squashes the fatty tissue responsible for the narrowing, and widens the artery. Anxiety Anxiety is a generalised, persuasive fear. Anxiety is one of a number of psychosocial factors which have been found to be associated with an increased risk of CHD. Aspirin Aspirin is an anti-platelet drug used to help prevent blood clots forming. The National Service Framework for CHD recommends that people discharged from hospital after a heart attack are prescribed aspirin to reduce the risk of further attack. Atherosclerosis A disease characterised by chronic inflammation in the artery walls. The disease is commonly referred to as ‘hardening’ or ‘furring’ of the arteries. Atrial fibrillation Atrial fibrillation is a type of arrhythmia (irregular heartbeat) in which the atria (the upper two chambers of the heart) beat very rapidly, at up to 400 beats per minute, and the ventricles respond by beating quickly and irregularly. Atrial fibrillation can produce quite unpleasant palpitations and sometimes breathlessness, and in some cases the fast irregular rhythm may lead to a clot forming in the heart. B Beta blockers Beta blockers are drugs that block the actions of the hormone adrenaline that makes the heart beat faster and more vigorously. Beta blockers are used to help prevent attacks of angina, to lower blood pressure, to help control abnormal heart rhythms, and to reduce the risk of a further heart attack in people who have already had one. They may be used in small doses in heart failure. Blood cholesterol See: "Cholesterol" Blood pressure The pressure of blood in the arteries. The heart is a pump that beats by contracting and then relaxing. The highest blood pressure (known as systolic pressure) occurs when the beat or contraction of the ventricles of the heart forces blood around the circulation. The lowest pressure (diastolic pressure) occurs between heartbeats when the ventricles are relaxing and refilling. Blood pressure is measured in millimetres of mercury (abbreviated to "mmHg"). A blood pressure reading gives two numbers, for example 140/85. The first is the systolic pressure and the second is the diastolic pressure. BMI Body mass index. A formula relating body weight to height to work out whether a person is overweight. BMI is calculated by dividing a person's weight (in kilograms) by their height (in metres squared). People with a BMI of 25-30 are considered overweight. Those with a BMI of over 30 are obese. C CABG See: "Coronary artery bypass graft" Cardiovascular disease The collective term for all diseases affecting the circulatory system (heart, arteries, blood vessels). Commonly known as CVD, cardiovascular disease includes coronary heart disease (about 50%), stroke (about 25%), and all other diseases of the circulatory system. CVD is coded as I00-I99 by the International Classification of Disease Tenth Revision. Central obesity The adverse effect of excess weight on risk of CHD is more pronounced when the fat is concentrated mainly in the abdomen. This is known as central obesity and can be identified by a high waist to hip ratio. For men central obesity is a waist to hip ratio of 0.95 or over; for women a ratio of 0.85 or over. Cerebrovascular disease The collective term for all diseases affecting blood vessels that supply the brain. Technically, stroke (and the many subtypes of stroke) is a subset of cerebrovascular diseases, but the two terms are often used interchangeably. Cerebrovascular disease is coded as I60-I69 by the International Classification of Disease Tenth Revision. CHD See: "Coronary heart disease" Cholesterol Cholesterol is a fatty substance mainly made in the body by the liver. Cholesterol plays a vital role in the functioning of every cell wall throughout the body. However, too much cholesterol in the blood can increase the risk of getting coronary heart disease. There are two types of cholesterol: the more "harmful" LDL (low density lipoprotein) cholesterol which carries cholesterol from the liver to the cells of the body, and the "protective" HDL cholesterol (high density lipoprotein) which returns excess cholesterol to the liver. UK guidelines suggest a total cholesterol target of less than 5.0 mmol/l, and treatment for those with HDL-cholesterol levels below 1.0 mmol/l. COMA COMA (Committee on the Medical Aspects of Food and Nutrition Policy) sets targets and recommends a reduction in fat intake, a reduction in salt intake, and an increase in carbohydrate intake. Co-morbidity Co-morbidity is the state where an individual has two or more diseases concurrently. Congenital heart disease Congenital heart disease is a heart condition resulting from an abnormality in heart structure or function that is present at birth. Most congenital heart conditions occur because the heart or its valves and vessels are not properly formed. Additional defects, such as holes between the chambers of the heart, may be present. Coronary artery bypass graft Coronary artery bypass graft (abbreviated to "CABG") is an operation to bypass a narrowed section or sections of coronary arteries and improve the blood supply to the heart. Coronary heart disease Coronary heart disease, commonly known as CHD, occurs when the walls of the coronary arteries become narrowed by a gradual build-up of fatty material called atheroma. The two main forms of CHD are heart attack (also known as myocardial infarction) and angina. CT (Computed Tomography) scan A rotational mechanical device