Risk Factors For Heart Disease

Think You’re Doing Everything to Protect Your Heart? Even THIS?

August 20, 2013 by James Bogash

heart disase sleep — Enough sleep needed to protect the heart

Despite societal beliefs, heart disease is NOT genetic. It is almost entirely environmental. Lifestyle factors to lower your risk are very well established.

Most of you can probably name off the top few easily: Exercise, not smoking, plant based diet, don’t stress, avoid animal based saturated fats, more omega-3 fatty acids, etc… But some are a little more elusive and less well known. But usually these risk factors may play a smaller (but no less important) role, such as BPA in plastic water, dark chocolate, nuts and lycopene in tomatoes. But what if there was a very important risk factor that had a large impact on your risk of a heart attack or dying of a heart attack that you were not aware of?

Enter this large study out of the Netherlands. Luckily, the Dutch are a generally healthy people, so these researchers were actually able to find some healthy people to study (as opposed to the US, where researchers have to peek into dark corners and seedy vegan restaurants to find the healthy residents). Basically, they looked at 17,887 men and women and how their health behaviors were linked to the later risk of heart attacks or cardiac deaths.

Here’s the behaviors and the amount they lowered the risk individually:

Sufficient physical activity (≥3.5 h/week cycling or sports–52% of study participants) led to 26% lower risk.
Healthy diet (Mediterranean Diet Score ≥5–37% of participants) led to 12% lower risk.
Moderate alcohol consumption (≥1 beverage/month–91% men, 78% of women participants).
Non-smoking (65% of participants) led to 43% lower risk.

Overall, when all 4 of these healthy lifestyles were done together, there was an overall 57% lower risk of heart disease and 67% lower risk of fatal heart attack. Sadly, even in this healthier country, only 12% of the study participants adhered to all the factors studied. And like many of the studies on heart disease, these guidelines are pretty basic and very easy to achieve. More specific lifestyle changes would likely lead to much greater reductions.

There was one more behavior they look at:

Sufficient sleep duration of at least 7 hours per night.

Man, I better hit the hiking trail drinking red wine and eating raw nuts dipped in pure cacao.

In the study, 80% of men and 86% of women obtained sufficient sleep. Pretty sure we wouldn’t see these numbers here in the US with salaried employees with kids (or 5 blog / week health related blog authors…). Overall, getting sufficient sleep lowered the risk of heart disease by 22% and fatal heart attack by 46%. These are some pretty strong numbers.

But when added to the 4 factors listed about, the protection jumped, lowering risk of heart disease by 65% and fatal heart attack by 83%. These are some pretty serious numbers.

Overall, this really should not come as too big of a surprise because we know that sleep is incredibly important and, conversely, not sleeping well is unhealthy. Study after study have linked poor or too little sleep to increased inflammation, obesity and diabetes.

Lest you think that you’re ok because you load up on Ambien and Lunesta with your valium, there are some pretty scary associations between the use of these types of drugs and death (arguably something we want to avoid…).

And stress kills sleep quality and duration, which likely feeds into this entire picture of preventing heart disease and fatal heart attacks.

With that said, I’m off to bed to lower my risk of a heart attack..

Heart Disease Prevention: Is Your Teen in the 1%?

May 3, 2013 by James Bogash

Cardiovascular disease is a lifestyle disease. Period. Genetics play a very small role. Period. In almost all cases, if you have heart disease it is due to choices you made.

Hard to swallow, but it’s the truth. We don’t want to think that the personal burden of heart disease was our fault. It’s much easier to blame genetics and age.

So what factors do the American Heart Association consider established risk factors for heart disease? Here’s the short list:

Ideal blood pressure
Ideal blood glucose
Ideal total cholesterol (not my favorite)
Ideal physical activity levels
Ideal body mass index
Non-smoking
Health diet score (very basic, simple changes)

Pretty simple list. These are all health decisions that you make (or don’t make).

So how well are our teens sticking to these guidelines?

Sickeningly few.

This particular study looked at just how well a group of 4673 teens aged 12-19 were following each of these guidelines. Here’s what they found:

Ideal blood pressure: males 78%, females 90%
Ideal blood glucose: males 89%, females 74%
Ideal total cholesterol: males 65%, females 72%
Ideal physical activity levels: males 44%, females 67%
Ideal body mass index: males 66%, females 67%
Non-smoking: males 66%, females 70%
Healthy diet score: less than 1% for both males and females

Overall, less than 45% of males and 50% of females had 5 / 7 factors in his or her favor.

As a society, if we can’t maintain even the most basic of lifestyle changes in our kids, things are going to get ugly in the future.

As I’ve mentioned many times in the past, the AHA guidelines are very basic and are still short of what I recommend in my free ebook, Dr Bogash’s Lifestyle Recommendations.

