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What Is Heart Disease?

Heart disease is an all-encompassing term to describe heart-related issues. It is largely a preventable disease that leads to an outstanding number of deaths in the United States every year. Heart disease is closely associated with lipids, or fat, in the blood and blood pressure, which are both dependent on our lifestyle and diet. It is imperative we stay informed on how we can continue to support our heart, and thus better our lives.



What is the heart and what does it do?

The heart is a muscle that is slightly to the left of the center of the chest. It has four main functions: maintaining blood pressure, which allows blood, along with nutrients, to be carried to all parts of the body; pumping oxygenated blood and hormones to all areas of the body, and bringing deoxygenated blood and metabolic waste products to the lungs to be filtered out. Basically, the heart keeps the blood moving, helps keep it clean, and keeps it oxygenated, while also transferring nutrients throughout the body [1][7][8].


The heart transfers blood throughout the body through capillaries, veins, and arteries. It utilizes coronary veins to bring deoxygenated blood to the heart. It then loops the deoxygenated blood to the lungs, where the blood is oxygenated, and waste products are breathed out. The heart also utilizes coronary arteries to take oxygenated blood and nutrients from the heart to the rest of the body. Capillaries form a connection between veins and arteries [2][3][5][7].


What is Cholesterol, triglycerides and blood pressure?

If we are going to discuss heart disease it is imperative to not only define what the heart is and what its function is, but also to define cholesterol, triglycerides, and blood pressure. All are major factors in heart health [2][3][4].


Cholesterol is a major contributor to heart disease. Cholesterol, a type of lipid, is essential for bodily functioning. It aids in creating cells, vitamins, and hormones. It is produced and broken down by the liver. It also helps create the bile our liver needs to break down fats, like cholesterol. The liver provides all the cholesterol our body needs. Extra cholesterol is obtained from food, predominantly meat, dairy products, and certain oils. A normal cholesterol is under 200 md/dL [2][5][10].


Cholesterol is also closely associated with triglycerides, another type of lipid, which are involved in providing the body with sustained energy. Any caloric intake that is not immediately used by the body, triglycerides store in lipids, or fat molecules, in order to use them later on. Triglycerides are in sugary and starchy foods like white bread, cereal, rice, pizza, bagels, pies, cookies, etc. A normal triglyceride level is under 150 mg/dL [2][4][12].


Blood pressure is exactly how it sounds. It is the pressure of the blood pushing against the arterial walls. The heart sets the blood pressure by controlling how much blood is being pumped out, how often it’s pumping blood, and how forcefully it’s pumping out the blood to the rest of the body. Blood pressure is much lower in the veins (diastolic pressure) than it is in arteries (systolic pressure). A normal blood pressure is around 120 systolic pressure and 80 diastolic pressure [11].


What is heart disease?

Heart disease is a catch-all term for a lot of different heart related illnesses. The most prevalent heart diseases are arrhythmia, atherosclerosis, cardiomyopathy, congenital heart defect, coronary artery disease, and heart infections [3][8].


Arrhythmia is when the heart is constantly beating either too fast or too slow. People with an Arrhythmia are often lightheaded, dizzy, experience a fluttering sensation in their heart, or have fainting spells [3][8].


Atherosclerosis is a heart disease where there is a reduced blood supply to the person’s limbs. Someone with atherosclerosis might feel cold, numbness, random pain, and weakness, especially in their extremities [3][8].


Congenital heart defects are heart issue that occur in the womb. People with a congenital heart defect may experience swelling, shortness of breath, or fatigue. It is also possible that people with congenital heart defects have no symptoms [3][8].


There are numerous types of Cardiomyopathies. Dilated cardiomyopathy is characterized by having a weak heart. Hypertrophy cardiomyopathy results in the thickening of the muscle chambers of the heart. Restrictive cardiomyopathy causes the walls of the heart to become rigid [3][8].