used to produce a large series of two-dimensional X-ray images of the interior of an object (such as the brain). These two-dimensional scans can be combined to generate a three-dimensional image of the object. CVD See: "Cardiovascular disease" D Decompressive haemocraniectomy A surgical procedure whereby a section of the skull is removed to treat swelling within the brain. Depression Depression is a mental state characterised by excessive sadness. Behaviour is governed by pessimistic or despairing beliefs, and sleep, appetite, and concentration are disturbed. Depression is one of a number of psychosocial factors which have been found to be associated with an increased risk of CHD. Diabetes A disease caused by a lack of insulin or an increased resistance of the body to insulin. Diabetes is characterised by high blood glucose levels. The chronic high blood glucose levels (hyperglycaemia) that result are associated with long-term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels. There are two main types of diabetes: Type 1 and Type 2. Type 1 diabetes results from an autoimmune destruction of the cells of the pancreas which produce insulin. People with Type 1 diabetes must take daily injections of insulin. Type 2 diabetes, which accounts for 90% of all diabetes, is characterised by an inability on the part of the body to respond to insulin (insulin resistance) and/or abnormal insulin secretion. People with Type 2 diabetes are treated with glucose lowering medication. Diabetes is a major risk factor for CVD. Diastolic blood pressure When measuring blood pressure, the diastolic blood pressure is the lowest pressure, which occurs between heartbeats. Diuretics Diuretics, also known as ‘water tablets’, increase the output of water and salt in the urine. They are used to treat heart failure and to lower high blood pressure. Dyspnoea Dyspnoea is laboured or difficult breathing, otherwise known as breathlessness. E Endarterectomy A surgical technique used to widen a narrowed artery by removing fatty plaque material from the within the artery. Equivalised household income A measure of household income adjusted for the number of dependents within the household. EU European Union. The EU currently has 15 Member States: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom. Excess winter mortality Excess winter mortality is mortality that occurs in winter above that which occurs in the rest of the year. Expenditure and Food Survey (EFS) The Expenditure and Food Survey (EFS) replaced the National Food Survey (NFS) from April 2001. The EFS is commissioned jointly by the Office for National Statistics (ONS) and the Department of Environment, Food and Rural Affairs (DEFRA). It is a continuous survey of households in the United Kingdom and provides information about food purchases and expenditure, food consumption (including food consumed outside the home) and nutrient intakes. Extradural Referring to the outermost part of the spinal canal. G General Household Survey The General Household Survey (GHS) is a multi-purpose continuous survey carried out by the Social Survey Division of the Office for National Statistics since 1971. It collects information from people living in private households in Great Britain on topics including population and fertility, family and household information, general health, housing, employment and education. Initial surveys included alcohol and cigarette consumption every 2 years but this has been annual since 2000/01. Age, sex, socio-economic and regional differences are presented. The GHS is used by the Government to monitor progress towards smoking prevalence targets. GHQ12 The General Health Questionnaire (abbreviated to GHQ12) is a self-complete questionnaire that is used to assess levels of depression, anxiety, sleep disturbance and happiness. It yields a single score, with a score of 4 or more indicating a high level of psychological distress. Great Britain Great Britain includes England, Scotland and Wales. GUCH GUCH (Grown-up congenital heart disease) is the term used in the UK to describe the range of conditions experienced by people aged over 16 years who were born with congenital heart disease. H Haematoma A collection of blood that has spilled from the blood vessels, as a result of a haemorrhage. Haemorrhage The technical term for bleeding. The term is commonly used to refer to internal bleeding. Haemorrhagic stroke A subtype of stroke resulting from a haemorrhage of one of the major arteries that feed the brain (the carotid, cerebral and subclavian arteries). It is often referred to as cerebral haemorrhage or intracerebral haemorrhage. In some instances the term haemorrhagic stroke incorporates subarachnoid haemorrhage and is coded I60-I62 by the International Classification of Disease Tenth Revision. In other instances, subarachnoid haemorrhage is not included, and haemorrhagic stroke is coded I61-I62. HDL (High Density Lipoprotein) cholesterol This is the fraction of cholesterol that removes cholesterol (via the liver) from the blood. Low levels of HDL cholesterol are associated with an increased risk of CHD and worse prognosis after a heart attack. Guidelines on HDL-cholesterol generally recommend treatment for those with concentrations below 1.0 mmol/l. Health Survey for England The Health Survey for England is a series of annual surveys about the health of people in England. The survey was carried out in 1991-1993 by the Office for Population