Cardiovascular disease continues to be the leading cause of death in the United States, representing over 34% of all mortality. Add in vascular disease (the #3 leading cause of mortality) and you can see why the prevalence of death from total vascular disease is such a concern. The bad news is that cardiovascular disease (CVD) is just as prevalent as it has ever been. The good news is that many risk factors for CVD can be modified, and in some cases, even eliminated.
So, what can YOU do? Risk factors can be divided into two groups: non-modifiable and modifiable. Obviously, the non-modifiable risk factors are fixed, but a close look at each allows us to better understand our own risk.
Non-Modifiable Risk Factors For Cardiovascular Disease:
Family History – If we could only choose our own parents, we would be able to take care of this one. Family history of risk factors continues to be the leading cause for the prevalence of CVD. If mom or dad had hypertension, your chance of developing hypertension is much greater. The same is true for cholesterol and diabetes. Armed with a thorough knowledge of family risk factors, one can focus on reducing the likelihood of disease occurrence.
Age – If someone could only figure out how to change this one. The good news is that the population is living to an older age. However, age continues to increase our risk for all types of disease.
Sex – Being male or female is not quite the difference (in risk) it was thought to be years ago. The number one cause of death in women is still cardiovascular disease. However, the occurrence rates tend to be about 10 years later for women than for men.
Modifiable Risk Factors For Cardiovascular Disease:
Smoking – Smoking continues to be the most modifiable risk factor for coronary disease. 22% of the American population still smokes; however, smoking continues to be on the decline. Smoking has been shown to decrease HDL-cholesterol (good cholesterol), increase blood pressure, increase risk for lung disease, and most importantly, dramatically increase risk for coronary disease.
Blood Pressure – The prevalence of hypertension in the U.S. population is approximately 33%, while the prevalence of pre-hypertension is approximately 28%. That means only 39% of the U.S. population has normal blood pressure. This increased pressure in the system creates an increased workload on the heart, which over time creates an increased risk for vascular disease. Hypertension is diagnosed with three separate readings of >140/>90 mm Hg, while pre-hypertension is described as 120-139/80-89 mm Hg.
Exercise – Physical inactivity continues to be a major problem, specifically in the U.S. youth population. 38.6% of the U.S. population still reports no physical activity. The Surgeon General recommends at least 30 minutes of physical activity on most, if not all, days of the week. While technology has added tremendously to our quality of life, if has also dramatically decreased the amount of physical work we perform on a daily basis. Be active!
Cholesterol – Most people know that the higher their cholesterol, the higher their statistical risk for coronary disease. However, one cannot just look at cholesterol. One needs to look at the entire blood lipid profile. 50.7% of the U.S. population still has a cholesterol over 200 mg/dl and 18.3% still have cholesterol results exceeding 240 mg/dl. Combine this with approximately 26% of the population having a compromised reverse cholesterol transport mechanism (low HDL-cholesterol or “good” cholesterol) and you can see the concern. What a lot of people don’t realize is that a 10% reduction in cholesterol nationwide can lead to a 30% reduction in CVD.
Weight – The U.S. population is getting heavier. In 2002, 65.1% of Americans were considered overweight (BMI >25.0) and 30.4% were considered obese (BMI >30.0). Taking into account that the prevalence of obesity has increased 75% since 1991, one can only imagine where we are in 2015! If a person can focus on reducing just one risk factor for CVD, weight reduction should be number one. Just look at all the other risk factors and see how weight reduction has a direct impact on heart health.
Diabetes Mellitus – No new news here – diabetes is on the rise. Approximately 9.5% of the population has diabetes, and roughly 3% of those people are currently undiagnosed. Add to that the 7% that are currently pre-diabetic (and will probably develop diabetes), and you can see the concern. The prevalence of diabetes in the U.S. increased 8% from 2000-2001 alone, and the prevalence increased 61% since 1990. Two primary factors are necessary in slowing the progression of diabetes, early identification and risk factor modification.
Nutrition – Diet plays a clear role in the reduction of risk for CVD. Most people have focused on the “quality” of the diet over the past years, reducing cholesterol intake, reducing sodium intake, increasing fiber intake, and decreasing fat calories. One of the major players in obesity is simply total calorie consumption. The U.S. population consumes approximately 12% more calories now than they did in 1985, representing approximately 300 additional calories per day. Using the calculation of 3,500 calories per pound of fat, that represents just about an additional pound every 12 days!
Stress – We are all very busy – most times too busy. Americans today try to accomplish more and more every day. Take time for yourself! Stress reduction is accomplished in many ways, but each person needs to find their own stress reducer. Many people exercise as a stress reducer, however any activity that removes you from a stressful environment has been shown to reduce stress.
The cornerstone to any disease prevention is early identification, education, and implementation of strategies to reduce risk. One such step is a physical examination with a physician. Another is clinical testing for several of the previously mentioned risk factors. When was the last time you had a blood lipid profile? Have you checked you blood pressure? What about your blood sugar for diabetes? Early identification is critical. Education is also critical, as it empowers everyone to take preventive measures into their own hands. Do you know all the latest research on optimizing your blood pressure? How about cholesterol reduction? Lastly, you need a plan. Just like any work project, a clear plan with defined goals, is essential in modifying risk. If losing weight is your goal, define your current status (body composition), educate yourself on different methods of success, and implement a clear, individualized strategy that will allow you to achieve your goal. Most importantly, reevaluation is imperative! It doesn’t do much good to plan an intervention program and not assess the success of the intervention.
If you would like more information regarding your risk for CVD or other health concerns, please feel free to contact any BaySport clinic to speak with a clinical exercise physiologist. The responsibility of your health falls directly on YOU!
References:
American Heart Association. www.heart.org
About the Author:
A native to the Bay Area, Christine graduated on the dean’s list with a B.S. degree in Health and Human Sciences from Loyola Marymount University in 2013. Soon after, she moved back up north from Los Angeles and joined the BaySport Preventive Medical team. She really appreciates BaySport’s dedication to detail in making every patient’s experience as enjoyable as possible while also educating them on ways to improve their lifestyle. As a current graduate student at San Francisco State University, she is now working on her thesis to determine if there is a trend within the Bay Area for certain ethnicities to have higher lipid profile (cholesterol, triglycerides, and glucose) values along with other measurements such as body mass index and blood pressure. During her off-time, Christine is an avid supporter and fan of Bay Area sports and she loves to play golf with her family when she can. She also likes to travel down to Los Angeles frequently to visit friends.
