Key Risk Factors and Treatments for Heart Disease

Today, cardiovascular diseases (CVD’s) have become the leading cause of mortality throughout the world. Even though America is one of the most developed countries in the world, it still has difficulties finding a cure to stop this deadly disease. According to the Centers for Disease Control and Prevention, “heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States.” From 2014 to 2015, heart disease cost the United States about $219 billion. This included the cost of healthcare services, medicines, and lost productivity due to death. About 18.2 million adults aged 20 and older have coronary heart disease (CHD), the most frequent heart disease that occurs. Some key risk factors for heart disease are high blood pressure, high blood cholesterol, and smoking.

High blood pressure increases the risk for heart disease and many either don’t know they have it or do not have it under control. Uncontrolled high blood pressure is a measured systolic blood pressure of 140 mm Hg or more, or diastolic blood pressure of 90 mm Hg or more. People defined as having uncontrolled high blood pressure may or may not be on medication. Preventing high blood pressure, which is also called hypertension, can lower your risk for heart disease. A few ways to lower your risk are having a healthy diet, keeping yourself at a healthy weight, being physically active, not smoking, limiting alcohol intake, and getting enough sleep.

The second key risk factor for heart disease is high cholesterol, nearly 1 in 3 American adults has high cholesterol. High cholesterol has no signs or symptoms, so the only way to know if you have it is to get your cholesterol checked. The Centers for Disease Control and Prevention states, “Strong evidence shows that eating patterns that include less dietary cholesterol is associated with reduced risk of cardiovascular disease, but your overall risk depends on many factors.” They also said “Certain health conditions, your lifestyle, and your family history can raise your risk for high cholesterol.” It may be true you can’t control factors, such as your age or your family history, but you can take steps to lower your risk for high cholesterol by changing things you can control. As cholesterol (plaque) builds up in the arteries, the arteries begin to narrow, which lessens or blocks the flow of blood.

Smoking is another risk factor that is linked to heart disease. The U.S. Food & Drug Administration states, “...when you breathe in cigarette smoke, the blood that is distributed to the rest of the body becomes contaminated with the smoke’s chemicals. These chemicals can damage your heart and blood vessels, which can lead to cardiovascular disease (CVD).” Cigarette smoke can also cause CVD by changing your blood chemistry, and causing plaque to build up in the arteries. This can create blood clots and ultimately lead to a heart attack or even death. The chemicals in tobacco smoke harm your blood cells. They can also damage the function of your heart and blood vessels, the structure of the blood vessels may also be harmed.

If someone does end up having heart disease, there are a few surgeries that may help fix the problem before it gets worse. The typical heart surgery performed for heart disease is Coronary Artery Bypass Grafting (CABG), it gets the blood flowing normally to the heart again. In this surgery, a healthy vein or artery from somewhere in the body is grafted (connected), to the coronary artery that’s blocked. The grafted artery/vein is guided around the blocked portion of the coronary artery to create a new path for the heart muscle to receive blood flow and normalize. However, for some people, this surgery doesn’t always work after one time. Another option for the patient may be Transmyocardial Laser Revascularization or TMR. During TMR, small channels are made with lasers to go through the heart muscle and into the heart's lower left chamber. If someone’s leaflets, a set of flaps in each valve, don’t open as wide as they should or don’t close tight enough, heart valve repair or replacement is done. A cardiologist will insert a catheter through a larger blood vessel and guide it to the heart to repair a mitral or pulmonary valve that's too narrow. Some people may have arrhythmias but if the medication doesn’t work, surgery may be used to implant a cardioverter-defibrillator or a pacemaker in the patient's body. Another arrhythmia treatment is called maze surgery. For this surgery, the surgeon needs to make new paths for the heart's electrical signals to travel through. This type of surgery is used to treat atrial fibrillation. In some very harsh, life-threatening cases, a heart transplant may need to be done. Removing a person's diseased heart and replacing it with a healthy heart from a deceased donor is called heart transplant surgery, this is only done if the person has had end-stage heart failure. Surgeons have access to three different ways to operate on the heart, those are open-heart surgery, minimally invasive heart surgery, and off-pump heart surgery.

