Cardiovascular disease is an umbrella term that refers to a variety of health concerns that impact the heart and blood vessels. In the United States, it is estimated that nearly 50% of adults have some kind of cardiovascular disease, including high blood pressure, with many not being aware of their health condition. Sometimes, lifestyle adjustments are enough to address the concern; exercise, shifts in diet, among other treatments may address the issue. But left untreated, cardiovascular disease can lead to more serious complications including heart attack, stroke, and heart failure.
A recent report from the American Heart Association states that over the next 26 years, the number of American adults that will have some type of cardiovascular disease will increase to over 60%. The report, compiled using data from a National Health and Nutritional Examination (2015-2020) and the Medical Expenditure Panel Survey (2015 to 2019), also estimates that diabetes (16.3% to 26.8%) and obesity (43.1% to 60.6%) will increase in addition to cardiovascular disease.
What is cardiovascular disease?
Cardiovascular disease remains the leading cause of death globally. After decades of a steady decline in the U.S., CVD deaths are on the rise (840,678 deaths in 2016 up from 836,546 in 2015), although worldwide, the number of people dying from CVD was lower in 2016 (17.6 million) than the previous year (17.9 million). In 2018, cardiovascular disease, listed as the underlying cause of death, accounted for nearly 836,546 deaths in the U. S. That’s about 1 of every 3 deaths in the U. S.
Sources share that cardiovascular disease includes heart or blood vessel issues, including:
- Narrowing of the blood vessels in your heart, other organs or throughout your body.
- Heart and blood vessel problems present at birth.
- Heart valves that aren’t working right.
- Irregular heart rhythms.
Some symptoms may be:
- Chest pain (angina).
- Chest pressure, heaviness or discomfort, sometimes described as a “belt around the chest” or a “weight on the chest.”
- Shortness of breath (dyspnea).
- Dizziness or fainting.
- Fatigue or exhaustion.
What are the risk factors for cardiovascular disease?
The behavioral factors that most heavily increase the risk of cardiovascular disease include:
- Unhealthy diet
- Physical inactivity
- Tobacco use
- Excessive alcohol consumption.
- Inconsistent/ inadequate sleep. (more than 8 hours or less than 7 hours)
Other factors include:
- Age – most common in people over 50 and the risk increases as you get older
- Gender – men are more likely to develop CVD at an earlier age than women, but it is also important to note that women often experience more subtle signs (which is why regular screening for everybody is so important).
People with these risk factors may experience:
- High blood pressure
- Raised blood glucose
- Elevated blood lipids
- Carry excess weight
High blood pressure specifically, is often called a “silent killer”, because of the prevalence of the serious health complications that can occur if elevated blood pressure is undetected. Every year, 9.4 million people die from complications related to high blood pressure (also referred to as hypertension), according to the World Health Organization. But many people with hypertension aren’t even aware they have it. Regular screening and early intervention were deemed so crucial to managing CVDs that parameters for measuring blood pressure were modified in 2017 and are now lower than previous levels. Instead of a reading below 140/90 being acceptable, it is now recommended to have a reading consistently below 130/80. The parameters were adjusted to promote early detection, but the shift did result in nearly half of the U.S. adult population being categorized as having hypertension.
It isn’t just about weight loss
While lifestyle changes are one of the best ways to decrease the risk of cardiovascular disease, the effort isn’t just to drop pounds. Medical providers often urge those with a higher BMI to lose weight to reduce potential health issues. Here enters the long-standing debate of the benefits of “fit but fat”, where increased levels of physical activity are encouraged to increase cardiovascular fitness in an effort to lessen the risk of a variety of issues, but the focus isn’t primarily on weight loss.
This isn’t a new topic, with early studies going back as far as 1999, when two large scale studies suggested that people that were obese could still be fit in the cardiovascular sense. One of the studies showed that obese men could reduce their risk of heart disease significantly through exercise, even when they didn’t lose any weight.
Since then, additional research has backed up those findings with many also supporting the benefits of shifting the focus from weight loss alone, to overall fitness and increased physical activity. Dr. Glenn Gaesser, a professor at Arizona State University and co-author of a new review, shares “Current obesity treatment guidelines do not even mention ‘fitness’ and only encourage physical activity as a means to facilitate weight loss. This approach ignores the major improvements in mortality and disease risk associated with increased physical activity and improved fitness in the absence of weight loss. [Evidence shows], improving fitness by increasing physical activity is associated with greater reductions in mortality risk compared to weight loss.“
Three recent meta-analyses support that weight cycling, or when weight is lost, then gained again, is associated with increased risk of cardiovascular disease-related mortality, as well as higher risk of all-cause mortality. This suggests that traditional methods of pursuing weight loss as the primary way to reduce mortality risk (along with other obesity related health issues), when resulting in weight cycling, may inadvertently be working against the intended benefits of weight loss.
