Risky Business

Risky Business

It can be hard to avoid risk factors for heart disease, but it pays to give it a try

Cardiovascular diseases (CVD) remain the number one killer in North America. These diseases, which encompass illnesses concerning the heart and blood vessels, include heart attack, stroke, angina pectoris, atherosclerosis and arteriosclerosis, and high blood pressure.

In the United States in 1994, CVD claimed 954,720 lives-representing nearly half (41.8 percent) of all deaths-making it by far the worst scourge we have. The next three highest killers-cancer, accidents, and AIDS-accounted for a total of 668,930 deaths. (536,860; 90,140; and 41,930 deaths, respectively.)

According to current estimates, 57,490,000 United States' citizens have one or more forms of CVD.

Things are not any better in Canada. In 1992, cardiovascular disease accounted for 38 percent of all Canadian deaths. Cancer accounted for approximately 28 percent, and all other deaths accounted for 34 percent.

Clearly, North America has a problem.

The sad thing is that these figures do not have to be as high as they are. CVD is a killer, but it is a killer that can be controlled through lifestyle. If North Americans would pay more attention to the risk factors for CVD, and act accordingly, we could see these statistics plummet.

Risk factors

Although different organizations define and categorize risk factors somewhat differently, they all acknowledge three general categories: risk factors that cannot be changed and primary and contributing risk factors that can be changed.

Reducing Risk Although we cannot change our age, sex, or heredity, we can pay attention to other risk factors and lower the risk of CVD. For example, one of the reasons men are more at risk than women may be because, on average and historically, they have smoked more and dealt more with job-related stress. The trend is now changing. Incidences of CVD in women are rising, and more women than men are now dying from CVD: In 1995, about 455,000 males and 505,000 females died from CVD. This may be because women are smoking more and are being subjected to more stress after entering the job market. The lesson? With gender, at least, other risk factors may be involved, and lowering them can lower your overall risk. Stop smoking. This limits your risk of cancer, emphysema, heart attack, stroke . not to mention you won't smell like an ash tray. Need more? Lose weight. Lowering your weight can raise your "good" cholesterol levels and lower your "bad" cholesterol levels. It also helps prevent diabetes and strengthens the heart. Exercise. Exercise has the same benefits as losing weight (see No. 3) and, hey, helps you lose weight! Change your diet. This is one of the biggest things you can do. Avoid foods high in cholesterol, saturated fat, trans-fatty acids, and all fat-doing so will reduce cholesterol levels, reduce risk of cancers, and help you lose weight. Eat more fruits, vegetables, and fiber. This again helps maintain healthy cholesterol levels, and substances found in fruits and vegetables known as phytochemicals work to prevent cancers. Fiber lowers cholesterol and is linked to lower incidences of some cancers and heart disease. It can also help you lose weight. Decreasing your sodium intake and increasing your potassium intake can help you maintain a healthy blood pressure. Use supplements. Supplements (and foods) high in antioxidants may help prevent CVD. Folic acid and B vitamins combat high homocysteine levels. Garlic and ginkgo both aid circulation in general, and garlic has been shown to reduce cholesterol levels and decrease blood pressure. Coenzyme Q10 helps in the manufacturing of energy, and has been found to be useful in those with heart problems. Fish oil reduces triglyceride (a type of fat) levels and may help reduce incidences of coronary heart disease. Tocotrienols reduce cholesterol levels and may help prevent breast cancer. Keep cool-that is, practice stress reduction exercises. Doing so can result in lower blood pressure, less incidence of CVD, and a stronger immune system.

Unchangeable: Age, sex, and heredity

As we age, risk increases. About four out of five people who die of a heart attack are over age 65. At older ages, women who have heart attacks are twice as likely as men who have heart attacks to die from them within a few weeks.

Males are more likely to have coronary heart disease than women, whether younger or older. Finally, children of those who have had some type of CVD are more likely to develop it.

Lessen your risk? See No. 1 in the "Reducing Risk" box above.

Primary and changeable: Smoking, high cholesterol levels, and hypertension

Lipid levels (cholesterol and tri-glycerides) are one of the bad boys of CVD risk. As LDL cholesterol (the "bad" cholesterol) levels increase, CVD risk increases. When other risk factors are present, risk increases even more. A person's lipid levels are also affected by age, sex, heredity, and diet. Lessen your risk? See Nos. 3, 4, 5, and 6.

Hypertension-high blood pressure-increases the heart's workload and can also lead to increased arterial damage, opening the door further for atherosclerosis. It is also the biggest risk factor for stroke. When high blood pressure exists with obesity, smoking, high blood cholesterol levels, or diabetes, the risk of heart attack or stroke increases several times. Lessen your risk? See Nos. 3, 4, 5, 6, and 7.

There may be a new kid on the block - homocysteine. Just making the news last autumn, this amino acid is now being regarded as a major risk factor. Researchers say it may play a cholesterol-like role in heart disease; that is, it may contribute to the build-up of plaque in the arteries. Lessen your risk? See No. 6.

Contributing and changeable: Diabetes, obesity, stress, and a sedentary lifestyle

Those who are overweight are more likely to develop heart disease and stroke even if they have no other risk factors. The weight itself is not the culprit; rather the excess pounds concentrate other risk factors. Obesity has a negative influence on blood pressure and cholesterol, and may lead to diabetes. Lessen your risk? See Nos. 3, 4, and 5.

Stress may also be a contributing factor. Research indicates that there is a relationship between the risk of developing coronary heart disease and stress. This may be because stress releases certain chemicals, which can increase heart rate and raise blood pressure. Stress also contributes indirectly to CVD, as people under stress may smoke and drink more than those who lead a stress-free life. Lessen your risk? See No. 7.

Sedentary lifestyle. Lack of exercise should be easy to change, but few people make the effort to exercise. Regular aerobic exercise plays a significant role in preventing CVD, and even "easy-going" exercise is beneficial if done regularly. Exercise can help control blood cholesterol, diabetes, and obesity. Lessen your risk? See No. 4. Risk of death of heart attack for an average American male: 50 percent. Risk for vegetarian male: 4 percent. Percentage you reduce your risk of heart attack by cutting consumption of meat, dairy products, and eggs in half: 45. How often an American suffers from a heart attack: every 20 seconds How often an American dies from some form of cardiovascular disease: every 33 seconds. How often someone dies from a heart attack: every 60 seconds. Risk of dying of a disease caused by clogged arteries if you do not consume saturated fat and cholesterol: 5 percent

Risk of death of heart attack for an average American male: 50% Risk for vegetarian male: 4% Percentage you reduce your risk of heart attack by cutting consumption of meat, dairy products, and eggs in half: 45 How often an American suffers from a heart attack: every 20 seconds How often an American dies from some form of cardiovascular disease: every 33 seconds. How often someone dies from a heart attack: every 60 seconds Risk of dying of a disease caused by clogged arteries if you do not consume saturated fat and cholesterol: 5%

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