Heart Disease

I hear heart disease is the number-one killer worldwide. I am a 25-year-old male living in a developing country. Am I at risk?

Cardiovascular disease (CVD), heart disease, is indeed the leading cause of death in the world today. In 2015 almost 18 million people died of CVDs. Most of these deaths occurred in low- and middle-income countries. Approximately 7.4 million deaths were the result of coronary artery disease, and 6.7 million the result of stroke.* These statistics reflect the fact that atherosclerotic disease of the arteries affects the entire vascular system; the heart and the brain are the most vulnerable. The heart muscle and the brain are particularly dependent on excellent oxygen supply and are especially affected by disease of the conduits that carry blood and oxygen to these tissues.

What is your risk? It is difficult to accurately assess risk without access to your full health biometric and family health history. You have the advantage of being young. Traditionally age is regarded as a risk factor from 45 years onward for males, and 55 years upward for females. Females enjoy hormonal protection until menopause; that is why their cardiovascular disease risk kicks in later. Family history of strokes and heart attacks, especially at a younger age, is important and indicates increased risk.

The use of tobacco is a strong risk factor and plays a role in all societies, but especially in developing countries. This is so for two main reasons. First, developed countries have seen lawsuits against the tobacco companies, which are exporting their poison to the more vulnerable markets and not-yet-litigious countries. Second, emerging economies have developed health infrastructures so that screening and early diagnosis of tobacco-related diseases are less accessible.

High blood pressure (uncontrolled hypertension) is another important risk factor. Additional factors that fuel the fires of the CVD pandemic include an unhealthful diet, obesity, diabetes (both types 1 and 2), and physical inactivity. These latter factors also are important culprits in the problem of noncommunicable diseases (NCDs), as is alcohol use.

Other markers of increased risk include abnormal blood lipids, including high cholesterol and triglycerides. There has been ongoing debate regarding the importance of fats. There is compelling evidence for the adverse role of cholesterol in atherosclerosis (the degenerative disease of the arteries that results in strokes and heart attacks), as seen in the condition known as familial hypercholesterolemia, a disease associated with exceedingly high blood levels of cholesterol. In severe forms of this condition, we have seen severe coronary artery disease in the very young, with the need for coronary artery bypass surgery in teenagers and adolescents! Beware of saturated fats and calorie-dense junk foods.

This summary of risk factors for coronary artery disease will help you assess your risk. Prevention works best when started at an early age. Eat healthfully and exercise, rest, be optimistic and temperate, and trust in God.

Enjoy life to the full!

* WHO Fact Sheet on CVDs: http://www.who.int/mediacentre/factsheets/fs317/en/.

Peter N. Landless, a board-certified nuclear cardiologist, is director of Adventist Health Ministries at the General Conference.
Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.