Take Heart Part II: Risk Factors and Prevention of Cardiovascular Disease

Take Heart, Part II: Awareness of physiological risk factors of CVD helps in prevention

High blood pressure, a major cause of early mortality, affects over a billion adults all over the world; 46% of those affected have no idea they have it.¹ Diabetes diagnosis numbers have exploded in the past decades, increasing by hundreds of millions of cases.² In 2019 alone, approximately two million people lost their lives due to diabetes and diabetes-related complications.² High cholesterol affects about 39% of adults and results in over two million lives lost each year.³ Atrial fibrillation, the most common heart rhythm disorder, affects about 7.6 million people over age 65 in European Union countries; this number is expected to increase by 89% by the year 2060.⁴ High blood pressure. Diabetes. High cholesterol. Atrial fibrillation (AF). All can be classified as diseases on their own, but they are also physiological risk factors for cardiovascular diseases (CVDs).⁵

This is the second article in a two part series about CVD risk factors and prevention. Last month, an overview of major CVDs was provided and behavioural risk factors and prevention discussed. This month, the focus is on physiological risk factors and their role in CVDs.

As discussed in the previous article, there are two major types of CVD risk factors: behavioural and physiological.⁶ Physiological risk factors for CVDs deal with physical signs and symptoms (such as raised blood sugar and blood pressure), as well as diseases (like diabetes and AF) that indicate a heightened possibility of developing CVD.^6,7 While behavioural risk factors can be identified and controlled by individuals, identifying physiological risk factors often requires input from a healthcare provider. For physiological risk factors, regular healthcare visits and screenings are vital: they not only allow a more comprehensive overview of a person’s health, but also the opportunity for early detection of major CVD risk factors: high blood pressure, diabetes, high cholesterol, and AF.⁵

Countless studies have proven that high blood pressure (also known as hypertension) is one of the most decisive factors leading to many CVDs, including coronary artery disease and heart failure.⁵ Worldwide, high blood pressure is the cause of approximately 47% of coronary heart diseases and 54% of strokes.⁸ High blood pressure is also extremely common; the likelihood of developing hypertension increases with age: about 65% of people over age 60 have been diagnosed with high blood pressure.⁸ Healthcare providers can help people identify high blood pressure: when hypertension is suspected, blood pressure should be measured over several visits.⁵ Lifestyle changes can decrease hypertension, and there are several effective medications that can help to lower blood pressure.⁵

Like high blood pressure, diabetes is quite common.⁹ One consequence of diabetes is consistently high blood sugar; these high levels of blood sugar can cause damage to both blood vessels and the nerves that control the heart.¹⁰ People with diabetes are two times more likely to have heart disease or a stroke than those who do not have diabetes, and tend to suffer from these conditions at younger ages.¹⁰ People living with diabetes often also have high blood pressure and high cholesterol, other risk factors for CVD.¹⁰

Cholesterol is a fundamental element in the body, but high cholesterol – essentially, high levels of low-density lipoprotein cholesterol or LDL-C – is a major risk factor for CVD.⁵ There are no symptoms for high cholesterol.¹¹ It can only be identified by tests performed by healthcare providers, which means regular medical appointments are essential for early detection of high cholesterol; early detection allows healthcare providers to take steps to reduce LDL-C.¹² When blood LDL-C levels remain too high over time, so-called plaques can form at the walls of arteries, which is a crucial event in atherogenesis (thickening of vessel walls, narrowing of vessel openings which leads to restriction of healthy blood flow).¹³ Simply put, LDL-C reduction in those with high cholesterol is essential in the prevention of CVD.⁵

AF is the most common sustained heart rhythm disorder in the world; over 40 million people worldwide have been diagnosed with it.¹⁴ When a person has AF, the heart beats irregularly and sometimes at a much faster rate than what is considered normal; the upper and lower chambers of the heart don’t work together as they normally would, either.¹⁵ Much like with high cholesterol, early detection of AF is crucial: when AF is identified and treated early (before symptoms appear), the risk of negative outcomes decreases.¹⁴ Studies show that early detection of AF provides opportunities to control the heart’s rhythm through medication and other therapies, which greatly reduce the likelihood of heart attack and stroke.¹⁴

While risk factors are often categorised as behavioural or physiological, prevention strategies for both areas are remarkably similar. As mentioned throughout this article, regular visits with healthcare providers to assess physiological risk factors are critical for CVD prevention; otherwise, as with behavioural risk factors, the best prevention is to live a healthy life. Diet is extremely important in CVD prevention: foods with unhealthy fats (trans or saturated fats, food high in cholesterol) increases CVD risk; too much salt can lead to high blood pressure.⁷ Regular exercise can help prevent CVD.⁷ Finally, smoking and excessive alcohol use can substantially increase the risk of developing CVD; both should be avoided.⁷

At Daiichi Sankyo, our focus on prevention is key: Our promise to patients is to continue expanding medical knowledge. We want to help protect as many people as possible from a diagnosis of CVD and support those who suffer from it, because we care for every heartbeat.