In last week’s column we introduced the idea of atherosclerosis as the major underlying pathology responsible for most of our circulation-related diseases, such as heart disease, stroke, cognitive losses, hearing loss, vision loss, kidney disease, high blood pressure, erectile dysfunction (impotence), degenerative disk disease, intermittent claudication (peripheral vascular disease) and some of the neuropathies associated with diabetes.
Risk factors for coronary heart disease:
The famous Framingham heart study has taught us that the risk factor concept is a good way of determining the likelihood of coronary heart disease in populations.
• The most serious risk factor by far is an elevated blood cholesterol. Men, 50 years and older with blood cholesterol levels over 295 mg% are five times more likely to develop atherosclerosis and fatal heart disease than men the same age with levels of under 160. A 20 percent decrease in blood cholesterol levels lowers the risk of a heart attack by 50 percent.
• By age 60, smokers are many times more likely than nonsmokers to die from heart disease. More than 125,000 coronary deaths a year are directly related to smoking, about 23 percent of the total of 550,000.
• In North America, every third adult has high blood pressure. This triples the likelihood of coronary death when compared to a person with normal blood pressure.
• Obese men are five times more likely to die of heart disease by age 60 than men of normal weight.
• Diabetes (the common Type 2 kind) has tripled over the last 30 years in America. And it is diabetes that is a major accelerator of atherosclerotic narrowing of many arteries leading to blindness, hearing loss, kidney disease, leg amputations, erectile dysfunction, stroke and increasing the risk for heart disease by 2 to 3 times.
• Other risk factors are elevated triglycerides, sedentary lifestyle (sloth), unresolved stress, and possibly an elevated homocysteine blood level. Genes are often blamed as a cause of heart disease. But with the new science of epigenetics, we know that genes load the gun but lifestyle pulls the trigger. By making wiser lifestyle changes, especially in the area of diet, many of these disease-causing genes can be suppressed, while health enhancing genes can be strengthened.
Fortunately, all of these listed risk factors can be controlled and modified by changes in diet and lifestyle. Only age and gender are difficult to change, if at all. In this case, fortuitously, they are usually the least important ones contributing to atherosclerosis and its various clinical expressions.