Like a bear shaking off the sleep of hibernation, most of us are ready to shake off the effects of winter and embrace the change of Spring. Warmer weather encourages us to leave our “caves” and venture into the great outdoors. With so much change around us, Spring often triggers us to make personal changes also. It’s estimated that globally wellness is approximately a $4 trillion industry (source: PolicyAdvice.net). For many of us Spring seems like an appropriate time to invest in our own health and wellness. Yet health and wellness can include everything from healthcare services to spirituality to personal care and beauty products. With such a broad scope, where does one begin?
For the purpose of this writing, we will examine the leading cause of death in the US: cardiovascular disease. Heart health is something we should all consider worthy of our attention as the first sign of heart disease for many of us will be sudden death. The Cleveland Clinic estimates:
- Fifty percent of all heart disease-related deaths are sudden cardiac deaths;
- Sudden cardiac death is most frequent between the ages of 35 – 45; and
- Sudden cardiac death is twice as likely to happen to men.
Protecting one’s heart is a reasonable thing to do. Additionally, protecting one’s heart has the added benefit of reducing risks for other chronic illnesses like diabetes. Reducing cardiovascular risk factors can serve as a guide to cardiovascular wellness. Remember there are risk factors that cannot be changed and risk factors that can be changed.
Risk Factors that cannot be changed.
1. Age. The older you are the greater your risk of heart disease.
2. Gender. Men tend to have heart disease more frequently than women. Men also tend to have heart disease earlier in life than women. NOTE: Women do have an elevated heart disease risk after menopause, but risk remains lower than for men at the same age.
3. Heredity. Children of parents diagnosed with heart disease tend to inherit the parent’s elevated risk.
4. Ethnicity. Individuals of African, Mexican, native American, native Hawaiian, and Asian ethnicity tend to have elevated risks of heart disease.
Risk Factors that can be changed.
1. Tobacco smoke. People who smoke have a significantly higher risk of developing heart disease than those who do not smoke. Each cigarette smoked increases blood pressure while smoking and for an extended time after the smoking session. This increased risk is shared by those who experience second-hand smoke. When persons stop smoking, blood pressure begins to return to normal shortly after.
2. High blood cholesterol. As cholesterol increases, so does cardiovascular disease risk. The identification of multiple types of blood lipids (or fats), some cholesterol being labeled good and another bad, and the different target numbers can be confusing. Consider the following:
- Triglycerides are the most common type of fat in the body. That being said, high triglyceride levels are associated with poor outcomes including heart disease. Triglyceride target levels vary by gender and age although <150 mg/dL is considered healthy. An individual target level should be determined by a primary care provider.
- LDL cholesterol. Low-Density Lipoprotein cholesterol is “bad” cholesterol. LDL cholesterol is best when “low” or <100 mg/dL. Diets higher in saturated fats and trans-fats can actually raise the LDL cholesterol.
- HDL cholesterol. High-Density Lipoprotein cholesterol is best when “high” or >40 mg/dL. High levels of HDL cholesterol are associated with healthier cardiovascular outcomes. Genetic factors, Type 2 diabetes, smoking, being overweight and sedentary lifestyles contribute to lower HDL cholesterol levels. Regular physical activity is associated with higher HDL cholesterol levels.
- Total cholesterol. Total cholesterol is best when low or <200 mg/dL. Total cholesterol is a combination of blood lipids and calculated from this equation:
HDL + LDL + 20% of Triglycerides = Total Cholesterol
3. High blood pressure. When blood pressure is high, it pushes blood out against the walls of blood vessels and arteries. This creates an excess workload on the heart and other vital organs the blood flows through. High blood pressure is associated with stroke and kidney failure, in addition to heart disease. Recommendations to lower blood pressure include a heart healthy diet, being physically active, smoking cessation, alcohol in moderation, and maintaining a healthy weight or weight loss.
4. Sedentary lifestyle. An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate to vigorous physical activity helps reduce the risk of cardiovascular disease. Physical activity can help control blood cholesterol, diabetes and obesity. It can also help to lower blood pressure after the activity..
5. Excess weight — especially central adiposity. Weight loss has been identified as one of the most effective ways to lower blood pressure. Even a 5% weight loss has improved blood pressure, cholesterol, and blood glucose control. Additionally, “where” the weight is located makes a difference in overall heart health. Central adiposity, or waistline level weight is associated with a greater risk of poor cardiovascular outcomes. In general:
- Men have elevated risk if a waist measurement is greater than 40 inches (102 centimeters).
- Women have elevated risk if a waist measurement is greater than 35 inches (89 centimeters).
- Target waist circumference numbers vary between ethnic groups. A primary care physician can provide guidance for desired individual waist circumference.
6. Diabetes. A diagnosis of diabetes elevates risk of a cardiovascular event to a level equivalent to that of a person who has already had a cardiovascular event. When blood glucose levels are not well-controlled, the risks of having a cardiovascular event or stroke are even higher.
7. Stress. Elevated stress is frequently associated with cardiovascular events. Science is not certain how much stress contributes to a heart disease. What is known is stress makes smoking cessation, weight loss, and practicing a healthy diet more difficult, thereby increasing risk factors.
8. Alcohol. One of the more confusing risk factors is alcohol intake. Too much alcohol can increase blood pressure, weight, and triglycerides. Additionally, high alcohol intake increases risk of cardiomyopathy, stroke, cancer, and other undesired health conditions.
Alcohol as a risk factor is complicated by evidence demonstrating light or moderate drinking of red wine contributes to a cardio-protective effect. The emphasis on the quantity of red wine consumed is limited to 5 ounces of wine a day. It should also be remembered that it’s the flavonoids and other antioxidants credited with reducing cardiovascular disease risk – not the alcohol. These micronutrients can also be acquired from fresh red grapes and blueberries or their fruit juices.
9. Diet. A heart healthy diet is one of the best behaviors to adopt in the fight against cardiovascular risk factors. The heart healthy meal plan is described as:
- Low fat meats and other foods.
- Low fat cooking methods.
- Low sodium flavor enhancers.
- High fiber.
- Carbohydrate controlled (not only do you reduce cardiovascular risk, but you also reduce diabetes risk).
A wellness plan that includes a heart healthy diet will address: fat, cholesterol, sodium and can support weight loss.
Cardiac health is the cornerstone to wellness. Other wellness practices do little good if they do not promote heart health and wellness. Wherever you want to go in life, protecting the heart along the way is good advice. It takes a plan and commitment. Hope or luck are not strategies for success. Talk to your primary care provider for additional guidance.