Heart disease - Your heart is trying to tell you something: are you listening?

Are you at risk of heart disease?

The cardiovascular disease threat

Everyone now knows that cardiovascular disease (CVD) is a scourge. Experts are actually putting forth the following alarming figures:

- One out of four Canadians (i.e. 8 million individuals) has some form of CVD.

- CVD is the leading cause of death in our country, killing approximately 80,000 Canadians per year.

- Eighty percent of Canadians have at least one CVD risk factor, and 11 percent have at least three.

- In Canada, CVD incurs healthcare costs of over 18 billion dollars per year.

- As a result of obesity and the toll it takes on the cardiovascular system, today's kids are the first generation whose life expectancy is shorter than that of its parents.

What is CVD exactly?

CVD is actually a rather general term that encompasses all diseases and lesions affecting the cardiovascular system, which includes both the heart and the vast network of blood vessels that irrigate your organs and body tissue. The role of the cardiovascular system is to distribute blood (which carries oxygen and nutrients) throughout the body. To do so, the heart functions as a pump to send blood to the arteries. These blood vessels send it to the various organs and tissue, thus feeding your body's billions of cells and allowing them to get rid of waste. Once these exchanges have taken place, the blood returns to the heart through other vessels called veins.

Healthy arteries are smooth and flexible, and blood can circulate through them easily. In the case of many types of CVD, however, the arteries harden or blood debris such as cholesterol starts to form on their inner walls, which hinders blood flow. This process, which is called atherosclerosis, is responsible for various CVDs. Among other things, atherosclerosis can cause thoracic pain (angina pectoris), myocardial infarctions (heart attacks) and strokes.

Several factors seem responsible for atherosclerosis, and these are what can predispose you to CVD. Thankfully, many of them are preventable.

Knowing your risk factors so you can prevent them

The main CVD risk factors are as follows:

- A family history of CVD: If a member of your immediate family has had (or currently has) CVD, you have a higher risk of also developing the disease. Unfortunately, you cannot change your genes, which means you have to take even more vigorous action on your other risk factors, if necessary.

- “Bad” cholesterol: Cholesterol is a fatty substance transported through the blood by a type of vehicle called lipoprotein. The two main types of lipoprotein are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is often called “bad cholesterol” because it tends to accumulate on artery walls, thus promoting the evolution of atherosclerosis. HDL, on the other hand, is often called “good cholesterol” because it helps bring cholesterol from the blood vessels back to the liver.

If your cholesterol level is too high, you’ll have to take certain measures to bring it down, for example by limiting your intake of cholesterol and fat, and especially of saturated fats and trans fats. It is sometimes necessary to take medication.

- Hypertension (high blood pressure): Hypertension is an important factor because it can double or even triple your CVD risk. A blood pressure measurement is shown as two figures (e.g. 120/80). The first number is higher and represents systolic pressure, in other words the pressure exerted when your heart contracts. The second number, which is lower, represents diastolic pressure – the pressure exerted by the blood when the heart is at rest. Blood pressure is considered “normal” when it is below 140/90 for the general population, and 135/85 in the case of individuals with diabetes, kidney disease or known CVD.

If your blood pressure is too high, lifestyle changes are necessary to avoid complications; examples include maintaining a healthy body weight, reducing your salt and alcohol intake, quitting smoking and doing regular physical exercise.

- Smoking: Smokers have a two to three times higher risk of developing CVD than non-smokers. The good news is that smoking cessation makes it possible to bring that risk back down to that of a non-smoker: less than two years after having quit, the CVD risk is cut by half, and after 10 to 15 years, it is identical to that of an individual who has never smoked.

- A sedentary lifestyle: It is estimated that inactive individuals are twice as likely to suffer from CVD as those who are active. That’s because physical activity helps maintain a healthy body weight and normal cholesterol levels, reduces the risk of hypertension and diabetes, and helps manage stress. For these reasons, it is recommended that at least 30 minutes of moderate-intensity exercise be worked into our daily schedule on most days of the week.

- Being overweight or obese: Obesity has become a real epidemic. It predisposes individuals to CVD because it is associated with high cholesterol levels and because it increases the risk of hypertension and diabetes.

Research shows that excess fat located around the waist is much more dangerous that the fat around the hips and thighs. So watch your waistline and beware of the dreaded “beer belly”!

The best way to reach and maintain a healthy body weight is to eat well and move a lot. Make sure you eat enough fruit and vegetables (at least 5 portions per day), choose whole grain bread products, limit your saturated fat intake, and avoid very sugary foods.

- Diabetes: Diabetes is a chronic disease that can have adverse consequences on the heart and blood vessels. To reduce these risks, optimal disease management is essential: measure your blood glucose often, take your medication as prescribed, and watch your diet and your weight. Cases of well-controlled diabetes are associated with much fewer complications and with a better quality of life.

Reducing your CVD risk

Many CVD risk factors are modifiable. It’s never too late to improve our cardiovascular health, even when you have diabetes, for example. The best way to succeed is to change certain lifestyle habits that have led us to gain a few pounds over the years and that have stopped us from taking the bicycle out of the tool shed for the past five years.

Have you tried recently to…

- take the stairs instead of the elevator?

- reduce the number of hours spent in front of the television in order to go play outside with the kids or take a walk with your friends?

- reduce the portions you eat at each meal?

- reduce your alcohol consumption?

- stop smoking?

- buy lower-fat dairy products and leaner meat cuts?

- resist adding salt to your food at the table?

These are simple little tricks you can try integrating on a daily basis. Gradually add them to your routine, your heart will thank you!