Peter P. Toth, M.D., Ph.D.
President, American Society for Preventive Cardiology; Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine
The year 2020 has been a difficult one for the world. The COVID-19 pandemic has taken a heavy toll on the health of people throughout the world. It quickly became apparent that people with heart disease and risk factors for developing heart disease (high blood pressure, high cholesterol diabetes, obesity, kidney disease, cigarette smoking) were particularly vulnerable as they experienced more severe complications and a higher rate of death compared to people without these conditions.
The timing of all this could not be worse. Between 1980 and about 2012, we observed a steady decline in cardiovascular deaths among both men and women in the United States. Since about 2013, this positive trend reversed and there has been a rising trend in cardiovascular deaths. The COVID-19 pandemic will make this trend suddenly accelerate for 2020-21.
Reversing the trend
What happened after 2013 to undo some of the progress we made? While our ability to answer this important question is still not complete, it is clear that we have experienced an alarming rise in the number of people who are sedentary, obese, and diabetic. More people are vaping (which is as bad as cigarette smoking), and although we have very effective medications for conditions like high blood pressure and high cholesterol, many people stop their medication prematurely and fail to reap the long-term benefits of having these conditions controlled.
Can we reverse this trend? The answer to this is an unequivocal “Yes!” We simply have to stick to basics. Eating a sensible diet, exercising daily, limiting salt intake, losing weight as appropriate, and not smoking have a remarkable impact on risk for heart disease. Make sure you have your blood pressure, cholesterol levels, blood sugar, and kidney function checked regularly. If medication is indicated, stick with it long-term.
Look at it this way: Elevated blood pressure, and high cholesterol and blood sugar levels are toxic to your heart and arteries. Their levels must be controlled in order to maintain good cardiovascular health. If you require medication to do this, adhere to it long-term.
Medications that lower blood pressure, cholesterol, and glucose definitely reduce risk for developing or dying of heart disease. Far too many people stop cardiac medications they need and pay a severe price. When it comes to your heart, the adage that an ounce of prevention is worth a pound of cure is most certainly true. These drugs help reduce risk of heart attack, stroke, death, and having to undergo stenting or bypass surgery.
Diabetes and heart disease
Diabetes dramatically increases risk for developing and dying from heart disease. New-generation diabetes medications lower risk for heart attack, stroke, death, progression of kidney disease, and heart failure. Controlling diabetes also reduces risk for going blind, requiring kidney dialysis, and losing toes or even a leg. Do everything you can to work with your healthcare provider to control your blood sugar and reduce risk for all of these dreaded complications from diabetes.
Heart disease remains the No. 1 cause of death and disability in the United States. It does not have to be this way. All of us must play an active, collaborative role in our healthcare. Get checked out. If you have risk factors for heart disease or find out that you already have heart disease, follow through on all recommendations, maintain follow-up with your healthcare provider, and adhere to medications.
These measures will help keep you healthier and happier, and greatly reduce the odds that you will wind up in an ER with chest pain, or require stenting or surgery after a heart attack.