Heart and vascular disease

Cardiovascular disease accounts for approximately 33% of total mortality in the Netherlands and is the main cause of death. However, the number of deaths from cardiovascular disease has decreased since 1972. The three most important risk factors for the development of cardiovascular disease are: high (serum) cholesterol levels, high blood pressure and cigarette smoking. In addition, obesity, a high fibrinogen level (clotting factor of the blood), physical inactivity, an incorrect composition of the diet, high alcohol consumption, a low socio-economic status and psychosocial factors such as stress.

Cholesterol level

People with high LDL cholesterol levels have two to three times the risk of cardiovascular disease than people with normal levels. In practice, the total cholesterol level is usually used as an indication that the LDL cholesterol level has increased.

Total cholesterol


Lower than 5 mmol/l


Between 5 and 6.5 mmol/l

slightly increased

Between 6.5 and 8 mmol/l


Higher than 8 mmol/l

Strongly increased

HDL cholesterol transports excess cholesterol to the liver. The removed cholesterol ends up in the intestines via the liver and will leave the body through the feces. HDL cholesterol is therefore called good cholesterol. The HDL cholesterol level in the blood must be kept relatively high. A low HDL cholesterol level (less than 0.9 mmol/l) increases the risk of cardiovascular disease. HDL cholesterol levels can be increased by physical activity, moderate amounts of alcohol, losing weight if you are overweight and quitting smoking.

High bloodpressure

People with high blood pressure are more likely to die from cardiovascular disease than people with normal blood pressure. Blood pressure is high if the upper pressure is greater than 140 mm Hg, or if the negative pressure is higher than 90 mm Hg. Your doctor may prescribe medication or you can adjust the following in your lifestyle. Quitting smoking, moderation of alcohol consumption, diet, limiting sodium (salt) consumption, exercise and weight loss. Relaxation in daily life can also help to lower your blood pressure.


Smoking mainly involves smoking cigarettes. Inhalation is an unfavorable factor, as are the greater absorptions of carbon monoxide in the blood. CO is also inhaled when inhaling the smoke of others (passive smoking). More than 40% of deaths from heart disease can be attributed to smoking. Smoking is a main factor that increases the fibrinogen level in the blood. Fibrinogen is an essential part of the process of blood clotting. Smokers therefore have an increased risk of forming blood clots in the veins.


An energy intake that is greater than energy expenditure will clearly lead to obesity over time. Being overweight is an important risk factor for cardiovascular disease. The effect of being overweight is partly due to another risk factor, namely an unfavorable ratio between HDL and LDL cholesterol, higher blood pressure and reduced glucose tolerance. Men and women who have a BMI of 30 or higher are more likely to develop cardiovascular disease than people with a normal BMI value.

Physical activities

Physical activity makes a direct contribution to the prevention of cardiovascular disease. In addition, physical activity has a beneficial effect on obesity, diabetes mellitus and has an effect on HDL cholesterol levels. Physical activity in this case is described as being active for half an hour at least 3 to 5 times a week with activities such as swimming, cycling, jogging or brisk walking.

Incorrect composition of the diet

An incorrect composition of the fat in the diet, namely too much saturated fat, trans fatty acids and too little unsaturated fat, leads to an increase in cholesterol levels.

High alcohol consumption

Moderate alcohol consumption (1 – 2 glasses per day) can lower cholesterol by causing an increase in HDL levels. With higher alcohol consumption, the risk of cardiovascular disease is greatly increased, because alcohol has a blood pressure-raising effect.

A low socio-economic status

A clear relationship has been established between socio-economic status (SES) and the risk of cardiovascular disease. Research has shown that the risk of dying from cardiovascular disease in people with the lowest SES is 3 to 6 times higher than the highest social category. It has been found that all the most important risk factors are more present in people with a low socio-economic status. Psychosocial factors such as stress in the family or in the workplace that are accompanied by little physical exertion are seen as unsettling factors.

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