Heart disease is the biggest killer in the world substantially ahead of cancer. Unlike cancer, heart disease is mostly falling in the developed world, but with the shocking exception of the us where it causes one in four deaths. Alarmingly parts of Britain are mirroring this. Other populations that follow the American junk diet and an increasingly sedentary lifestyle are also experiencing stubborn mortality rates from heart disease. It is particular sad to see developing countries that once had reasonably nutritious diets succumb to the pernicious influence of junk food and physical inactivity as urbanization spreads, and thus their rates of heart disease are rocketing accounting for as much as 42% of all premature deaths compared to just 4% in France. It is deeply ironic that as global affluence spreads it reaps this terrible toll. It comes down to education. Heart disease is largely avoidable.
There are many misperceptions about heart disease. Arguably the biggest are that it is essentially an old man’s disease and secondly that it is a primarily failure of the heart. In the US and the UK the numbers are roughly equal between men and post-menopausal women. In recent years, cardiovascular risk in women has been increasing and has killed substantially more women than breast cancer. Most deaths from heart disease are actually caused by clogging of the arteries that supply blood to the heart. An otherwise healthy heart cannot survive more than five minutes if it is deprived of blood. Autopsies of young American soldiers since WWII have consistently found symptoms of the early onset of heart disease in the form of blood vessel or arterial injury, known as atherosclerosis. Hence heart disease is not termed ‘ cardio disease ’ but ‘ cardiovascular disease ’. It is now known that the process of heart disease can start as young as seven years old and that the popular American diet of junk food and colas is the chief culprit. Note that strokes or cerebrovascular disease where blood is cut off from the brain by atherosclerosis are generally included in any appraisal of heart disease.
Risk factors for heart and arterial disease can be divided three ways. The first set are fixed and include age, gender and heredity. While oestrogen protects woman before menopause, its decline after makes them just as vulnerable as men in their post menopause. The second are potentially modifiable risks, in as far as sufficient capital and income may allow an individual to escape them. Among these are air pollution, notably that caused by diesel fumes which produce particles small enough to invade even the smallest airways. Various studies have shown that long-term exposure to diesel fumes increases the rate of atherosclerosis and inflammation. It is cited as a factor in raising systolic and diastolic blood pressure, in irregular heart rhythm, in reduced heart rate variability, in carotid artery thickening and increased risk of heart attack. The third set is truly modifiable and includes lack of exercise, obesity, smoking and alcohol. The heart is a muscle. Without exercise, the heart has no reserve capacity to deal with shocks and arteries lose elasticity. Obesity causes high blood pressure, diabetes and an increase in cholesterol, all of which contribute to the degeneration of arteries. Smoking increases your blood pressure, narrows arteries and causes irregular beating of the heart. Heavy use of alcohol elevates triglycerides (saturated and unsaturated fat) levels and thus clogs arteries as well. Constant stress can increase your blood pressure and even your heart rate leading to sudden heart failures.