Understanding the Scope of Cardiovascular Disease
When you hear the term “heart disease,” it’s essential to recognize that the focus is often on cardiovascular disease (CVD). This umbrella term includes conditions affecting the entire vascular system. Terms like MI (Myocardial Infarction), CVA (Cerebrovascular Accident), and PAD (Peripheral Artery Disease) all fall under this category.
Simply put, cardiovascular disease arises from fatty deposit accumulation in the arteries. This buildup can impede blood flow to crucial organs like the heart and brain. Moreover, CVD often goes hand-in-hand with other conditions, like chronic kidney disease, which in turn can lead to further heart-related complications. Even cancer patients may face cardiovascular risks due to their treatments.
Risk Factors: What Can and Can’t Be Changed
There are both modifiable and non-modifiable risk factors associated with CVD:
Modifiable Risk Factors: Smoking, sedentary lifestyle, high blood pressure, elevated cholesterol levels, poor diet, diabetes, and obesity.
We know elevated levels of cholesterol specifically LDL-C and low levels of good cholesterol HDL-C is a significant risk factor. Hypertension contributes significantly to the development of CVD. Diabetes and obesity also contribute. Lifestyle factors such as smoking, physical inactivity and poor diet, high sodium intake, low intake of fruits and vegetables are also associated with increased risk of cardiovascular disease.
Non-modifiable Risk Factors: Age, race/ethnicity, sex, family history and genetic predisposition.
Older age is associated with higher risk of cardiovascular disease events. Men have a greater risk than women as well as certain racial and ethnic groups. A family history of cardiovascular disease may give you a genetic predisposition as well.
A Stark Reality: The Impact of Cardiovascular Disease
It’s a grim fact, but cardiovascular disease claims more lives every year than any other illness. Though the margin has become narrower over the decades, CVD remains the leading global cause of death. However, there’s a silver lining. Since the late 20th century, understanding and managing risk factors like cholesterol, blood pressure, and lifestyle habits have contributed significantly to a decrease in U.S. deaths from coronary heart disease. However, the rise in diabetes and obesity has somewhat offset these positive outcomes. Medical and surgical advancements account for nearly half of the decline in heart disease over recent decades.
Unpacking the Science: How Does CVD Develop?
The development of CVD involves a multitude of intricate processes: from atherosclerosis (plaque buildup in the arteries) and inflammation to cellular stress and vascular aging. At its core, CVD is rooted in chronic arterial inflammation.
A variety of factors – including chronic kidney disease, obesity, hypertension, and even environmental factors – play roles in CVD’s onset. To gauge your risk, consider undergoing some straightforward tests that your healthcare provider can recommend, such as a lipid panel or hs-CRP, along with a blood pressure check. More advanced screenings like the coronary calcium score can provide in-depth insights, but not everyone requires them. As a preventive cardiologist, I find tests like carotid artery ultrasound, APO-B and lipoprotein (a) among others quite valuable, even if they’re not universally adopted. They’re cost-effective and non-invasive, so it might be worth discussing with your doctor.
The Heart of the Matter: Preventing and Managing Cardiovascular Disease
Cardiovascular disease (CVD) may sound intimidating, but with today’s medical advancements, not only can we prevent and stabilize it, but in some instances, even reverse its course. As someone deeply passionate about heart health, I’m here to guide you through the paths you can take to ensure your heart beats strong and steady for years to come.
A Comprehensive Approach:
Tackling CVD isn’t a one-size-fits-all strategy. It requires a multifaceted approach that may include lifestyle adjustments, medications, and potentially more invasive methods like stenting or coronary artery bypass grafting.
Lifestyle at the Core:
Before diving into medications and surgeries, let’s talk about the basics. Embracing a heart-healthy lifestyle is fundamental:
Regular Physical Activity: The heart loves a good workout! Regular exercise helps keep it robust and efficient.
Eating Heart-Healthy: Incorporate a diet rich in fruits, vegetables, whole grains, and lean proteins. Think about starting a Mediterranean diet.
Kicking the Habit: If you smoke, quitting is perhaps the best thing you can do for your heart.
A Balanced Weight: Maintaining a healthy weight helps control several risk factors, from high blood pressure to elevated glucose levels.
Medications – Tailored to You:
For many, medications become a necessary ally in this fight:
Statins: These are the go-to for lowering cholesterol and taming vascular inflammation. They’re especially recommended if your 10-year risk score is on the higher side.
Beyond Statins: If statins aren’t enough or aren’t suitable, alternatives like Ezetimibe, PCSK9 inhibitors, bempedoic acid or angiopoietin-like 3 inhibitors can be explored.
Blood pressure, another critical piece of the puzzle, can be regulated with various antihypertensives. Your doctor will help select the one best suited to your unique profile.
For patients with advanced CVD or those who aren’t finding relief with medications alone, procedures like coronary revascularization, stenting, or bypass grafting might be suggested.
Nature’s Blessings – Plant-derived Compounds:
Mother Nature has always had our backs! There’s mounting interest in plant-derived compounds for both CVD prevention and management. Many of these natural wonders have shown promising effects on lipid profiles and other cardiovascular risk factors. While this is an exciting frontier, it’s also a budding one – more research will pave the way for clearer insights.
Wrapping Up:
The journey to heart health might seem overwhelming, but remember, every step, whether it’s a brisk walk or a heart-friendly meal, takes you closer to a healthier, happier heart. Embrace the journey, and know you’re not alone – your preventive cardiologist is here to guide, support, and cheer you on every heartbeat of the way!
Actionable Steps to Assess and Counteract CVD Risk:
- Assess Your Risk: Start by evaluating your chances of developing heart disease using a risk calculator. Click below to assess your risk.
- Understand Your Optimal Risk: Use the same tools to see where you ideally should be.
- Adopt Measures to Minimize Risk: This could involve lifestyle, dietary changes or medications.
- Go Beyond Standard Guidelines: Explore advanced methods and schools of thought, such as the BaleDoneen approach.
- Stay Updated with Medical Advancements: Keep an eye out for new medications and treatments like PCSK9 inhibitors, evinacumab and bempedoic acid (Nexletol).
- Craft a Personalized Plan: Ensure it’s sustainable and tailored to your needs.