Managing cardiovascular risk factors to live a heart-healthy life

NATION — Cardiovascular disease (CVD) refers to a number of health conditions that affect the circulatory system, including the heart, arteries, veins, and capillaries. The treatment, symptoms, and prevention of the conditions that are part of CVD often overlap.
CVD is now the most common cause of death worldwide. However, there are many ways to reduce the risk of developing these conditions. There are also many treatment options available if they occur.
Types
CVD comprises many different types of condition. Some of these might develop at the same time or lead to other conditions or diseases within the group.
Diseases and conditions that affect the heart include:
angina, a type of chest pain that occurs due to decreased blood flow into the heart
arrhythmia, or an irregular heartbeat or heart rhythm
congenital heart disease, in which a problem with heart function or structure is present from birth
coronary artery disease, which affects the arteries that feed the heart muscle
heart attack, or a sudden blockage to the heart’s blood flow and oxygen supply
heart failure, wherein the heart cannot contract or relax normally
dilated cardiomyopathy, a type of heart failure, in which the heart gets larger and cannot pump blood efficiently
hypertrophic cardiomyopathy, in which the heart muscle walls thicken and problems with relaxation of the muscle, blood flow, and electrical instability develop
mitral regurgitation, in which blood leaks back through the mitral valve of the heart during contractions
mitral valve prolapse, in which part of the mitral valve bulges into the left atrium of the heart while it contracts, causing mitral regurgitation
pulmonary stenosis, in which a narrowing of the pulmonary artery reduces blood flow from the right ventricle (pumping chamber to the lungs) to the pulmonary artery (blood vessel that carries deoxygenated blood to the lungs)
aortic stenosis, a narrowing of the heart valve that can cause blockage to blood flow leaving the heart
atrial fibrillation, an irregular rhythm that can increase the risk of stroke
rheumatic heart disease, a complication of strep throat that causes inflammation in the heart and which can affect the function of heart valves
radiation heart disease, wherein radiation to the chest can lead to damage to the heart valves and blood vessels
Vascular diseases affect the arteries, veins, or capillaries throughout the body and around the heart.
They include:
peripheral artery disease, which causes arteries to become narrow and reduces blood flow to the limbs
aneurysm, a bulge or enlargement in an artery that can rupture and bleed
atherosclerosis, in which plaque forms along the walls of blood vessels, narrowing them and restricting the flow of oxygen rich blood
renal artery disease, which affects the flow of blood to and from the kidneys and can lead to high blood pressure
Raynaud’s disease, which causes arteries to spasm and temporarily restrict blood flow
peripheral venous disease, or general damage in the veins that transport blood from the feet and arms back to the heart, which causes leg swelling and varicose veins
ischemic stroke, in which a blood clot moves to the brain and causes damage
venous blood clots, which can break loose and become dangerous if they travel to the pulmonary artery
blood clotting disorders, in which blood clots form too quickly or not quickly enough and lead to excessive bleeding or clotting
Buerger’s disease, which leads to blood clots and inflammation, often in the legs, and which may result in gangrene
It is possible to manage some health conditions within CVD by making lifestyle changes, but some conditions may be life threatening and require emergency surgery.
Symptoms
Symptoms will vary depending on the specific condition. Some conditions, such as type 2 diabetes or hypertension, may initially cause no symptoms at all.
However, typical symptoms of an underlying cardiovascular issue include:
pain or pressure in the chest, which may indicate angina
pain or discomfort in the arms, left shoulder, elbows, jaw, or back
shortness of breath
nausea and fatigue
lightheadedness or dizziness
cold sweats
Although these are the most common ones, CVD can cause symptoms anywhere in the body.
Lifestyle tips
People can take the following steps to prevent some of the conditions within CVD:
Manage body weight: The National Institute of Diabetes and Digestive and Kidney Disorders advise that if a person loses 5–10% of their body weight, they may reduce their risk of developing CVD.
Get regular exercise: The American Heart Association (AHA) recommend doing 150 minutes of moderate-to-intense physical activity every week.
