Chippenham Hospital - January 01, 2016

Too Much Sitting is Deadly

A recent large meta-analysis (an aggregation of several medical studies) in the Annals of Internal Medicine found that prolonged sitting was associated with higher mortality from all causes, as well as increased incidence of cancer, cardiovascular disease, and type 2 diabetes. This association between all-cause mortality and sedentary behavior is greatest among people who exercise the least. Interestingly, exercise cannot necessarily negate the detrimental impact of prolonged sitting, as another study in the Journal of the American College of Cardiology found the low or moderate levels of exercise failed to ameliorate the effect of sitting for long periods of time. Conclusion: Sit less, even if you exercise, because it may save your life!

We Are What We Eat

An article in the Journal of the American Medical Association (JAMA) last year showed that among 17 risk factors, nutrition was the number one risk factor responsible for death and disability in the United States, with impacts greater than all of the other terrible habits upon which we need to work – such as smoking, physical inactivity, diabetes, etc.. Many would argue that nutrition should be our number one target for improving wellness. The 2013 American Heart Association/American College of Cardiology Guidelines on Lifestyle Management to Reduce Cardiovascular Risk advises us to consume a dietary pattern that emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts; and limits intake of sodium, sweets, sugar-sweetened beverages, and red meats. Many, including myself, advocate the “Mediterranean-style” diet – because it is heavy on the vegetables and fruit, involves whole grains instead of refined, encourages more fish and less red meat, and conveys cooking oil should be predominantly olive oil. Conclusion: Be mindful of what you eat, every day.

Stress Impacts Your Cardiovascular Health

The association of mental stress and cardiovascular disease prognosis is well established, and mental stress is now gaining wide recognition as a potentially modifiable, nontraditional cardiovascular disease risk factor. From studies of individuals with post-traumatic stress disorder (PTSD) to studies of individuals exposed to mental stress by way of experimentation, stress is associated with adverse cardiac outcomes, including increased risk of coronary heart disease. This increased risk is thought to be mediated through physiological and neurohormonal changes on the vasculature that are yet to be clearly explained). Recent studies have taken this to a new level, where higher stress is linked to differences in platelet aggregation, which could affect an individual’s response to antiplatelet medications (medications which are commonly used in cardiovascular patients). Conclusion: Take action to reduce stress in your life – it really could be killing you!

Maintain a Healthy BMI (Body Mass Index)

BMI is a calculated, numerical value of your weight in relation to your height. A BMI between 18.5 and 25 kg/m² indicates a normal weight. A BMI of less than 18.5 kg/m² is considered underweight. A BMI between 25 kg/m² and 29.9 kg/m² is considered overweight. A BMI of 30 kg/m² or higher is considered obese. This should be a no brainer, as the Center for Disease Control (CDC) states that overweight and obese people have an increased risk of suffering from heart disease, stroke, some cancers, type 2 diabetes, joint problems, chronic inflammation, and various other health conditions. Exercise and a healthy weight also lends itself to higher confidence and lower incidence of depression which together lead to improved health. Conclusion: Maintain a healthy weight.

It’s Never Too Early to Manage Your Cardiovascular Risk

With all of the risk factors mentioned above (diet, sedentary lifestyle, stress, BMI, etc), there are many studies that conclude the more healthy habits we developed earlier in life, the more likely we will be able to maintain these habits, and the more likely we will benefit with a longer healthier life, free from disease. A recent study published in Circulation hits this point – 55 year olds who had prolonged, moderately elevated non-HDL cholesterol levels (≥ 160) when they were young adults were much more likely than their peers to have coronary heart disease by the time they were 70, in an analysis based on the Framingham Offspring Cohort. In essence, having decades of exposure to what many would consider mild to moderately elevated cholesterol levels is associated with a significantly elevated risk of cardiovascular disease. Some state that like we think about smoking in terms of “pack-years,” we should be thinking about “lipid-years” of exposure to high cholesterol. Conclusion: Young adults need to remember that the foundation for cardiovascular disease is being laid in our 20s, 30s, and 40s, and risk factor modification at that age may be really important.

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Denise Dietz, MS, MD, FACC | Cardiology Associates of Richmond