Coronary artery disease, or CAD, is caused by a combination of inflammation and cholesterol containing plaque deposits that buildup in the coronary artery. Plaque can be made up of calcium, fat, or other material. Clots can get caught in a plaque buildup and contribute to the blockage, as well [3][8].


Heart infections are just that, infections in the heart. It is when the tissue of the heart become infected due to an untreated infection, parasite, bacteria, or virus within the body [8].



What are the risk factors for heart disease?

There are two main mechanisms that lead to heart disease. These two mechanisms are caused by risk factors. The mechanisms are high blood pressure and high cholesterol. The risk factors are: smoking, inflammation, untreated mental illness, pollution, excess stress, diabetes, obesity, poor diet, inactive lifestyle, or excessive alcohol consumption. These practices, or risk factors, all increase the likelihood of developing the mechanisms that lead to the contraction of heart disease. These are all semi-controllable risk factors, but there are some risk factors that are completely uncontrollable for heart disease such as sex, age, ethnicity, and genetics [3][8].

There are two types of cholesterol, HDL and LDL. HDL is known as the “good” cholesterol, because it brings cholesterol the body doesn’t need back to the liver to be broken down. While LDL, the “bad” cholesterol, transports cholesterol all throughout the body, which can lead to excess cholesterol in a concentrated area, also known as buildup. LDL is offset by HDL, meaning that a high LDL is perfectly safe if the HDL cholesterol is also high. While there is a genetic component to cholesterol, it can be controlled, to some extent, by our diet and physical activity. Having too much LDL in the blood without having enough HDL cholesterol to mitigate the LDL can lead to buildup in the veins and arteries of the body, leading to heart issues [5][10].


Additionally, triglycerides are usually grouped together with cholesterol health. Our level of triglycerides is directly related to our food consumption and activity level. Having too many lipids, or fat, in our blood can lead to buildup and heart issues [12].


The heart sets the blood pressure, but hypertension, or high blood pressure, can be caused by issues other than the heart. There are two types of high blood pressure: primary and secondary. Primary blood pressure is high blood pressure that slowly increases over time without a specific cause. Secondary high blood pressure is caused by other issues going on within the body such as, kidney or thyroid problems, drug use, medications, congenital birth defects, or untreated sleep apnea [1][4][5].


Untreated mental health disorders have been linked to heart disease. An untreated mental illness can lead to prolonged increased heart activity, due to excessive stress, which can cause high blood pressure and calcium buildup in the arteries. Untreated mental illness, such as depression, anxiety, and PTSD, are most commonly associated with heart disease. Certain untreated mental disorders are also affiliated with unhealthy self-medication practices, such as smoking and excess alcohol consumption, which both increase the likelihood of heart disease. Untreated depression can lead to an inability to perform normal everyday activities, such as taking prescribed daily blood pressure medication [12][9][10].


Men are much more likely to contract heart disease than women. Everyone below the age of 59 are at the same risk for developing heart disease. The percentage of men that contract heart disease after 60 is around 28%, whereas the percentage of women contracting heart disease, after 60, is around 14%. Every ethnicity is at a higher percentage of contracting heart disease compared to Native Alaskan and Native American people. If there is a history of heart disease within a family, the people within that family may have a greater genetic likelihood of contracting heart disease [2][3][8].


How Common is heart disease?

Heart disease is the primary cause of death in the US. Around 610,000 people die from heart disease every year. It is estimated that by 2035, almost half of the people in the US have at least one of the risk factors for heart disease, whether that is high blood pressure, high cholesterol, etc. (8,9).


Is heart disease becoming more or less prevalent?

Interestingly, there was a consistent decline in deaths from heart disease from 1999 to around 2010. This was due to effective blood pressure and cholesterol medication use, and increased awareness of heart healthy behavior. Unfortunately, around 2011, the number of deaths caused by heart disease has started to increase again and has continued to increase since [8][9].


