Episode 2 of 7 in our series on Top Threats to Good Health

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Cardiovascular (heart and vascular) disease is the leading cause of death for adults. Over one out of every 5 adult deaths each year.  677,650 people in 2023.  That was worth saying three times!

  • You should know these words:
    • Cardiovascular – multiple conditions affecting the heart and blood vessels (e.g. coronary artery disease, heart attacks, cardiomyopathy, aneurysms, and more)
    • Morbidity – disease (as in, “leading cause of morbidity”)
    • Mortality – death (as in, “leading cause of mortality”)

Cardiovascular disease contributes significantly to the burden of morbidity and mortality. Knowing the epidemiology, risk factors, preventive approaches, and treatments for cardiovascular disease is extremely important for you to reduce the impact on your health.


Epidemiology

  • Each year, ~678,000 U.S. adults die from cardiovascular disease
  • Each year, ~800,000 U.S. adults have a heart attack
  • Heart disease in:
    • 55-64 year old -> 9%
    • 65-74 year old -> 17%
    • >75 year old -> 24%

Certain groups are affected by cardiovascular disease more than others. Increasing age is a significant factor, particularly among adults over 65, but genetic and lifestyle factors predispose some people to early-onset cardiovascular disease in their 30’s and 40’s.  There are also racial and ethnic differences in cardiovascular disease prevalence with African Americans, Hispanic Americans, and American Indians experience higher rates.


Risk Factors

Certain risk factors lead to cardiovascular disease.  Some risk factors you can do something about (modifiable risk factors), while other risk factors can’t be changed (unmodifiable risk factors).  Identifying the risk factors as early as possible is key to prevent disease.  If you have modifiable risk factors, it’s important to modify them now, reduce your risk, and prevent morbidity and mortality from cardiovascular disease.  

  • Age
  • Sex (male or female)
  • Family history of heart disease
  • Lifestyle (diet, activity, sleep, stress, etc.)
  • Underlying health conditions (diabetes, kidney disease, etc.)

Prevention

A Medicine 3.0 approach to health is to identify risk factors early, seek ways to reduce the risk by modifying those risk factors that you can, in order to prevent developing the disease in the first place. Look at those modifiable risk factors and consider which ones you may have.  Here is our approach to cardiovascular disease prevention in the Paradigm Health clinic:

  1. Screening and Early Detection: Routine, ongoing screening for all modifiable risk factors enables early detection and intervention.  This includes health history, vital signs, labs, certain body scans (e.g. CT and ultrasound), and cardiopulmonary exercise testing. 
  2. Promoting Healthy Lifestyles: It’s a challenge, no doubt, to incorporate regular exercise, choose healthy food, and control stress. For some, this is easier than for others.  However, these are key to reduce the risk of heart disease.  At Paradigm Health we work with each person to look for opportunities to take positive steps towards healthy lifestyle.  Positive lifestyle changes have to be possible and sustainable.  

Treatment

It is true that an ounce of prevention is worth a pound of cure.  Many people never regain their prior level of function after a heart attack or after developing heart failure.  But what if you already have diseases that are risk factors for cardiovascular disease, or already have cardiovascular disease, or have had a heart attack or even a stroke? 

While prevention is paramount, some patients come to us with known or unknown heart disease already.  For these patients, effective treatment strategies are essential for managing their heart disease and reducing the risk of mortality as well as the loss of function.

Treatment approaches for cardiovascular disease vary depending on the specific condition and individual patient factors but often include a combination of non-medication lifestyle modifications, natural medications, traditional medications, and occasionally procedures and surgeries.


Optimization

Now that we have gone over 1) prevention, and 2) treatment, we need to mention Paradigm Health’s 3rd pillar of medical care, 3) optimization.

Optimization involves strengthening your heart and vasculature to be better than before, making it more likely that you will increase your healthspan and lifespan.  If you already exercise, we will measure your performance and help you improve your fitness.  If your blood pressure is well controlled at baseline, we will measure it under activity and stress to guide improvement.  If you already sleep well, we will focus on improvement in recovery, heart rate variability, etc. There is a lot to talk about in this space, so we’ll leave this for a later date when we start our blog series on Performance & Therapy.


As always, we’re excited and optimistic about this health journey.

In it with you,

Dr. Matt and Dr. David