Heart disease remains one of the leading causes of serious illness and death, often developing silently over many years before symptoms appear. By the time it is detected, the damage is frequently irreversible.

Pharmacist Thabo Lephalala of Medipost Pharmacy warns that many people are unaware of their risk until they experience a medical emergency such as a heart attack or stroke. He says the misconception that heart disease presents clear early warning signs is a major obstacle to prevention.

“Heart disease is often silent in its early stages. By the time symptoms appear, there may already be significant damage to the arteries,” Lephalala says, stressing the importance of early screening and proactive management.

Risk factors include age, genetics, high blood pressure, high cholesterol and lifestyle habits such as smoking. These contribute to damage of the arterial lining, which over time leads to plaque build-up — a combination of fat, calcium and inflammatory material that narrows and stiffens arteries.

If this plaque ruptures, it can cause a clot that blocks blood flow to the heart or brain, resulting in a heart attack or stroke.

Routine health checks, including blood pressure, cholesterol and blood glucose testing, can identify risks early. Lephalala notes that these simple screenings can detect warning signs long before serious complications develop.

Treatment can slow disease progression and, in some cases, partially reverse damage. Medications such as statins help stabilise plaque, while blood pressure drugs reduce strain on arteries. However, maintaining consistent treatment remains a challenge, with some patients discontinuing medication due to side effects or financial constraints.

“Consistency is what protects the heart over time,” Lephalala says, adding that simple measures such as pill organisers and regular communication with healthcare providers can improve adherence.

He emphasises that medication alone is not enough, and must be combined with lifestyle changes such as a healthy diet, regular exercise, quitting smoking and managing stress.

“Medication helps control the condition, but lifestyle changes address the cause. The two must work together,” he says.

While genetics play a role, many major risk factors — including poor diet, inactivity, smoking, excess weight and chronic stress — are within individual control. Small, consistent lifestyle adjustments, alongside early detection and treatment, can significantly reduce risk or improve outcomes.

Lephalala also cautions that supplements such as omega-3 fatty acids, coenzyme Q10, magnesium and vitamin D may offer supportive benefits, but should only be taken under medical supervision due to potential interactions with prescribed medication.

He concludes that heart disease is largely preventable with the right approach.

“With early detection, the right treatment and healthy lifestyle choices, people can protect their hearts and their lives.”