by Hanna Keith Santos Barrientos

Heart disease, also called cardiovascular disease (CVD), is the leading cause of death for both men and women worldwide. In fact, around 17.9 million died from CVD in 2019, representing approximately 32% of all deaths globally. That proportion is relatively smaller in the US, but the number is still massive, with 1 in 5 deaths attributed to CVD. 

Cardiovascular disease describes a group of conditions that affect the heart and blood vessels. There are several types of CVD including atrial arrhythmia, congenital heart defects, heart attack, and stroke. Coronary artery disease is the most common, which killed 382,820 Americans in 2020.

The statistics on CVD can be alarming, especially when some heart diseases are inherited at birth, but the good news is that there are many ways to reduce your risk of developing these conditions. Read on to learn about the most common CVDs, their symptoms, and their causes. We will also discuss their risk factors as a measure of prevention.

Atherosclerosis 

What is atherosclerosis?

Atherosclerosis is the buildup of fats and other substances in the blood, forming a sticky mass called plaque. It causes your artery to narrow and reduces blood flow, making it harder for oxygen and nutrients to be transported to vital organs. Plaque can also burst, leading to blood clotting.

Atherosclerosis is mainly considered a heart illness, but it can also have an impact on other body parts, including the brain, arms, legs, and kidneys. Here are specific conditions related to atherosclerosis.

• Coronary Artery Disease- clogging of blood vessels in the heart
• Carotid Artery Disease- plaque buildup in arteries that supply blood to the brain and head
• Renal Artery Stenosis- plaque buildup in the blood vessels that delivers blood to your kidneys
• Peripheral Artery Disease- blockage of the arteries that carry blood to legs, arms, and pelvis
• Mesenteric ischemia- reduced blood flow to small intestines due to plaque buildup in mesenteric arteries.

What are the risk factors for atherosclerosis?

Did you know that around half of people in America ages 45 to 80 have atherosclerosis? And some of them might not even know it! But don’t worry. You can avoid or delay the progression of atherosclerosis by taking note of several key factors. 

The first thing to consider is your triglyceride (TG) level. Triglyceride is the most common type of fat found in your blood and adipose cells, and it is equally important to your health as other fats. A survey in the US showed that one-quarter of the statin-treated patients have relatively high triglycerides, and researchers have discovered that abnormally high TG levels or hypertriglyceridemia are associated with an increased risk of atherosclerotic cardiovascular diseases.

Cholesterol is another type of fat that you need to look out for. Low-density lipoprotein or LDL cholesterol is considered bad cholesterol due to its contribution to fatty buildup in the artery. Because of this, LDL cholesterol has been established as a causal factor for atherosclerosis and targeted for therapy to reduce its production. 

However, studies have shown that a significant number of atherosclerotic cardiovascular disease events still occur despite the extensive statin therapy, which indicates that cholesterol alone is not the only clinically relevant marker for the disease. In fact, no single biomarker can sufficiently predict the risk for atherosclerosis. Instead, multiple determinants, including triglyceride levels and genetic biomarkers, are needed to predict and accurately identify patients at risk.

Note that you can lower your triglyceride and LDL cholesterol levels by managing your diet. One way to do that is to avoid eating foods that are high in saturated fats and maintain a balanced diet. In addition, it is best to limit your exposure to cigarette smoking, stress, and pollution, as they have also been found to worsen the risk of atherosclerosis.

Atrial fibrillation 

What is Atrial Fibrillation?

Atrial fibrillation, or AFib, is when the heart beats irregularly (too slowly or too fast) because the heart’s upper chamber (the atria) is out of sync with the lower chamber (the ventricles). 

This can occur in brief periods of time, and some people may not show any symptoms at all. However, it can become permanent and may cause palpitations, difficulty in breathing, and muscle weakness. In worst cases, AFib may result in blood clotting in the heart leading to stroke or heart failure.

Who is affected by it?

The population with atrial fibrillation has been growing globally. In the US alone, 2.7 to 6 million have AFib and is predicted to increase by 10 million more in 2050. In Europe, the prevalence of Afib reached around 9 million in 2010 and is projected to reach 16-17 million by 2050. 

One of the primary risk factors for atrial fibrillation is age. While this condition can occur across any lifespan, AFib is more common in older individuals. The risk of getting AFib doubles with each progressive decade of gaining and can surpass 20% by the age of 80 years. 

What are the risk factors for Atrial Fibrillation?

The key to preventing the development of atrial fibrillation is early detection and identifying other conditions that may put your heart at greater risk. One condition closely linked to AFib is sleep apnea, which is a type of sleep-breathing disorder. In sleep apnea, your airways narrow or close while sleeping, which causes your body to wake up briefly. This can result in pressure changes in your chest and lower blood oxygen levels, leading to the development of AFib.

Weight gain and obesity is also a risk factor for AFib. An increasing number of studies show that obesity can contribute to cardiac remodeling, as well as atrial enlargement and fibrosis, which leads to AFib. Although the role of dietary intervention in AFib has yet to be fully elucidated, maintaining proper body weight is recommended as it is associated with reduced progression of AFib.

