During the last several years, scientific research has expanded our understanding of heart disease, its causes and prevention. Recently, a host of previously unsuspected factors and conditions have been identified and linked to heart disease, including inflammatory diseases (such as rheumatoid arthritis), migraine headaches, and even “living near a highway” (www.Heart411book.com). Despite these advances, cardiovascular disease remains on the rise—projected to increase by a rate of 10% over the next 20 years— and is still the leading cause death in the U.S., according to the Surgeon General in a report cited by the Centers for Disease Control in 2012 (http://goo.gl/fpQeR).
The Incidence of Cardiovascular Disease
According to Dr. Marc Gillinov and Dr. Steven Nissen, authors of Heart 411: “Eighty-two million American adults have cardiovascular disease, a broad group of disorders that includes coronary heart disease, stroke, high blood pressure, heart failure, and cholesterol abnormalities. Each year, 800,000 Americans will have a new heart attack while half-a-million will suffer a second (third or fourth). In other words, somewhere in America, a person has a heart attack every twenty-five seconds. Couple this with the fact that approximately one in three deaths in the U.S. is caused by coronary heart disease or stroke, and the implications become even starker.
A key contributor to cardiovascular disease are behaviors linked to contemporary lifestyles, such fast food consumption and sedentary recreational habits. These lifestyle factors are also associated with obesity, which is also linked to an increased risk of cardiovascular disease. The latest statistics from the American Heart Association (AHA) are both daunting and distressing: 149.3 million among Americans age 20 and older, are either overweight or obese (BMI of 25.0 kg/m2 and higher) and roughly split between men and women at 78.0 million men and 71.3 million women, respectively. The statistics for ethnic groups like African Americans and Hispanics are extremely disturbing as well as for children and adolescents, where the prevalence of obesity is rising at alarming rates (http://goo.gl/CNs2j).
The Cost of Cardiovascular Disease
Annual cardiovascular procedures and operations have also increased from 5.4 million to 6.8 million over the last decade, according to Gillinov and Nissen, and “the economy and health care budgets are buckling under the $167 billion annual price tag to treat cardiovascular disease…” that the AHA estimates the total excess cost related to the prevalence of adolescent overweight and obesity to be $254 billion. Finally, the study warns, “If current trends in the growth of obesity continue, total healthcare costs attributable to obesity could reach $861 to $957 billion by 2030, which would account for 16% to 18% of US health expenditures.”
Today, the causes of heart disease are well known—high blood pressure, smoking, elevated cholesterol, diabetes, obesity, and family history. This is why Gillinov and Nissen observe, “when it comes to the heart, ignorance and complacency are the enemies.” What can be done about these factors as “this society-wide increase in cardiac risk factors is shifting the ground beneath us, preparing to create a tsunami of cardiovascular disease”?
Treating Cardiovascular Disease
The solutions as well as the causes are well known and “not complicated,” according to Gillinov and Nissen: “We know how to prevent cardiovascular disease and (how to) better treat existing heart problems.” The key is to address the lack of good information by increasing public knowledge of the risk factors for heart disease, medicines for high blood pressure and high cholesterol, available prognostic tests and diagnostic procedures, and other strategies for dealing with both the management of extant risk factors as well as preventing them in the first place. While some risk factors are not in our control—such as family history of heart disease and advancing age—an individual can manage heart health by many lifestyle adjustments, including exercise and proper nutrition.
Among the specific risk factors that can be changed by individual actions are: high-blood pressure, diabetes (Type 2 diabetes can be treated with lifestyle changes in many patients), cholesterol/lipid abnormalities, tobacco use, and obesity. In addition, more recently identified risk factors for cardiovascular disease that can be addressed by individuals include sleep apnea, periodontal/gum disease, air pollution and emotional stress (Heart 411).
Finally, genetic testing promises to play a greater role in prediction and treatment of heart disease. Gillinov and Stevens see a future in which genes will guide an individual’s choice of medicines: “In addition to identifying people afflicted by or at risk for illnesses, genetic testing will one day be used to tailor medical therapy, telling us which patients are most likely to respond to particular medicines. This concept is already edging its way into medical practice. Scientists have demonstrated that a person’s genetic profile helps to predict the response to the anticoagulant warfarin and the risk of developing rare but serious muscle damage from statin therapy. Genetic testing before administering these drugs may become commonplace…”