Age Science: Prevent Heart Disease

The adult heart beats more than 100,000 times a day, pushing about 7,580 litres of blood through 96,600 kilometres of blood vessels. February is heart month, so with the help of, we give you an expert guide to keeping yours pumping as it should.

Atherosclerosis, from the Greek words athero (gruel) and sclerosis (hardness), is a buildup of plaque in the lining of arterial walls (arteries take blood away from your heart, veins bring blood in). Plaques, which include cholesterol, calcium and fatty materials, can rupture. The blood clot that then forms at the site restricts or stops blood flow or floats off to block an artery in the heart, brain or limbs.

Dr. Leonard Sternberg, director of cardiology at Toronto’s Women’s College Hospital and director of the Women’s Cardiovascular Health Initiative and Cardiac Rehabilitation Program, often tells his patients: “In western society, atherosclerosis is an inevitable consequence of aging. That’s why heart disease is the most common cause of death in Canada.”

Risk factors for atherosclerosis include a family history of early heart disease (HD), high blood cholesterol, high blood pressure, poor eating habits, having diabetes, being overweight or obese, physical inactivity and smoking. If these cause damage to arterial  walls, plaque will stick and narrow them, like grease clinging to the drains of a sink. If a total blockage occurs in a blood vessel supplying your heart, you will experience a myocardial infarction, a.k.a. heart attack.

Over time, the fat accumulates and, eventually, HDL (good cholesterol) is overwhelmed and can’t perform its natural task, which is to “scrub” away the fat in our bloodstream and take it to the liver. Risk factors and genetics are what determine whether you get HD when you’re 45 or 85, says Sternberg. Preventative measures such as quitting smoking, eating a health-promoting diet, enjoying an active lifestyle, knowing your risk factors and asking your doctor the right questions can help your heart stay healthy and strong.

Eat Smart, Get fit

Results from the INTERHEART study conducted by McMaster University across 52 countries (the mean age of participants was close to 60) showed diet is the biggest driver for cardiovascular risk. A high-fat, high-salt diet — a North American favourite — compared to a low-salt, high-fruit-and-vegetable diet, increased risk of HD by 30 per cent in a few months, says Dr. Marco Di Buono, director of research, Heart and Stroke Foundation of Ontario.

Dr. Martha Gulati, a Chicago-based cardiologist and co-author of the newest guidelines on heart disease prevention in women published by the American Heart Association (AHA), says a sedentary life will do you more harm than good. Gulati, a guest speaker at this February’s Heart Beat Ball that benefits the Women’s Cardiovascular Health Initiative at Women’s College Hospital in Toronto, recommends, “When you’re walking … test yourself and if you can carry on a normal conversation comfortably, then you’re not walking fast enough. You should be breathing hard.”

Researchers from the Mid America Heart Institute in Kansas City, Mo., found vitamin D also plays a major role in heart health, and a lack of the sunshine vitamin helps boost the risk of heart attacks. Health Canada recommends everyone 50 and older take 400 IU of vitamin D but not more than 2,000 IU a day. “I’ve started taking vitamin D now because of that study,” says Sternberg.

Quit Smoking

According to Health Canada, approximately 1.75 million people aged 45 or older still smoke, with men averaging 18 cigarettes a day and women 15.5. On a positive note, things look brighter for those who break the habit. Within a year of quitting, the risk of dying from smoking-related heart disease is cut in half; after 15 years, the risk of death is nearly that of a non-smoker, the Heart and Stroke Foundation notes.

“Quitting smoking is the most important thing people can do to save their lives,” says Gulati. As previously noted, physical stress, such as smoking, can cause plaque in the arterial wall to rupture.

Your Numbers

As early as your 20s, you should be screened for HD. But it’s never too late, and screening should be part of your yearly physical. The U. S. National Institute of Health has a risk calculator that assesses your 10-year risk for heart disease based on age, gender, total cholesterol, HDL cholesterol, systolic blood pressure levels and whether you smoke. Plug in your data to learn your risk. If you don’t know your numbers, take the questions straight to your doctor and ask for help in filling them out.

Latest Innovations

In the world of open-heart surgery, more doctors are opting for noninvasive procedures when possible. A new generation of stents used in angioplasty to open a narrowed or blocked blood vessel is being tested, says Dr. Lyall Higginson, past-president of the Canadian Cardiovascular Society. Coated with an antibody that stimulates cells lining artery walls to grow over the stent, the innovation may keep the inner walls from narrowing again. Bypass surgery, which once used veins from the legs, now also employs arteries from inside the chest or the radial artery (which delivers blood to the hands). Veins tend to have thinner walls; doctors find arteries a better choice.

Newest is artificial valve surgery, which slips new valves up through arteries in the leg and into the heart to replace damaged valves. Essentially, this valvular replacement method avoids the necessity of open-heart surgery. Currently, this method is used only on people who can’t handle open-heart surgery, says Higginson