By Dr. Lin Wilder
An average of 600,000 people die each year from cardiovascular disease; either a heart attack or stroke. Cardiovascular disease has been the leading cause of death in the United States for decades and remains so now, well into the 21st century.
Despite these distressing facts, there is clear and compelling good news in our impact on cardiovascular disease: The medical advances made in the diagnosis and treatment of heart attacks and strokes within the last 50 years are nothing short of spectacular. Death rates from heart attacks and strokes have dropped by 60 % in the last 50 years. Not all that long ago, sudden occlusion of one of the coronary arteries supplying the heart with blood resulted in sudden death with frightening certainty. One of the giants of medicine of the last century, William Osler wrote in his Textbook of Medicine that an occlusion of one of the coronary arteries supplying the heart with blood would result in certain death. But the medical, surgical advances in revascularization beginning in the seventies via surgical coronary arterial bypass, angioplasty and use of thrombolysis or ‘clot busting ‘ agents like have resulted in a stunning reversal of what had been a death sentence a mere fifty years ago.
Early and aggressive medical and surgical management of strokes including the use of thrombolytic agents beginning in the late seventies have contributed to a drop of over 40% in deaths from strokes. Not all that long ago, high blood pressure was considered a normal response to atherosclerosis (hardening of the arteries) by the medical profession. Dr. Paul Dudley White, was considered the top cardiologist at Harvard Medical School and its teaching hospital Massachusetts General. Dr. White wrote that hypertension was a compensatory response to atherosclerosis and ‘should not be tampered with.’ Historians have commented about the possible changes in world history had President Roosevelt’s malignant hypertension received the aggressive management we now know was critical.
At the infamous post World War 11 meeting in 1945 at Yalta, Roosevelt’s blood pressure was 260/150 mm Hg. Predictably, the President was dead within two months of a massive stroke. Had Roosevelt not been suffering the massive headache, weakness, foggy thinking, fatigue and sleeplessness of malignant hypertension, he may have been able to defend the interests of post war Europe against Stalin’s aggression.
The Framingham Heart Study, the longest running population study of persons at risk for developing heart disease has provided over 50 years of data considered reliable enough to create an ‘absolute risk score’. The Framingham data has galvanized the development of more specific risk scores which are currently being used across the world and contributing to understanding the risk factors and ways they can be managed both medically and with changes in dietary habits and life styles. The extensive medical and public education about the critical importance of managing the major risk factors of high blood pressure, smoking, presence of diabetes, and consumption of saturated fats have had substantial effects on the reduction of deaths from heart disease.
Unfortunately, there are three factors which seriously compromise the good news of recent successes in the war against heart disease and are increasingly bad news for the health of Americans:
1. An increasingly elderly population.
2. The epidemic of Type 11 Diabetes among American adults and children.
3. A corollary and causal epidemic of obesity among American children and adults.
In 2013, 14.1% of Americans were over 65. By 2050, the number of Americans over 65 is expected to increase to 78.3 million or potentially 20% of the population.
Why is this a factor in managing heart disease?
Because heart disease is increasingly seen in the older population; specifically men over 65. As age increases, the mortality rate from heart disease more than doubles. As baby boomers continue to become seniors, the prevalence of cardiovascular disease is expected to increase by more than 50%.
One in three adults in this country is obese and 10 percent of children are obese. One in five children under 12 is a type 11 Diabetic, a condition rarely seen prior to the nineties. Of the 30 million Americans with Diabetes, one out of three will develop cardiovascular disease. Of the 10 percent of obese children, significant numbers already possess markers for the development of cardiovascular disease.
Despite the facts that the data regarding increased incidence of type 11 Diabetes and obesity in American adults and children are redoubtable; dreadful, the very good news is that the answers to these appalling numbers resides squarely in the hands of non-medical health practitioners and is very much in the control of the individual.
Ten Ways You Can Protect Your Cardiovascular Health:
1. If you smoke or use any tobacco products, stop. The data are fairly incontrovertible: Smoking is a primary risk factor for cardiovascular disease.
2. If overweight, decide to lose weight by changing what, when, why and how you eat. There are many non-medical experts to help you do this; you can safely assume that you are overweight because you need to change your dietary habits.
3. Exercise consistently most days of the week for a minimum of thirty minutes; sixty minutes is better.
4. Sleep seven to eight hours each night. Insomnia is very common for all of us and seems to increase with age; thought to be simply annoying, lack of sleep is extremely stressful on us physically; the cellular regeneration that occurs naturally with deep sleep is essential for the health of our bodies.
5. Consider cutting out sugar from your diet. When we’re young, we can safely eat those pastries, ice cream sundaes so long as we work off the excess calories. As we age, however, our metabolism changes and we must work to keep fat from accumulating.
6. Cut down on carbs- breads, pastas, and the like-consider eliminating them; to our bodies, those whole wheat bagels and breads work exactly like sugar and can turn very quickly to fat.
7. Stop thinking of your age as a diagnosis.
8. Avail yourself of the experts in order to become an expert on your own health: There are many excellent sources of great information; among my favorites are: http://www.mercola.com; http://www.foundmyfitness.com/about-dr-rhonda-patrick
9. Develop a consistent prayer or meditation time.
10. Decide to partner with your doctor regarding your health: Understand that what he or she prescribes may not be in your best interest but is rather a standard guideline and that medical training teaches doctors about disease, not health. If your doctor is uncomfortable with the idea of partnering with you, consider finding another doctor.
Dr. Lin Weeks Wilder holds a Doctorate in Public Health from The University of Texas School of Public Health and has over thirty years administrative experience in academic health centers ranging from critical care nurse to hospital director.
She spent twenty-three years at the Texas Medical Center (as Dr. Lin Weeks) and another three years as Hospital Director at University of Massachusetts Medical Center. While serving as Chair of the Hermann Hospital Institutional Ethics Committee for five years, Weeks-Wilder was featured in TIME Magazine and in Lisa Belkin’s award winning book on the committee and Weeks-Wilder.
She is currently writing the sequel to The Fragrance Shed By A Violet.