Heart disease is a huge problem in the USA. Based on data from 2021, the CDC reports that:
- One person dies every 33 seconds to heart disease, which adds up to 695,000 Americans each year
- Heart disease accounts for 1 in every 5 deaths
- Heart disease costs the United States more than $239.9 billion per year
Why is heart disease so common now, even among young adults? Let’s zoom out and look at the bigger picture.
Also from the CDC:
- America’s obesity prevalence was 30.5% in 2000. By 2018, it was 41.9% nationwide.
- In the same period of time, the severe obesity rate almost doubled from 4.7% to 9.2%.
- In 2019, 96 million Americans over the age of 18 were pre-diabetic.
- Diabetes was the US’s eighth leading cause of death in 2023, costing the country $173 billion.
This is not a difficult puzzle. Americans are dying from heart disease and other chronic diseases as a direct result of our modern lifestyles.
As the obesity rates go up, so do our rates of heart disease. We have been failed by the food pyramid, eat huge quantities of processed foods, spend most of our lives sitting down, and consume a staggering amount of medication.
These numbers should be a wake-up call. Every week, I see people on my operating table that are there because of their lifestyle choices.
This doesn’t have to be your future.
In this article, I take you through the different types of heart disease, their signs and symptoms, and the steps you can take for heart disease prevention.
The different types of heart disease
Although we talk about “heart disease” as though it’s a single diagnosis, there are three main types with different causes and effects:
Coronary artery disease (atherosclerosis)
Atherosclerosis is the most common form of heart disease, and occurs when a blockage in the arteries stops the heart from beating. This blockage is caused by plaque narrowing the arteries, which restricts blood flow until it blocks the vessels off completely. When this plaque ruptures unexpectedly, it can cause the vessel to become completely blocked.
Heart valve diseases
The heart has four valves to move and process blood. Sometimes one or more can fail to open (called “stenosis”) or close (called “leaking valve” or “regurgitation”). The end result is disruption to your blood flow which causes a higher risk of heart attack.
Heart failure
When the heart’s pumping weakens, blood can’t normally cycle around the body. This is what we call heart failure. It can happen on its own accord or as a result of the above conditions.
The symptoms of heart disease
The symptoms of heart disease can vary widely. Mild atherosclerosis may not have symptoms at all until the arteries are so narrowed that blood can no longer reach your organs. More severe cases manifest as high blood pressure, kidney failure, chest pain, or angina. If arteries leading to the brain become blocked, then symptoms may indicate a transient ischemic attack (such as slurred speech, numbness in the limbs, and drooping facial muscles). This can eventually lead to a stroke.
The signs of heart valve disease often get overlooked, especially with symptoms like swollen ankles and feet, shortness of breath, or fainting. It can also manifest with fatigue, a heart murmur or irregular heartbeat, chest pain, a swollen midsection, or unexplained dizziness.
Heart failure’s symptoms are similar to those for valve disease, namely fatigue, swollen ankles and feet, and breathlessness.
Unfortunately, tiredness and breathlessness can often be dismissed as needing more rest or exercise. And often, this is entirely true. But if you experience these symptoms, monitor them carefully – if they are persistent or worsening, see a doctor as soon as you can.
How heart disease is diagnosed
If someone has symptoms of heart disease or is considered to be high risk, there are various tests available to set benchmarks and track progression.
Coronary calcium scan (CAC)
This particular type of X-ray shows the amount of calcium-containing plaque in your arteries. If there is any, the scan will identify it, which equips you to work on lowering your risk for coronary artery disease.
CT angiogram
A CTA is an imaging test where a dye is injected and tracked by a CT scan. This technique outlines tissues and blood vessels more clearly so doctors can identify damaged or narrowed blood vessels, abnormal vessels in the brain, blood clots, and aneurysms.
Cardiac catheterization
As the name implies, cardiac catheterization involves a thin tube inserted into an artery in either the arm, neck, or groin. This tube is then fed through your vessels until it reaches your heart. While it may be an invasive procedure, it also enables doctors to find blockages or arterial narrowing, check the heart’s pumping, spot valve problems, and measure pressure and oxygen levels in your heart. Doctors can also take a heart biopsy using this method if one is required for testing.
Echocardiogram
An echocardiogram is an ultrasound of the heart, allowing doctors to see the heart pumping blood and identify possible heart disease.