Cardiovascular exercise is also an effective way to reduce two types of fat- visceral adipose tissue, which is around the internal organs in the abdomen, as well as fat that is in the liver. Reducing these two types of fat decreases the risk of cardiovascular disease and type 2 diabetes. Sources share that even when weight loss is not achieved, a clinically relevant reduction in the fat stores in the liver and visceral adipose tissue can occur with exercise training, further supporting that “fit but fat” can reduce the risk of significant health risks, despite not necessarily resulting in immediate weight loss results.
The reviews and studies that support focusing on cardiovascular fitness rather than calorie restriction as a weight loss method aren’t saying that obesity and carrying extra weight do not harm your health. These studies as many others do, isolate specific data points to evaluate how they interplay with other factors. Cardiovascular fitness can be achieved, sometimes without weight loss, but that isn’t to say that excess weight doesn’t impact overall health. Evidence shows that obese and overweight people have higher risk of diabetes, high blood pressure, and high cholesterol- all of which can cause severe health issues like a stroke or heart attack, along with increased levels of pain and even higher rates of depression.
Ways to decrease the risk of cardiovascular disease
There isn’t one singular way to eliminate the risk for cardiovascular disease, especially when you consider each health concern under the larger umbrella of “cardiovascular disease” has its own risk factors. But addressing a handful of the same elements can have a significantly positive impact on overall risk.
The basics include:
- Diet: Reduce ultraprocessed foods, which have been found to increase the risk of cardiovascular disease, among many other health issues. Increase consumption of whole, plant-based foods.
- Limit or eliminate alcohol: No amount of alcohol benefits your health, not even moderate drinking. If you choose not to completely cut out alcohol, limit consumption.
- Sleep: Irregular, too much, or too little sleep can all impact your cardiovascular and overall health. Aim for 7-9 hours of sleep every night, and the same 7-9 hour window.
- Get moving: Without a doubt, Americans don’t get enough exercise. And we get it. Between work, family, home responsibilities, school, commuting, and more- it can be difficult to even think about squeezing in a workout. But every step we take, and every moment we decrease our sitting time benefits our health.
- Decrease stress: Increased blood pressure, increased inflammation, impact to heart rhythm, and to blood flow are all ways that stress can increase the risk of cardiovascular disease. Manage stress using these breathing techniques, aromatherapy, exercise, art, friends, and more.
Check out the six posts below that go more into detail on how to reduce your risk of cardiovascular disease.
A final note. . .
An aspirin a day keeps the doctor away? Over the years, people had been taught that a daily aspirin was a sound routine to help protect against CVDs, but as we shared in this post, that is no longer the recommendation. Research now shows that the risk outweighs any benefit it may have. A doctor may suggest aspirin if a person has a high risk of experiencing a cardiovascular event, such as a heart attack or stroke, and a low risk of bleeding. Doctors may also recommend it to those who have already had a heart attack or stroke. Please speak to your provider before starting any new medication (or supplement) regimen.
-https://my.clevelandclinic.org/health/diseases/21493-cardiovascular-disease
-https://pubmed.ncbi.nlm.nih.gov/27340299/
-https://www.ahajournals.org/doi/epdf/10.1161/CIR.0000000000001256
-https://www.medicalnewstoday.com/articles/obesity-exercising-not-dieting-may-be-key-to-avoiding-health-risks#Fitness-and-mortality-risk
-https://www.healthline.com/health/fitness/fat-but-fit#history
-https://www.google.com/amp/s/www.insider.com/fat-but-fit-not-possible-study-finds-experts-disagree-2021%3Famp
-https://my.clevelandclinic.org/health/diseases/21493-cardiovascular-disease
-https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118
-https://www.ahajournals.org/doi/full/10.1161/01.atv.0000116216.56511.39
https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20049357
https://pubmed.ncbi.nlm.nih.gov/31423912
https://medical.andonline.com/blog/are-wrist-blood-pressure-monitors-accurate
-https://www.cdc.gov/heartdisease/facts.htm
-https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
-https://www.hopkinsmedicine.org/health/wellness-and-prevention/surprising-body-cues-that-could-be-a-heart-concern
-https://www.nhs.uk/conditions/cardiovascular-disease/