Cardiovascular disease, which includes heart attack and stroke, kills more people than anything else on the planet. Risk Factors are factors that affect our chances of having cardiovascular disease. The three main categories are: Controllable Risk Factors, Non-Controllable Risk Factors, and Contributing, or Other Risk Factors. “Contributing” Risk Factors include Diabetes, Obesity, and Stress. Controllable Risk Factors include Smoking, Diet, Exercise, and High Blood Pressure, and finally, the Non-Controllable Risk Factors, which include Heredity, Gender, and Age. Let’s begin by discussing the Controllable Factors.
It should be no surprise to most people that smoking is bad for your health. Most people are aware of lung cancer and emphysema, but you should be aware that smoking is one of the leading causes of heart attacks as well. Cigarette smoke contains chemicals which, when ignited and inhaled, affect the body’s lungs, circulatory system, and ultimately the heart itself. One of these chemicals is nicotine. Nicotine is highly addictive; it’s the stuff that keeps you coming back for more. But it’s also a vasoconstrictor, which means it tightens the walls of the blood vessels. In the case of smaller blood vessels, nicotine may constrict them to the point of complete occlusion, and the largest collection of these small blood vessels in your body is the neural network of your brain. Upon inhalation, nicotine enters the bloodstream and begins constricting blood vessels. This may even create the temporary light-headed sensation associated with asphyxiation.
Even worse than nicotine, however, is a chemical asphyxiant known as Carbon Monoxide (CO). CO is the same stuff that comes out of the tailpipe of a car, and it is an extremely dangerous chemical. CO attacks the red blood cells of your body, robbing them of the oxygen you have already breathed in. Every cell in your body needs oxygen in order to survive. Red Blood Cells (RBC) are like a bus that delivers the oxygen. There are receptor sites on the RBC called hemoglobin, which are like seats on the bus. When the RBC’s arrive at the lungs, they are surrounded by oxygen, and if an oxygen molecule bumps up against the hemoglobin, it will become attached. Ultimately, a healthy RBC will have all of its “seats” filled with oxygen. Unfortunately, hemoglobin also likes to attach to CO. In fact, it has a 250 times greater affinity for CO than for oxygen, and CO will push the oxygen out of its way to take its spot on the RBC. This means that moments after cigarette smoke enters the lungs, millions of RBC’s are becoming depleted of the very oxygen than they’re designed to carry. When these RBC’s circulate through the body, they begin to run out of oxygen prematurely. Cold fingers and toes are just some of the symptoms of a condition known as “Peripheral Vascular Disease.” These areas become cold because the circulatory system has begun to shut down as the cells begin to die.
Another hazard of smoking (and chewing tobacco) is the creation of blood clots. With the introduction of these various chemicals into the bloodstream, the RBCs begin to clump together forming what’s known as a thrombus. If this thrombus begins moving through the bloodstream, it is called an embolus. An embolus that becomes lodged in a smaller blood vessel, blocking the blood flow to an area of the body is called an embolism, and is just about the most dangerous thing you can have in your body. These blood clots can escape the scrutiny of an x-ray, and you may never even know they exist until one becomes lodged in an artery leading to the heart (causing heart attack) or the brain (causing a stroke). They can happen at any time, with no warning, and at any age.
Let’s move on to something a little less frightening.
What did you all have for breakfast this morning?
If you’re like me, you had a good, balanced meal including all the necessary food groups: eggs, bacon, sausage, biscuits & gravy, hash browns, a glass of whole milk and a stick of butter. What I’m describing is also called Saturated Fat. It comes from animal products and is naturally broken down in your liver. In fact, your liver would get right to work on a breakfast like this and probably have it completely processed by sometime next Thursday. Now, if you don’t eat any more saturated fat until next Thursday, you’ve got no problems. But most of us don’t wait a week between meals; we wait about three hours and then you’ll find us eating a Super Bacon-Cheeseburger with fries and a shake for lunch. Saturated fat is a long-chain fat that is difficult and time consuming to digest. The problem is not that we EAT the fat, but that we eat TOO MUCH FAT. When this fat tries to go to the liver, it may find that there is no room. It can’t wait in the stomach, so it waits in the bloodstream, which can become “milky” with fatty residue. The longer this saturated fat circulates through your bloodstream, the more likely it is to begin sticking to the interior walls of the arteries. This dangerous condition is known as atherosclerosis. Gradually, the walls of the arteries close in, blocking blood flow, and causing such life threatening conditions as heart attack and stroke.
The best type of exercise for good heart health is called Aerobic exercise. Aerobic exercise is any activity that causes your heart and breathing rates to increase for sustained periods of time. Examples of aerobic activity include running, walking, bicycling, hiking, swimming, or sports like tennis, soccer, or basketball. This kind of activity can strengthen your heart; it can help improve circulation, occasionally even creating new blood vessels, and even helps to lower blood pressure. A good aerobic exercise program, combined with a healthy diet can help to decrease the chances of a heart attack. If a person still has High Blood Pressure, even after the modification of their smoking, diet, and exercise levels, they should see a doctor for prescribed blood pressure medications that are readily available.
In the next column, of your student handbook, we have the Non Controllable risk factors. Heredity, for example, is something we have no control over. If everyone in your family has had a heart attack, you may have an increased risk of having one yourself. This is not a guarantee, it has more to do with the odds, and the odds become greatly increased with each successive risk factor. A person with two risk factors is about 10 times more likely to have a cardiovascular disease than an individual with only one risk factor, and an individual with three risk factors is 100 times more likely. As you can see, they add up quite rapidly.
Another Non Controllable risk factor is Gender. Women are at lower risk than men in this category because women produce more Estrogen. Estrogen is a hormone which allows a women’s arteries to dilate, or expand when necessary, to allow the free passage of blood. This keeps women’s blood pressure typically ten points lower than a man’s. This hormone can keep women healthy, but it does not last forever. With the onset of menopause, a woman’s estrogen level will begin to diminish. For a period of ten years following menopause there will be a gradual increase in the level of heart attack risk for women until they reach the same risk level as men. One alternative for women is the introduction of HRT, or Hormone Replacement Therapy, which has had some good results for many post-menopausal women.
The last aspect of our list of Non Controllable risk factors is Age. We cannot control how old we get, but we can help to control how healthy we are when we get there. Older people traditionally have a higher incidence of cardiovascular disease than younger people do. Often, this is because of the accumulated effects of Controllable risk factors. These factors add up over time, creating problems, as we get older. By stopping or slowing our smoking, or by increasing our daily exercise level we may decrease our overall heart attack risk significantly over time. By cutting our fat intake by as little as 5 grams a day, you can make a lasting difference… it may not matter today or tomorrow, but over time it can add up.