Follow a heart-healthy diet: Eating foods that contain polyunsaturated fats and omega-3, such as oily fish, alongside fruits and vegetables can support heart health and reduce the risk of CVD. Reducing the intake of processed food, salt, saturated fat, and added sugar has a similar effect.
Quit smoking: Smoking is a key risk factor for almost all forms of CVD. Although quitting can be difficult, taking steps to do so can drastically reduce its damaging effects on the heart.
Treatment
The treatment option that is best for a person will depend on their specific type of CVD. However, some options include:
medication, such as to reduce low density lipoprotein cholesterol, improve blood flow, or regulate heart rhythm
surgery, such as coronary artery bypass grafting or valve repair or replacement surgery
cardiac rehabilitation, including exercise prescriptions and lifestyle counseling
Treatment aims to:
relieve symptoms
reduce the risk of the condition or disease recurring or getting worse
prevent complications, such as hospital admission, heart failure, stroke, heart attack, or death
Depending on the condition, a healthcare provider may also seek to stabilize heart rhythms, reduce blockages, and relax the arteries to enable a better flow of blood.
Risk factors
Researchers reported in the journal JAMA that the lifetime risk of CVD is more than 50% for both men and women. Their study paper notes that even among those with few or no cardiovascular risk factors, the risk is still higher than 30%.
Risk factors for CVD include:
high blood pressure, or hypertension
atherosclerosis or blockages in the arteries
radiation therapy
smoking
poor sleep hygiene
high blood cholesterol, or hyperlipidemia
diabetes
a high fat, high carbohydrate diet
physical inactivity
obesity
sleep apnea
excessive alcohol consumption
stress
air pollution
chronic obstructive pulmonary disorder or other forms of reduced lung function
People with one cardiovascular risk factor often have more. For example, obesity is a risk factor for high blood pressure, high blood cholesterol, and type 2 diabetes. A person may have all four conditions at the same time.
Causes
Many types of CVD occur as a complication of atherosclerosis. Damage to the circulatory system can also result from diabetes and other health conditions, such as a virus, an inflammatory process such as myocarditis, or a structural problem present from birth (congenital heart disease).
CVD often results from high blood pressure, which produces no symptoms. It is therefore vital that people undergo regular screening for high blood pressure.
Prevention
Many types of CVD are preventable. It is vital to address risk factors by taking the following steps:
reducing the use of alcohol and tobacco
eating fresh fruit and vegetables
reducing salt, sugar, and saturated fat intake
avoiding a sedentary lifestyle, particularly for children
Adopting damaging lifestyle habits, such as eating a high sugar diet and not getting much physical activity, may not lead to CVD while a person is still young, as the effects of the condition are cumulative. However, continued exposure to these risk factors can contribute to the development of CVD later in life.
Does aspirin protect a person from CVD?
Many people will have taken an aspirin a day as a routine measure to protect against CVD. However, current guidelines no longer recommend this for most people, as it can lead to bleeding. This risk outweighs any benefit it may have.
That said, a doctor may suggest aspirin if a person has a high risk of experiencing a cardiovascular event, such as a heart attack or stroke, and a low risk of bleeding. Doctors may also recommend it to those who have already had a heart attack or stroke.
Anyone taking a daily dose of aspirin to reduce their risk of CVD should ask their doctor whether or not they should continue.
Statistics
According to the World Health Organization (WHO), CVD is the leading cause of death worldwide.In 2016, around 17.9 million people died from CVD, accounting for 31% of all registered premature deaths. Of these, 85% resulted from a heart attack or stroke. These conditions affect equal numbers of men and women.
The WHO estimate that by 2030, 23.6 million people will die from CVD conditions annually — mostly due to stroke and heart disease. Although these conditions remain prevalent in global mortality rates, people can start taking steps to prevent them.
Q: Can I receive regular screenings to prevent CVD if I have no symptoms?
A: Yes. Everyone, even those with no symptoms, should receive regular screenings for CVD, starting from the age of 20 years.
The frequency of screening and the type of screening will depend on the current risk factors and any other medical problems. Discuss screening with a doctor, as it’s never too early to start.
—Adam Felman