Heart disease is predicted to increase in the years of 2030 to 2035 by around 5%. The reason for this stark increase is due to a myriad of explanations. Pollution, stress, and obesity are all factors that are only becoming more prevalent in our society, and all contribute to the development of heart disease [3][9].


What should be done to help prevent the increase of heart disease?

Most ways to mitigate heart disease are relatively self-explanatory. More importantly, people should be getting a physical every year that includes a blood pressure check and a cholesterol test. This is pivotal, because being informed about your body allows you time to make life changes before your health becomes unmanageable [8][12].


People can help prevent heart disease by exercising regularly, eating a well-rounded diet, not exceeding the daily recommend number of drinks, reducing stress levels, and choosing to not smoke. Abstaining from smoking is actually the leading practice for disease prevention. Cigarettes cause 20% of the cardiovascular related deaths every year [3][6][8][9].


There should be more education surrounding heart disease prevention from a young age. For example, children are often taught about “heathy” vs. “non-healthy” foods, but children should be taught about healthy physical practices, as well. Children should be well educated on the importance of getting movement in everyday, whether that be a walk or a 10-minute dance party, and on the importance of developing strong methods for coping with stress [14][15].


There should also be education specifically surrounding mental health and its connection to heart disease, along with regular mental health screenings as a primary form of prevention. If mental health problems are quickly diagnosed the body is less likely to experience trauma from the untreated mental illness [6].


Some doctors have found great benefit in people carving out 15 minutes every day to meditate or focus on their thoughts to help prevent, or reduce the damage of, heart disease. Lastly, it is important that people remember to breathe and spend time with the people they love to foster not only physical, but emotional wellbeing [3][13].





Author: Katrina Peavy

Editor: Sophia Galvez

Public Health Scientist: Hira Mughal

@werise4wellness



References


1. Allarahka, Shaziya. (2021). Medicine Net. What are the four main functions of the heart. Retrieved from https://www.medicinenet.com/what_are_the_four_main_functions_of_the_heart/article.htm.

2. Donelly, Erin. (2021). Johns Hopkins Medicine. Why Cholesterol Matters for Women. Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/why-cholesterol-matters-for-women.

3. Donovan, Robin. (2020). Healthline. Everything you need to know about Heart Disease. Retrieved from https://www.healthline.com/health/heart-disease.

4. Woolley, Elizabeth. (2021). Very Well Health. Foods and Beverages that Raise Triglycerides Levels. Retrieved from https://www.verywellhealth.com/what-foods-cause-high-triglycerides-1087467.

5. American Heart Association. (2020). What is Cholesterol? Retrieved from https://www.heart.org/en/health-topics/cholesterol/about-cholesterol.

6. Center for Disease Control. (2020). Heart Disease and Mental Health. Retrieved from https://www.cdc.gov/heartdisease/mentalhealth.htm.

7. Cleveland Clinic. (2021). How Does Blood Flow Throughout Your Body. Retrieved from https://my.clevelandclinic.org/health/articles/17059-how-does-blood-flow-through-your-body.

9. Healthline. (2017). Why Heart Disease in on the Rise in America. Retrieved from https://www.healthline.com/health-news/why-is-heart-disease-on-the-rise.

10. Heart UK. (2021). What is Cholesterol? Retrieved fromhttps://www.heartuk.org.uk/cholesterol/what-is-cholesterol.

11. Mayo Clinic. (2021). High Blood Pressure (Hypertension). Retrieved from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410.

12. Mayo Clinic. (2020). Triglycerides: Why do they matter? Retrieved from https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186.

14. Medlin Plus. (2021). Atherosclerosis. Retrieved from https://medlineplus.gov/ency/article/000171.htm.

15. U.S. Food & Drug Administration. (2020). How Smoking Effects Heart Health. Retrieved from https://www.fda.gov/tobacco-products/health-effects-tobacco-use/how-smoking-affects-heart-health.


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