The bottom line is that, statistically, if you’re reading this blog post, you are not maintaining ideal cardiovascular health factors. If you are not at least at this basic level, the responsibility for your cardiac disease is yours and yours alone.

Are You Going to Have a Heart Attack in 35 Years?

February 28, 2013 by James Bogash

Seems like an awful long time to worry about. 35 years. Heck–I don’t even know what I’m doing this weekend, let alone in 3 1/2 decades. So why should anyone worry if they might have a heart attack in 35 years?

Because you will care in 35 years from now. Try to sound as tough as you’d like now, but once that crushing pain hits your chest and you get rushed to the ER to have your sternum cracked open with a spreader and have one of your more precious organs replumbed, you would be willing to go back and change it all.

On the other hand, maybe this is why you’ve made the right choices. You’re exercising with short burst methods, avoiding refined carbs and eating omega 3’s instead of omega 6’s. In general, you’re following the recommendations that can be found by by clicking here.

But it’s not you I’m addressing this post to. It’s your young child.

We are seeing growing evidence that heart disease begins in childhood. Or rather, we should NOT see heart disease beginning in childhood, but we are. Rest assured it is because of the preprogramming that begins in the womb and continues through childhood and adolescent. The poor lifestyle choices aquired early are very likely to perpetuate for the rest of his or her life.

This particular study took the research we have seen on risk factors for heart disease and put a practical spin on it. Basically, how likely are these risk factors going to turn into a heart attack 35 years later?

If you’re doing the math, we are talking about an adult in his or her 40’s or 50’s having a heart attack, the beginnings of which stretched back to childhood.

Researchers looked at the ESR levels of 433,577 young adult men in Sweden. ESR is a general marker of inflammation (erythrocyte sedimentation rate). And inflammation is a strong player in heart disease. So what did they find in those kids with higher levels of ESR?

Those kids who had an ESR of ≥15 mm/h had 70% increased risk of having had a heart attack 35 years later (Tweet this). And this was after accounting for traditional risk factors associated with heart disease.

70% increased risk. From behaviors your child is adopting NOW. It is becoming far too common to hear about parents in their 60’s or 70’s losing a child to heart disease. Unless we wake up and change our kids’ behaviors (which always starts with changing YOUR behaviors…), the number of parents burying their adult children will only go up.

What are YOU going to change today?

Risk Factors for Heart Disease: Diabetes Tops the List

January 22, 2013 by James Bogash

If queried, many would name high cholesterol as one of the major risk factors for heart disease. Not even close. Many wouldn’t think of a condition 50% of us have.

I was giving a short presentation last week and one of the participants asked about diabetes and heart disease. I had mentioned that, for me, there is little difference between the two, and this appeared to be something she had not heard before.

While not surprising, this fact is very true. 84% of diabetics die of cardiovascular related complications (heart disease and stroke combined). So it would seem to me that every diabetic needs to work on protecting his or her heart.

Here’s the good news: improving your lifestyle to protect or improve diabetes and improving your lifestyle to protect your heart are one and the same. Good luck trying to find something to avoid or improve your diabetes that doesn’t have a protective effect on the heart. Exercise? Both. Stress management? Both. Avoiding BPA in plastics? Both. Nuts? Both.

You get the idea.

So why does this concept seem to be a secret? Maybe it’s because primary care doctors or endocrinologists manage diabetes and cardiologists manage heart disease. Sad to think this way, but it seems to fit. The closest we seem to come to managing both conditions is to make sure that diabetics are taking his or her diabetic medications or that diabetics are taking their Lipitor. No one seems to take into account that these two conditions are caused by the same lifestyle choices, rather than being two separate entities needing to be managed with distinct tools.

This particular study drives this concept home. Researchers looked at HbA1c levels and how they related to the risk of heart disease. HbA1c is a marker to see how well you have been managing your blood sugars over the past 3 months or so. HbA1c is actually a protein in red blood cells that gets damaged by blood sugar when it goes up. So, higher blood sugar = more damage to the proteins in your body. EVERY protein, not just this one. So lower is always better. Higher means that every protein in every cell of your body is being damaged more. Not good.

Here’s the problem: elevations in HbA1c do not just occur in diabetes. Basically, it’s a spectrum, with lower numbers being better and higher numbers getting worse. Whether or not you are diagnosed with diabetes, higher HbA1c numbers are not good, and in the study, elevated HbA1c levels were associated with heart disease regardless of whether or not the person had been diagnosed with diabetes (yet).

The bottom line is, regardless of whether you are diabetic or prediabetic, your heart is in grave danger. Luckily, you don’t need to pick which condition you want to make lifestyle changes for. My recommendations can be found here.

Are you at risk?