Raising Heart Health Awareness: American Heart Month

Raising Heart Health Awareness: American Heart Month February marks American Heart Month — a campaign aimed at educating citizens about the importance of cardiovascular health. The National Heart, Lung, and Blood Institute (NHLBI) is encouraging visitors to their website to adopt heart-healthy behaviors through increasing exercise, as well as positive diet and lifestyle changes.

Why Heart Month?

Cardiovascular disease is the leading cause of death amongst both men and women in the U.S. each year, with roughly 800,000 deaths estimated by the American Heart Association in 20171. However, reducing risk factors such as high blood pressure, high cholesterol, and smoking has been shown to decrease the risk for developing heart disease.

Cardiovascular Disease, Heart Disease, and Coronary Heart Disease

Cardiovascular disease (CVD) is a general term that encompasses a multitude of heart and blood vessel-related conditions. However, it is not interchangeable with heart disease. Heart disease specifically refers to diseases that affect the heart's structure and function. The most common form of heart disease is coronary heart disease, also known as coronary artery disease, which results from a build-up of plaque in the arteries.

Plaques can be composed of fat, cholesterol, calcium, cellular waste, and other substances found in the blood. When the arteries become severely clogged, the amount of oxygen-rich blood traveling to the heart is reduced, resulting in chest pain and shortness of breath. When plaques rupture they can cause blood clots, which are the most common cause for heart attacks2.

Cholesterol and Cardiovascular Disease

The CDC's Division for Heart Disease and Stroke Prevention (DHDSP) has decided to focus on the role of high cholesterol on heart disease for American Heart Month in 2019. One in three Americans has high cholesterol, with most of them presenting no physiological symptoms of the condition3.

The DHDSP is actively encouraging people to get regular, yearly blood tests that can analyze the levels of good and bad cholesterol in the bloodstream. Cholesterols are a type of lipid molecule that comprise the majority of cellular membranes and are essential for daily life. While the human body can metabolize 1300-1700 mg of cholesterol daily, only 300 mg is recommended to come from dietary sources4.

In order to travel between organs, cholesterol is transported in the blood by carrier proteins. The two most commonly mentioned are high-density lipoproteins (HDLs) and low-density lipoproteins (LDLs). HDLs are responsible for carrying cholesterol molecules to the liver where they will be processed and excreted and have therefore been hailed as the "good" cholesterol. However, LDLs, carry cholesterol around the blood and can deposit high levels to certain organs and tissues5.

It is important to understand the specific levels of good and bad cholesterol in each blood test, and address any concerns with either cholesterol-lowering medications (statins) and/or improved dietary practices.

It has been shown that incorporating omega-3 fatty acids into the diet can increase the levels of HDL in the blood, and stopping smoking and limiting sugar consumption can decrease LDL and triglyceride levels6,7.

Exercise is the Best Solution

Recent studies have shown that better fitness levels can partially reverse the risk for developing CVD in those with higher body mass indexes (BMIs). Additionally, increased levels of physical activity were correlated with a decrease in the risk for heart failure and an increase in the survival rate of those with coronary artery disease8.

The Heart Truth® program, along with the NHLBI, are both recommending that Americans exercise for at least 150 minutes (2 ½ hours) per week. The level of exercise is defined as "enough to leave you a little breathless" and can be broken up into smaller amounts of time in order to better incorporate into your daily schedule. "Even small amounts add up and can have lasting heart health benefits," according to the NHLBI9.

1. J., B. E. et al. Heart Disease and Stroke Statistics--2017 Update: A Report From the American Heart Association. Circulation 135, e146-e603 (2017).
2. NHLBI. Know the Differences: Cardiovascular Disease, Heart Disease, Coronary Heart Disease.
3. CDC. American Heart Month. Accessed: 29th January 2019.
4. Shepherd, J. The Role of the Exogenous Pathway in Hypercholesterolemia. Eur. Soc. Cardiol. (2001).
5. Badimon, L. & Vilahur, G. LDL-cholesterol versus HDL-cholesterol in the atherosclerotic plaque: inflammatory resolution versus thrombotic chaos. Ann. N. Y. Acad. Sci. 1254, 18-32 (2012).
6. Mozaffarian, D. & Wu, J. H. Y. Omega-3 Fatty Acids and Cardiovascular Disease. J. Am. Coll. Cardiol. 58, 2047-2067 (2011).
7. DiNicolantonio, J. J., Lucan, S. C. & O'Keefe, J. H. The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease. Prog. Cardiovasc. Dis. 58, 464-472 (2016).
8. Nystoriak, M. A. & Bhatnagar, A. Cardiovascular Effects and Benefits of Exercise. Front. Cardiovasc. Med. 5, 1-11 (2018).
9. American Heart Month | National Heart, Lung, and Blood Institute (NHLBI). Accessed: 29th January 2019.

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