Censuses and Surveys which is now part of the Office for National Statistics. From 1994 onwards the survey has been carried out by the Joint Survey Unit of the National Centre of Social Research and the Department of Epidemiology and Public Health at University College London. The adult population has been included since the survey started in 1991, children aged 2 to 15 have been included since 1995, and infants aged 0 to 2 since 2001. Core questions and measurements in each survey include: height, weight, body mass index, fruit and vegetable consumption, alcohol intake, smoking, general health (acute and long standing illness), prescribed medicines, social support, use of health and dental services. The survey focused specifically on CVD in 1994 and 1998. Heart attack A heart attack is where one of the coronary arteries becomes blocked by a blood clot and part of the heart is starved of oxygen. A heart attack usually causes severe pain in the centre of the chest. The pain lasts for more than 15 minutes, and may last for many hours. The pain usually feels like a heaviness or tightness which may also spread to the arms, neck, jaw, face, back or stomach. There may also be sweating, light-headedness, nausea or shortness of breath. Sometimes a heart attack is ‘silent’ and produces little discomfort. A heart attack is also known as a myocardial infarction or MI. Heart failure Heart failure is a clinical syndrome which occurs when the heart is unable to pump enough blood to meet the demands of the body. It occurs because the heart muscle is damaged or overworked. The "failing heart" keeps working but not as well as it should. Some people with mild heart failure may have very few symptoms. People with moderate or severe heart failure suffer from a number of problems, including shortness of breath, general tiredness and swelling of the feet and ankles. Hypertension Hypertension is high blood pressure. High blood pressure happens if the walls of the larger arteries lose their natural elasticity and become rigid, and the smaller vessels constrict. I Incidence Incidence is a measure of morbidity based on the number of new episodes of an illness arising in a population over an estimated period. Inpatient care Inpatient care is the care of a patient who is admitted to a bed in a hospital. International Classification of Disease (ICD) A coding system published by the World Health Organization that provides an internationally recognised method of coding diseases in order to categorise mortality and morbidity statistics. The ICD is revised approximately every ten years. The tenth and most recent revision (ICD-10) was introduced in 2000. Change between revisions can result in discontinuities in mortality and morbidity trends, such as the move from ICD-9 to ICD-10 which resulted in an artificial increase in the number of reported stroke incidents and mortalities. Ischaemic stroke A subtype of stroke that is a result of a blockage in one of the major arteries that feed the brain (the carotid, cerebral or subclavian arteries). It is often referred to as occlusive stroke. Ischaemic stroke is coded as I63 by the International Classification of Disease Tenth Revision. L LDL (Low Density Lipoprotein) cholesterol LDL cholesterol is the more ‘harmful’ fraction of cholesterol which carries cholesterol from the liver to the cells of the body. LDL is the fraction of cholesterol that causes atherosclerosis. M MONICA European populations The MONICA (monitoring trends and determinants in cardiovascular disease) Project collected data in 29 populations in 16 countries in Europe. These included two populations in the UK: Glasgow and Belfast. The populations are not necessarily representative of the countries in which they are located. MONICA Project The MONICA Project (monitoring trends and determinants in cardiovascular disease), was funded by the World Health Organization. The project collected data on the incidence of heart attack (myocardial infarction), coronary case fatality rates, and levels of risk factors associated with CVD in 35 populations in 21 countries during the mid 1980's until the mid 1990's. Morbidity Morbidity is the state of being diseased. Mortality Mortality is the incidence of death in a population in a given period. Myocardial infarction See: "Heart attack" N National Dietary and Nutrition Surveys The National Dietary and Nutrition Surveys are a series of detailed surveys undertaken in Britain since 1992, commissioned jointly by the Department of Health (DH) and by the Ministry of Agriculture, Fisheries and Food (MAFF). The surveys collect information on diet and health including questions on the number of portions of fruit and vegetables consumed each day, total energy intake, macronutrient intake, mineral and vitamin intake, and cover different age ranges: children aged 1½ to 4½ (1992/93), older people aged 65+ (1994/95), children aged 4 to 19 (1997) and adults aged 18 to 64 (2000/01). Age and sex, regional and socio-economic differences are presented. National Food Survey The National Food Survey (NFS) is a series of annual surveys carried out in Great Britain since 1940 (first by MAFF and more recently by DEFRA). The survey has provided continuous information about household food purchases and the nutritional value of the domestic diet for over 60 years. The last NFS was carried out in 2000 and questions on food purchases, in and out of the home, will be included in the