This epidemic started in the developing world and has now spread to become among the leading causes of death worldwide.
It is the epidemic of cardiovascular disease. Heart disease, stroke and other cardiovascular diseases kill more than 800,000 people each year in the United States. They are responsible for one in every three deaths in the population. Cardiovascular disease is the nation’s leading killer of men and women.
The U.S. Department of Health and Human Services is embarking in 2017 on an initiative to save a million lives from cardiovascular disease in the next five years. It is the Million Hearts initiative, and it aims to optimize health care, keep people healthy through prevention and improve outcomes for priority populations at the highest risk.
There are many modifiable risk factors for cardiovascular disease. Most are directly or indirectly linked to lifestyle. For example, physical inactivity is among the most common risk factors and consists of a sedentary lifestyle. There is evidence that regular low impact physical activity such as walking as little as 20 to 30 minutes daily can improve heart health.
Obesity, already at epidemic proportions in the U.S., has been linked to heart disease. In particular, abdominal obesity increases risk for men and women.
Cigarette smoking continues to be the single most important modifiable risk factor for cardiovascular disease and cancer. While smoking rates have declined overall since the middle of the last century, nearly one in five U.S. adults smoke, and there is a concerning trend among adolescents regarding the rising use of nicotine products.
Three common health conditions linked to cardiovascular disease are amenable to treatment to reduce heart disease risk. These are high blood pressure, high cholesterol and diabetes. Effective treatment strategies for each of these conditions have been recently outlined by the American Heart Association, American Diabetes Association and partner organizations. Efforts to control these conditions through lifestyle change and adherence to medication therapy, in partnership with a health care professional, can substantially reduce cardiovascular risk.
Dietary factors may play a significant role in prevention efforts. These include a reduction in sodium intake to prevent or control high blood pressure as well as consumption of a diet rich in vegetables, fruits and whole grains. Limiting intake of saturated fat and choosing healthier foods high in healthy Omega-3 fatty acids (such as certain types of fish) can be beneficial.
While there is some evidence of a protective benefit to moderate alcohol intake to reduce cardiovascular risk among adults, excessive alcohol intake, such as binge use, can increase risk.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.