World Heart Day: What are the most important factors for prevention & heart health

World Heart Day has been celebrated every year on September 29^th , since 2011, and it reminds us of the danger posed by Cardiovascular Disease (CVD), also called the world's biggest killer, because, conditions affecting the heart and blood vessels such as myocardial infarctions, vascular strokes and heart failure kill more than 20. 5 million lives every year altogether.

The heart has the size of a fist and it is the strongest muscle in the body. It starts beating about 3 weeks after the embryo is conceived and by the time it reaches the age of 70 it will have beaten 2.5 billion times! However, despite its impressive structure, our heart is vulnerable to common risk factors such as smoking, diabetes, hypertension, high cholesterol, an unhealthy diet and a sedentary lifestyle.

Statistically speaking, it is estimated that nearly 80% of early deaths, coming from CVD, could have been prevented. How? By making small changes in our daily lives, on what we eat and drink, how much we exercise and how we deal with daily stress and anxiety.

Risk factors and how they are modified

There are many risk factors, associated with coronary heart disease and vascular strokes and some of them, such as heredity and family history, cannot be modified, while other factors, such as high blood pressure, can be modified with appropriate treatment. The more risk factors that are present, the greater the chances of developing cardiovascular disease unless they are treated early and appropriately.

Diabetes mellitus (DM)

One in eleven adults suffer from DM, adding up to 425 million people worldwide and these unfortunately are twice as likely to develop and end up with CVD. The vast majority of these, 90%, suffer from type 2 DM and the risk on developing cardiovascular health lies on the fact that DM damages blood vessel and nerve function in the body and usually co-exists with other risk factors such as hypertension, high cholesterol and obesity and cumulatively increase the chances of cardiovascular disease. It is estimated that worldwide 212.4 million people, or half of the entire population of those aged, between 20-79 years, with DM are unaware of their condition and they are at increased risk of developing CVD.

High cholesterol

Cholesterol is produced in the liver and it is necessary for the hormone production and other useful components of our body, but we also take it in from our food and when it is in excess, it can lead to narrowing or blockage of the arteries, resulting in coronary heart disease and other ischemic diseases. We can and do measure our cholesterol only with blood tests.

Elevated cholesterol is estimated to be responsible for 2.6 million deaths (4.5% of the total) and it is implicated in cardiovascular disease. When cholesterol builds up on the walls of arteries it is referred to as cholesterol plaque.

Total cholesterol consists of two types, high-density-good (HDL) and low-density-bad (LDL) lipoproteins and the ratio of good to bad determines the risk of developing CVD. A 2008 study found that in economically developed countries, more than 50% of adults present elevated levels of total cholesterol, almost double the percentage, estimated at the population of economically poorer countries.

It is believed that LDLs are the vehicle by which cholesterol circulates in our body and its excess forms plaques that narrow arteries, reduce blood flow or even rupture and cause myocardial infarctions and/or strokes. Good cholesterol (HDL) collects cholesterol from the body and carries it to the liver for catabolism (breakdown).

All scientific recommendations point towards maintaining a healthy body weight, incorporating exercise into our daily lives and quitting smoking as ways to counteract the damaging effect of high cholesterol on the body. Our eating habits play a key role in maintaining a healthy heart, but our daily habits and heredity also play a major role in this.

Also, triglycerides comprise another type of dietary fats that can increase excessively due to high consumption of fats and sugar and can also block arteries over time, so they also need monitoring with proper blood tests.

Smoking

Globally more than 1 in 10 deaths from CVD are due to smoking and about 1.2 million deaths are due to exposure to smoking and 80% of adult deaths from second-hand smoke are due to CVD. Smoking not only causes lung diseases and malignancies, but also increases the risk of CVD, especially in female smokers who are 25% more at risk of CVD than men. The devastating effects of smoking include damaging blood vessels, causing arterial hypertension and weakening the body to exercise. It reduces oxygen transport within the blood and increases the risk of intravascular clot formation, which can cause heart attack, stroke and sudden death. The risk of non-fatal heart attack increases by 5.6% for every cigarette smoked and persists even with 1-2 cigarettes a day.

Encouragingly, in smokers who quit at age 66, men gained 2 years of life and women gained 3.7 years of life. Stopping smoking helps to normalize blood pressure and heart rate, save family finances and reduce the exposure of family members to second-hand smoke, particularly the most vulnerable, such as children and pregnant women. After one year of smoking cessation, the risk of developing coronary heart disease is half that of a smoker and after 15 years is equal to that of a non-smoker.

Sedentary life and arterial hypertension

It has been estimated that about 150 minutes of moderate physical activity per week reduces the risk of cardiovascular disease by 30% and the risk of developing DM by 27%. Physical activity should be combined with the promotion and adoption of basic healthy eating principles, such as reducing salt consumption with diligent blood pressure control and eliminating trans-fatty acids.

Scientific Sources

World Heart Federation (WHF)

World Health Organization (WHO)