Family Expenditure Survey. O Obesity Obesity is the state of being excessively overweight or carrying an excess accumulation of body fat. Obesity is defined as a body mass index (BMI) of 30 and above. Our Healthier Nation Our Healthier Nation (OHN) was published in 1999 and is the Government's comprehensive public health strategy for England. It aims to improve health and reduce health inequalities. It contains a number of public health targets which relate to CVD. Overweight Overweight is defined as a body mass index (BMI) of between 25 and 30. P Prevalence Prevalence is a measure of morbidity based on current sickness in the population at a particular time. The prevalence of angina, for example, is the number of people (often expressed as a rate per 100,000) in the population who are suffering from angina. Primary prevention Interventions aimed at reducing the risk of disease before the disease has presented. Primary prevention interventions are usually aimed at populations, such as regulation of tobacco advertising. Prognosis The prognosis is the outlook or the forecast of the course of a disease. Psychosocial well-being The psychological and/or social effect of an illness on an individual’s well-being. Q Quintiles Quintiles are where data are divided into five equal groups. Each group is a quintile. S Saturated fat Saturated fat is a type of fat found mainly in food from animal sources (particularly dairy and meat products). Secondary care Secondary care is the term for care in hospital. Secondary prevention Interventions aimed at reducing the risk of disease recurrence after the disease has initially presented. Secondary prevention interventions are therefore targeted at individuals already at high-risk of disease. SF-36 The Short Form 36 (known as the SF-36) is a well established, self-complete questionnaire which measures various aspects of health-related quality of life. Social class Social class is the term for any one of the subdivisions of the population made by the Office of Population Censuses and Surveys based on occupation. Five classes are recognised: I professional/self-employed; II administrative; III (non-manual) clerical, and (manual) skilled manual workers; IV semi-skilled; V unskilled. Social support Social support refers to the contact and support an individual receives from family and friends. Lack of social support is associated with an increased risk of CHD. Standardised mortality ratio The ratio of the number of events observed in a population to the number that would be expected if the population had the same structure as a standard or reference population. Statins Statins are the main type of drugs now used to reduce cholesterol levels. The National Service Framework for CHD recommends prescribing statins on discharge from hospital after a heart attack. Stress Stress can be any factor that threatens the health of the body or has an adverse effect on its functioning, such as injury, disease or worry. Work-related stress is one of a number of psychosocial factors which is associated with an increased risk of CHD. Stroke A stroke is the consequence of an interruption to the flow of blood to the brain. A stroke can vary in severity from a passing weakness or tingling of a limb to a profound paralysis, coma and death. Also see: haemorrhagic stroke; ischaemic stroke; subarachnoid haemorrhage; and unclassified stroke Subarachnoid haemorrhage A subtype of stroke that is a result of internal bleeding in the subarachnoid space (the area between the arachnoid membrane and the brain). Subarachnoid haemorrhage is coded as I60 by the International Classification of Disease Tenth Revision. Subdural Referring to the artificial space created by the separation of the outer membrane of the brain and spinal canal from the inner material. Systolic blood pressure When measuring blood pressure, systolic blood pressure is the highest pressure, which occurs when the beat or contraction of the heart forces the blood around the circulation. T Temporal trends Temporal trends are where data are compared over time. Thrombolysis Treatment to help dissolve a clot blocking an artery. Thrombolytic drug A drug used to dissolve a clot blocking an artery. Transient Ischaemic Attack (TIA) A condition caused by a brief delay in the blood supply to a particular area of the brain resulting in neurologic dysfunction that persists for less than 24 hours. It is often referred to as a mini stroke or TIA. Transient ischaemic attack is coded as G45.9 by the International Classification of Disease Tenth Revision. Transluminal embolisation A non-surgical procedure that aims to introduce a blockage to a specific artery in order to prevent internal bleeding. U Unclassified stroke A subtype of stroke classification that is used when it is not clear whether a haemorrhagic or ischaemic stroke has occurred. The symptoms for different forms of stroke are virtually identical and identification of stroke subtype is only possible via a CT scan or an autopsy. When neither procedure is necessary, the incident or mortality is coded as ‘unclassified stroke’. Unclassified stroke is coded as I64 by the International Classification of Disease Tenth Revision. United Kingdom The United Kingdom includes England, Northern Ireland, Scotland, and Wales. W WHO World Health Organization   Page last updated : 8th October 2009 Top © The British Heart Foundation | www.bhf.org.uk | Legal notice | Privacy Website by Baigent