Sept 29 is World Heart Day, a global campaign during which individuals,families, communities, and governments around the world participate in activities to take charge of their heart health and that of others.
Nearly 18 million people around the world die from cardiovascular diseases each year – mainly from heart disease and strokes.
CVDs are no longer diseases of old men in high-income countries. Today, they also affect women, young adults, and even children. They affect the wealthy and the poor alike. They claim more lives in low and middle-income countries, and over half of these deaths are in Asia. Nearly 40 percent of these deaths are premature (defined as the death of a person under 70 years old).
Cardiovascular diseases are more than just health problems; they levy a substantial financial toll on individuals, their households and the public purse. These include the costs of hospital treatment, lost productivity, and knock-on costs as other family members withdraw from the workforce to care for a CVD patient. Businesses and industries lose trained workers. Governments lose tax revenue due to early retirement and death.
The COVID epidemic is taking its toll. The 520 million people globally living with CVD have been disproportionately affected by COVID, not only from increased risk of severe COVID illness and death, but also from cancelled or missed medical appointments, lack of contact with family and friends, increased smoking and obesity during lockdowns, and reduced physical exercise.
Some of the overall increase is due to aging. Remarkably, life expectancy is now above 70 years in most of Asia, and well above 80 years in some countries. As CVD is a disease that mainly occurs in middle and old age, there are simply more people alive nowadays in those age group. Aging is inevitable, but what can we do to reduce the risk of CVD?
Some major risks can be prevented, treated, and controlled. For example, there are considerable health benefits at all ages in stopping smoking, reducing cholesterol and blood pressure, by eating a healthy diet and increasing physical activity. Other risk factors include poverty, poor mental health and stress, the misuse of alcohol and some medications.
Yet many people don’t even know they have these risk factors, and remain untreated. For example, almost half of adults with high blood pressure are unaware that they have the condition, and even fewer are on treatment.
Although CVD typically causes symptoms in the second half of life, risk factors are determined to a great extent by behaviors acquired in childhood, such as smoking and diet.
Although CVD typically causes symptoms in the second half of life, risk factors are determined to a great extent by behaviors acquired in childhood, such as smoking and diet. The average age of those starting to smoke is under the age of 20 years. Worldwide 40 million children under the age of five are now overweight or obese.
Post-mortem examinations of youths who died in accidents have found early signs of CVD such as fatty streaks and fibrous plaques in the coronary arteries, especially in those who smoked and were obese, and had elevated plasma lipids and high blood pressure. Unhealthy children grow up to become unhealthy adults. Lifestyles adopted during childhood are likely to become ingrained and more difficult to change in adulthood.
Children are vulnerable to the influence of big business. The most obvious is the tobacco industry, which has for decades promoted its products to youth, interfered with policy and legislation, tried to influence public opinion in its favor, fabricated support through front groups, discredited proven health and economic science, and even threatened governments with litigation.
Other industries such as the multinational food, soda and alcohol industries are copying these tactics to delay, minimize or stop governments from adopting lifesaving, sensible policies like mandatory warning labels on harmful products, taxes on unhealthy products, or restrictions on marketing to children.
If you have a risk factor, you will not inevitably develop CVD. However, the more risk factors you have, the greater the likelihood – unless you act. As an adult, it is never too late to change to:
1. Eat a heart-protective diet, with at least three servings of vegetables and two servings of fruit per day.
2. Read the food labels. The dietary slogan for World Heart Day 2021 is: “3 Low, 1 High and 0 Transfat.” The three lows refer to low fat, low sugar and low salt. One high means high fiber. Zero transfat means just that.
3. Heart exercise: The official recommendation is either 150 minutes of moderate intensity or 75 minutes of vigorous-intensity aerobic exercise per week to diminish your CVD risk. Digital tools, like phone apps and wearables monitors, can help you to get motivated and stay on track. However, ‘little and often’ bursts of five to 10 minutes of exercise such as walking upstairs or around the block before breakfast are better than planning to go to the gym (but never making it). To be effective, you should exercise hard enough to feel your heartbeat, feel warmer, and breathe harder. Even two minutes of climbing stairs over the course of a day leads to an improvement in blood pressure and blood lipids. Any exercise is better than no exercise.
4. Say no to all forms of tobacco: Quit smoking, vaping, using hookah or heated-tobacco-products. Even one day after quitting smoking, the risk of a heart attack starts to diminish. By one year, the excess risk of heart disease is reduced to half that of a smoker, and continues to improve. It is never too late to quit.
5. Take care of your heart. Check your blood pressure, weight, and have a body check every year.
But prevention should go far beyond these individual efforts. Governments should adopt more stringent policies to control unhealthy industries and their products.
The author is a special adviser to the Global Center for Good Governance in Tobacco Control, senior policy adviser to the World Health Organization, and director of the Asian Consultancy on Tobacco Control.
The views don't necessarily reflect those of China Daily.