In 2004 -the most recent data available - about 75,000 Canadians had a heart attack, 19,000 of them died. Indeed, about a quarter of Canadians develop some for of heart disease. That's too bad because so many of them might have protected themselves by controlling some of their risk factors for coronary heart disease.
The heart is a muscle in many ways the same as others in the body. That means it requires proper nutrition and regular exercise to stay fit. But unlike other muscles, the heart also faces other dangers. These are categorized as coronary artery risk factors; two out of three Canadians have one or more coronary artery disease risk factors.
Some risk factors cannot be controlled by choice. Age, gender, family history are all risk factors for coronary artery disease - none of which we can control.
As we age, the risk increases, regardless of gender. But men do experience more heart disease than women, until middle age, then women start catching up (estrogen helps protect women until menopause). And if your family has a history of it, you face a higher risk of heart disease.
And we come to the risk factors over which we can have control, those where we can make decisions to improve the odds. Among these are hypertension, high blood sugars, weight and cholesterol levels.
Hypertension, or high blood pressure, is a significant risk factor for heart attack, yet so many people do not realize they have it - the "silent killer" indeed. Measured as a pair of numbers, high blood pressure is usually defined as a reading of 140/90 or higher. The first number is called the systolic pressure. It measures blood pressure when the heart is contracting. Diastolic pressure is the lower number and measures the heart relaxed. Uncontrolled, persistent hypertension is hard on the arteries, including those that supply kidneys and the brain.
Cholesterol levels include two forms. High levels of HDL, the so-called "bad" cholesterol contributes to hardening of arteries. LDL, or "good" cholesterol, can help check the amount of HDL in the blood so can reduce the risk that HDL has on coronary heart disease. Moving towards an ideal body weight and consuming less fat both help reduce risk from cholesterol.
Elevated blood sugar levels, measured as fasting blood glucose, can also lead to heart disease. Indeed, diabetes significantly increases the risk.
It is estimated that three-quarters or more of those with diabetes will die from some form or heart or blood vessel disease.
Smoking is a major risk factor. It causes one in every five deaths from heart disease. And smokers are also more likely to die from their first heart attack. Even non-smokers exposed to second-hand smoke at home or in workplaces experience a sharp spike in risk: 30% higher risk for coronary heart disease.
Obesity itself is a risk factor, even if no other risks are present.
Among the many online resources (including Vancouver Coastal Health and the Canadian Heart and Stroke Foundation) is the First Heart Attack Risk Test from Alberta Health Services www.calgaryhealthregion.ca/healthinfo/tools/ that can estimate your risk for heart attack.
Whatever your personal risk factors, it is a good idea to discuss the subject with your doctor who will help explain the risks and what can be done to reduce them.
Dr. Paul Martiquet is the Medical Health Officer for the Sea-to-Sky.
