The Paradox of Heart Disease - How to Develop Your Personal Strategy

When it comes to improving your vital longevity it is essential that you have a strategy to avoid the complications of atherosclerosis, the underlying disease process that causes heart disease and stroke.

Heart disease and stroke are the second and third leading causes of death behind cancer accounting for approximately 25% of all deaths in Canada.  Worse heart disease alone is the number one cause of life years lost.

It is estimated that 50% of middle age men and 33% of middle age women will develop some manifestations of heart disease in their lifetimes.

The INTERHEART study found that the top nine risk factors account for 90% of the related risk:

• Smoking
• High cholesterol
• High blood pressure
• Diabetes
• Abdominal obesity
• Psycho-social factors
• Low consumption of fruits and vegetables
• Regular alcohol consumption
• Physical activity

What is notable is that all of these risk factors are potentially modifiable - in other words 90% of heart disease risk is preventable.  

The challenge is that only 1 in 10 Canadians are in ideal heart health and over 90% of Canadians have at least one risk factor.

Digging further, smoking and high cholesterol account for almost two thirds of the risk - and their importance is highlighted by correlation of declining smoking rates and improved cholesterol management with decreasing incidence of diagnosed heart disease as well as a decreasing incidence of first heart attack observed over the past 30 years.

Atherosclerosis is a chronic disease that begins at birth and progresses throughout life (fatty streaks, the earliest sign of developing fatty plaques are seen in fetal autopsies).  

As a result the single greatest risk factor is age.  

The longer you live the more likely you are to develop complications of atherosclerosis.

Here is the paradox of heart disease:

• The process that causes it, atherosclerosis is ubiquitous (meaning we all have some degree of it)

​BUT

• The risk factors for actual disease and preventable

If you want to live a long and heart disease free life, you need to have an active strategy to avoid or manage these risk factors.

The place to start is to assess your risk:

• Do you smoke?
• What is your LDL-Cholesterol level?
• What is your blood pressure?
• Do you have normal blood glucose levels?
• Do you have any sign of insulin resistance (the process underlying Type II Diabetes)?
• What is your waist circumference?
• How are your stress levels?
• Are you eating >5 portions of fruits and vegetables per day?
• Do you drink more than 5 drinks per week?
• Do you get more than 150 minutes of moderate to vigorous exercise a week?

Once you have this information, put the data into one of the cardiovascular risk calculators like Framingham.  This will give you the % risk of having a cardiac event in the next 10 years, as well as comparisons between your age/gender average and optimal (all risk factors optimally managed).

The process of doing this will help you get started in taking control of your your health:

• If you smoke - seek help for smoking cessation
• If your cholesterol is high - change your lifestyle, if it is still high consider a medication
• If your blood pressure is high - change your lifestyle, if it is still high consider a medication
• If you have diabetes - seek to reverse it
• If you have abdominal obesity - recognize that you likely have insulin resistance, the process underlying Type II Diabetes and seek to reverse it
• If you are stressed - develop strategies to manage stress
• If you are not eating enough fruits and vegetables - overhaul your diet, learn to cook
• If you are drinking too much - change your lifestyle, and seek help
• If you are not physically active - change your lifestyle and develop a fitness plan

If you need help doing this assessment and developing your strategy,  we can help.

Our Precision Health Tune Up’s start with a Comprehensive Lifestyle Medical Assessment, where we review your key biomarkers, medical history and lifestyle behaviours known to impact health.  Included in this is a full cardiovascular risk assessment, along with recommendations for change, additional investigations and or follow-up.

From the medical assessment, our team can help you implement the recommendations through a TARGET Nutrition Plan, a TARGET Fitness Plan or a Comprehensive Plan encompassing both nutrition and fitness.

Finally a plan is only as good as its implementation,  and here our six month digital coaching program (myhealthjourney.ca) and team-based support will help you get started, make the changes and fine tune your strategy.

Other Posts on Heart Disease:

• Atherosclerosis Part I
• Atherosclerosis Part II
• Evolution Gave Us Heart Disease. We’re Not Stuck With It.
• High Blood Pressure - 7 ways to take control​
• Is Saturated Fat Bad For You?​
• Guide to Fats
  
• 7 Numbers You Should Know About Your Health