Treatments for heart disease normally include lifestyle changes, medications, and medical procedures or surgeries as listed above. There are ways to improve or even prevent heart disease right at home. Quitting smoking, controlling your blood pressure, checking your cholesterol, keeping your diabetes under control, moving, eating healthy, maintaining a good weight, managing stress, dealing with depression, and practicing good hygiene are all ways to lower your risk of heart disease. It’s good to exercise to maintain your weight and still control those factors, such as diabetes, blood pressure, and cholesterol. A heart-healthy diet consists of fruits, vegetables, and whole grains that are low in saturated fat, cholesterol, sodium, and added sugars. Eating healthy will also help you maintain a healthy weight, a BMI of less than 25 is the goal. Having major stress can put pressure on you, this is why it’s important to manage that stress. When the stress isn’t managed, depression can occur and your risk is increased by a lot. The best way to deal with heart disease is to watch your health and keep your hygiene good. It’s always great to get regular medical checkups because early detection and treatment mean a better heart!

One of the treatments used for heart disease is medication. The use of these medications has saved/prolonged lives and improved the heart’s function. There are many types of drugs, such as Angiotensin-Converting Enzyme (ACE) Inhibitors, Angiotensin II Receptor Blockers (or Inhibitors), Angiotensin-Receptor Neprilysin Inhibitors (ARNIs), Channel Blocker (or inhibitor), Beta Blockers, Aldosterone Antagonists, Hydralazine and isosorbide dinitrate, and Diuretics. Some less commonly used drugs include blood thinners, statins, and Digoxin. Some of these medications could be prescribed to a patient if they’ve had a heart attack. The patient may have to take these drugs for the rest of their lives. Medications can be combined to treat CAD, but a doctor will decide what’s the best treatment option. Most people with coronary artery disease are treated with aspirin for their whole life.

Heart disease can be genetic, so if you’re aware that someone in your family had or has it then it’s good to make lifestyle changes before it starts or worsens. Some lifestyle changes might include no smoking, choosing good nutrition, lowering your high blood pressure, being physically active every day, aiming for a healthy weight, managing diabetes, reducing stress, and limiting alcohol. One of the best weapons to fight cardiovascular disease is a healthy diet. Your diet controls other risk factors such as cholesterol, blood pressure, diabetes, and weight. It’s more beneficial to choose foods which have vitamins, minerals, fiber, and nutrients low in calories. It’s also important to include vegetables, fruits, and whole grains in your meal. Limit sweets, sugar-sweetened beverages, and red meats. While having a good diet, you also need to be physically active. The amount of exercise needs to be coordinated with the diet so the calories taken in are being used up.

These lifestyle changes do make a huge impact on a person’s risk for heart disease. Harvard Health Publishing states, “In a study analyzing over 55,000 people, those with favorable lifestyle habits such as not smoking, not being obese, engaging in regular physical activity, and eating a healthy diet lowered their heart disease risk by nearly 50%.” Consumption of light to moderate alcohol may be good, but excess alcohol increases the risk for death, heart disease, and liver disease. This also contributes to high cholesterol, everything interlinks with the other creating a bigger risk. A lot of research shows that reducing saturated fat and replacing it with polyunsaturated fat may lower your risk. Many may ask how much exercise they need and the Physical Activity Guidelines for Americans say all adults ages 18 to 64 need at least 150 minutes of moderate aerobic or 75 minutes of vigorous aerobic activity per week. Activities like brisk walking, running, swimming, biking, and other aerobic exercises are all great ideas.

Cardiovascular diseases are a rising problem in the United States, but surgeries, treatments, and lifestyle changes are all options to lower your risk. However, it’s critical to watch your health, diet, and exercise to prevent heart disease before it can even start and get worse.