Electrocardiogram (EKG)
EKGs are simple tests. Using sensors placed on the skin, doctors detect tiny electrical signals that your heart produces when it beats. This technique can identify abnormal heart rhythms, look for coronary artery disease, and even discern whether you’ve had a heart attack in the past.
Cardiac MRI
MRIs produce detailed pictures within the body, and a cardiac MRI does the same specifically for the heart. Not only does it show the anatomy of the heart (including any inflammation or tumors), but it also shows if there is any scarring to the heart or limited blood flow as a result of narrowed arteries.
Blood tests
The humble blood test can provide a lot of information regarding a person’s heart health. Cholesterol panels help to identify the risk of future heart disease, and heart failure blood markers can show if a patient has recently suffered a heart attack.
Just keep in mind that cholesterol isn’t necessarily the cause of heart disease — just a sign that something’s awry with your metabolic health.
How heart disease is treated
Treatment of heart disease is split into three broad categories: lifestyle changes, medications, and interventions.
Lifestyle changes
Even if medication or physical interventions are required to keep a person alive, lifestyle changes are still important. Without them, you’re continuing the same habits that led to heart disease in the first place.
The changes should focus on metabolic health, improved cardiovascular health through suitable exercise, and reducing your stress levels.
Medications
There are a large number of medications available for heart disease. These include:
- Anticoagulants (blood thinners) to decrease the blood’s ability to clot
- Antiplatelet agents to prevent blood clots from forming, which is achieved by disallowing platelets to stick together
- Dual Antiplatelet Therapy (DAPT) is for some patients who are in need of two simultaneous antiplatelet agents
- Angiotensin-Converting Enzyme (ACE) Inhibitors to allow the blood to flow more easily
- Angiotensin II Receptor Blockers help to prevent blood pressure from increasing
- Angiotensin Receptor-Neprilysin Inhibitors (ARNIs) to open narrowed arteries and reduce strain put on the heart
- Beta blockers to make the heart beat slower and with less force
- Combined alpha and beta blockers to treat heart failure and elevated blood pressure
- Calcium channel blockers to treat high blood pressure and chest pain by interrupting the movement of calcium
- Cholesterol-lowering medications to lower levels of LDL cholesterol
- Digitalis preparations to make the heart’s contractions more forceful
- Diuretics to lower how hard the heart has to work, by reducing sodium, fluid buildup throughout the body, and excess liquids
- Vasodilators to relax blood vessels
Remember: medications aren’t the only way to treat chronic disease.
Interventions
Physical interventions for heart disease include stents, which are used to prop open a narrowed artery, or open surgery such as a heart bypass or valve replacement. Surgery is a last resort to save a person’s life, and should be followed up with specific medications and lifestyle changes.
How to prevent heart disease
Although we’re fortunate enough to live in a time when medical interventions exist to help people survive and recover from heart disease, my goal is to help you avoid it in the first place. Heart disease prevention is the primary reason that Ovadia Heart Health exists.
The main reason that my patients need heart surgery is because of the food they eat. Exercise is important, particularly to improve cardiovascular health and increase heart health, but exercise cannot overcome a bad diet. Yes, it’s possible to eat unhealthy foods and stay slim, but no, being thin does not make you healthy.
Sadly, we’re surrounded by terrible food options — and many of them are marketed as “heart-healthy.” But choosing good foods is simple and sometimes cheaper as well when you avoid anything that comes in a box or a bag.
My guiding principle is that human beings are designed to eat two types of food: things that grow in the ground, and things that eat what grows in the ground. In other words, animal products and whole, real foods that grow naturally.
If it was made in a lab or a factory, avoid it. Those cookies, chips, fries, ice cream, microwave meals, and other so-called convenience foods should be ignored.
You should also avoid seed and vegetable oils. Consume extra virgin olive oil or coconut oil as much as possible, then cut the others from your diet.
The problem is that vegetable and seed oils are in almost all of the food in our shops, from granola bars to mayonnaise and microwave meals. That’s because they’re cheap and it keeps the manufacturers’ costs down. Don’t fall for the false ‘heart-healthy’ marketing: choose a diet with little sugar, plenty of animal protein, and healthy fats like butter, tallow, and lard.
How to know if you’re at risk for heart disease
The easiest way to work on heart disease prevention is to monitor your metabolic health. If you consume the right foods, improve cardiovascular health through exercise, and work on becoming metabolically healthy, you can increase your heart health holistically and become unlikely to meet me on the operating table.
To measure your metabolic health and see if you need to make improvements, you can take my free metabolic quiz and get customized results sent to your inbox.