Intoxicants like alcohol and illicit drugs not only trigger an episode but also increases the risk of AFib. Alcohol consumption and drugs like methamphetamine and cocaine can directly have toxic and oxidative effects on your heart, resulting in left atrial enlargement and left ventricular remodeling. Long-term smokers can also develop AFib due to damaged blood vessels and increased lung pressure.

What diseases are associated with Atrial Fibrillation?

People generally do not die from AFib, but raising awareness of this disease is important as it can be part of a more serious underlying condition. The figure below shows several examples of accompanying comorbidities and complications of AFib. Note that AFib has an interdependent relationship with these comorbidities, so don’t forget to get tested to detect them at an early stage.

Figure from Journal of Americal Heart Association

Hypertension

What is Hypertension?

Hypertension, or high blood pressure, is a condition that develops when the blood pressure in your arteries is abnormally high. There are two numbers related to blood pressure: systolic and diastolic. Systolic pressure is when the heart exerts force to pump out blood. In contrast, diastolic pressure is the force exerted in your blood vessels when the heart relaxes.

The normal systolic and diastolic pressure is less than 120 and 80 mmHg, respectively. But your blood pressure changes based on your daily activities. Hypertension occurs when the blood pressure exceeds 130/80 mmHg. 

People with hypertension may not feel any symptoms. In fact, around 46% of individuals with this condition are not aware of it. So getting your blood pressure checked regularly is necessary as this is the only way to detect hypertension.

What causes high blood pressure?

Blood is pumped from the heart and flows through blood vessels or arteries to other parts of your body. This is because blood contains nutrients and oxygen that must be delivered to keep every cell alive and working.

However, when the oxygen level declines or the resistant pressure of higher due to the narrowing of small blood vessels, high blood pressure develops. This causes the blood to exert more pressure against the vessel, forcing the heart to work harder to accommodate these changes. Without proper treatment and prevention measures, the arteria will get rigid over time. The heart may also eventually enlarge, causing injuries in major organs.

What are the risk factors of hypertension?

The exact cause of hypertension is not always known. But in some cases, it is associated with other underlying conditions.

When there is no underlying cause of high blood pressure, it is called primary or essential hypertension. This is the most common type with 90-95% of patients. Although physicians cannot directly pinpoint the cause, several factors are known to play a critical role in the development of primary hypertension. This includes:

• Genetic factors
• Age
• Physical inactivity
• Smoking and alcohol intake
• Elevated salt intake
• Being overweight/ excess adipose tissue

Secondary hypertension is when the cause of hypertension is identified, which is often another disease like sleep apnea, diabetes, and obesity. In most cases, correcting the underlying causes can mitigate this hypertension.

Complications 

Note that hypertension is a silent killer. You may not feel it initially, but it can quietly damage your body for years. When the constant high pressure of blood moves through your artery, it can form a bulge or abnormal swelling, leading to aneurysm. This aneurism can potentially rupture and cause serious internal bleeding.

Other complications of hypertension include:

• Stroke
• Coronary Artery Disease
• Heart attack
• Heart Failure
• Kidney problems/ Renal failure
• Atherosclerosis 

Click here to learn more about hypertension.

Final Thoughts 

The cardiovascular diseases discussed above may be frightening, but there are ways to prevent you from getting them. Remember to get regular checkups as some conditions don’t exhibit signs and symptoms at early stages. And finally, it is never too late to take action toward a healthier heart. Start by changing your lifestyle and eating a heart-healthy diet.

References

Farnier, M., Zeller, M., Masson, D., & Cottin, Y. (2021). Triglycerides and risk of atherosclerotic cardiovascular disease: an update. Archives of Cardiovascular Diseases, 114(2), 132-139.

Fan, W., Philip, S., Granowitz, C., Toth, P. P., & Wong, N. D. (2020). Prevalence of US adults with triglycerides≥ 150 mg/dl: NHANES 2007–2014. Cardiology and therapy, 9, 207-213.

Javed, S., Gupta, D., & Lip, G. Y. (2021). Obesity and atrial fibrillation: making inroads through fat. European Heart Journal-Cardiovascular Pharmacotherapy, 7(1), 59-67.

Magnani, J. W., Wang, N., Benjamin, E. J., Garcia, M. E., Bauer, D. C., Butler, J., … & Harris, T. B. (2016). Atrial fibrillation and declining physical performance in older adults: the health, aging, and body composition study. Circulation: Arrhythmia and Electrophysiology, 9(5), e003525.

Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., … & American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2022). Heart disease and stroke statistics—2022 update: a report from the American Heart Association. Circulation, 145(8), e153-e639.

National Heart, Lung, and Blood Institute. (2022) ​​What Is Atherosclerosis? https://www.nhlbi.nih.gov/health/atherosclerosis

National Heart, Lung, and Blood Institute. (2022) What Is High Blood Pressure? https://www.nhlbi.nih.gov/health/high-blood-pressure

Winters, W.L (2023) Hypertension https://www.britannica.com/science/hypertension#ref343322

Medical News Today (2023) High Blood Pressure. https://www.medicalnewstoday.com/articles/150109#treatment

CDC.gov. (2022) Heart Disease Facts. https://www.cdc.gov/heartdisease/facts.htm