Economics play role in cardiovascular disease

Much of the attention on potentially fatal diseases often focuses on cancer, but most people may not realize that cardiovascular disease in the U.S. outnumbers cancer by a 2-1 ratio.

It’s a margin not seen in poorer countries, contends Dr. David Shuler, a cardiologist with Mercy Clinic Carthage.

“Cardiovascular disease is a disease of economic success,” he said recently while speaking at the Carthage Chamber of Commerce quarterly luncheon at Mercy Hospital Carthage.

What Shuler is referring to is that an overabundance of resources and access to as much food as one can consume leads to many health issues, including cardiovascular disease.

Cardiovascular disease can result for many reasons, but a main culprit is being overweight and/or having high cholesterol. To keep your cholesterol in check, aim for a total cholesterol level of less than 200, triglycerides less than 150, high-density lipoprotein (good) cholesterol greater than 40 and low-density lipoprotein (bad) cholesterol less than 130.

When cholesterol combines with fat, calcium and other substance in the blood, plaque can form in the wall of an artery. As plaque builds up, hardens and causes the artery to narrow, it eventually can rupture, allowing a clot to form around the rupture and block blood flow. The result can be heart disease, a heart attack or a stroke.

“Plaque gradually will increase as one ages and can depend on things like diabetes, smoking or hypertension,” Shuler said.

The good news is there are common steps than can be taken to lower cholesterol, including:

• Eat heart-healthy foods that contain healthier fats, lack trans fats, are rich in omega-3 fatty acids and contain more soluble fiber.
• Increase physical activity and exercise at least 30 minutes most days of the week.
• Quit smoking.

Cardiovascular disease, which includes coronary artery disease, coronary heart disease, peripheral arterial disease and cerebral vascular disease, affects the majority of adults over the age of 60 “who have some form of this plaque buildup,” Shuler said.

According to the Framingham Heart Study, the lifetime risk of coronary heart disease at age 40 is 40 percent for men and 32 percent for women. Women tend to be more protected until menopause.

“After women go through menopause,” Shuler said, “their incidents of coronary heart disease increase. Ten to 15 years down the road, the risk is equivalent to men.”

Another culprit of cardiovascular disease is the economic means to purchase and smoke tobacco products.

Female cigarette smokers have a six-fold increased risk of a heart attack, while male smokers have a three-fold increased risk. Post-menopausal woman who smoke one pack of cigarettes a day have a six-fold increased risk of suffering a heart attack than a post-menopausal woman who doesn’t smoke.

“The good news,” Shuler said, “is that if have a heart attack and quit smoking, two years later you are at the same risk of a heart attack as a non-smoker, so it is reversible.”

Modifiable risk factors:

• Diabetes
• Dyslipidemia (elevated or out-of-control cholesterol lipid profile)
• Hypertension (acceptable blood-pressure limit is 140/90)
• Abdominal obesity (different than peripheral obesity and is an inflammatory-type disease as inflammation lends to heart arterial disease)
• Poor diet
• Psychosocial factors (such as stress)
• Lack of regular physical activity (exercising as little as 20 minutes every other day can elevate the heart rate to 70 percent of its maximum and help the heart)
• Smoking

To learn more, contact Mercy Clinic Cardiology at 417-451-2277 or Mercy Clinic Heart Care at 417-781-5378 on the McCune-Brooks Campus, 3125 Dr. Russell Smith Way, Carthage.