Heart disease

It’s one of those terms that has–alarmingly–become omnipresent in our lives, so much so that it has ceased, to a large extent, to carry much weight. This is not to say that the concept of heart disease is taken lightly by anyone, but rather, with the pandemic of obesity and related maladies surrounding us daily, it tends to get lumped in, so that it almost becomes generic–another reason to eat right, or to take the stairs once in awhile. But just roll that term around the dome for a moment or two.

Heart disease. Heart. Disease. Pretty serious stuff, and our collective heart health is an ugly picture.

You can look at that picture from the human side, and consider that it caused over 2,200 deaths in Manitoba last year. There were almost 51,000 total heart-related patient visits to hospitals under the purview of the WRHA, where about 30 patients per week are treated for a heart attack, and roughly 7,000 Manitobans report having some form of congestive heart failure.

You want to talk dollars? According to a Manitoba Centre for Health Policy brief, Chronic Disease in Manitoba: What Are the Costs?, Manitoba spends $3.6 billion healthcare dollars annually for hospitals, physicians, prescriptions, nursing homes and home care. About 13 per cent of that–$500 million–was spent on people with heart disease alone. There’s more: less than five per cent of Manitobans were even diagnosed with it, so you know those numbers are going through the roof.

Did you ever stop to ponder just exactly what heart disease refers to? Dr. Allan Menkis, medical director of the Cardiac Sciences Program of the Manitoba Health Sciences Centre, explains, “Coronary artery disease is atherosclerosis of the arteries of the heart, which the lay public refers to as hardening of the arteries. The same process takes place in the arteries that go to the heart muscle, causing narrowing or blockages in those arteries that take blood to that muscle. If an artery gets blocked, the heart muscle dependent on it dies, scar tissue replaces muscle, and that part of the heart does not pump properly any longer.”

Another bit of bad news: heart disease doesn’t generally manifest in a wellness vacuum. If you have developed heart disease, the overall state of your health is probably not very good either, and there are probably other bad things going on. “If you have narrowing of the arteries of the heart,” explains Dr. Menkis, “there is a good chance you are going to have narrowing of other arteries, and those could affect anything–your brain, vision, mobility and so on–which is a direct relationship of a common disease entity.”

The other side of it is that there are secondary effects. If you have either coronary artery disease or valvular heart disease, you may be predisposed to an irregular heartbeat called atrial fibrillation, and that leads to the possibility of clots forming in the heart. If those break free, they can cause stroke or blockages in other arteries and organs. “The chronic disease itself begets more disease,” explains Menkis, ”and we are less able to exercise because we are out of breath, or we have problems with our legs, then we exercise less, and that just compounds the problem even more.”

The causes will be no surprise to you by now: inactivity, obesity and smoking are all major contributors not just to heart disease, but to the various other chronic diseases that affect so many and cost so much. And if you think that your fate is preordained through genetics, you’re only a fraction correct. “The conventional wisdom would state that maybe 50 per cent of heart disease is (a result of genetic predisposition),” notes Menkis, “when in fact, you can probably modify 90 per cent of heart disease.” In other words, if you have a family history, there is a 90 per cent chance that behavioural factors, rather than genetics, was the cause of their poor health as well.

You might have read news stories suggesting that we’re all figuring this healthy lifestyle thing out, because the incidence of heart disease is actually decreasing in Canada. This actually plays into a key myth about heart disease: that it’s a disease of the old. “Younger people think that it’s not a concern for them,” says Lisa Scharf, heart health manager with the Manitoba Heart and Stroke Foundation, “but now, more than ever, with these lifestyle factors, the problems are showing up earlier than ever before–kids are getting high blood pressure and Type 2 diabetes, which was typically thought to be an older onset problem. The thing that many people don’t understand is that, what we do now to our bodies will greatly increase our risk of death at an early age.”

In fact, if you’re a 40- or 50-year-old guy without heart disease symptoms, don’t kid yourself. “You should have started thinking about it 20 years earlier because this is a slow process,” Menkis says, “and it involves lifestyle. We can do more about preventing heart disease than we ever thought before. We consume far too many calories, we eat the wrong foods and consume way too much fat, we don’t exercise enough and we smoke. If we controlled those items, we would be going a long way as individuals to positively impacting our lifestyle, our ability to do the things we like to do for a longer period of time.”

Start with a visit to your family physician to make sure your blood pressure is in the normal range of 120 over 80. If it’s not, make some changes, which doesn’t necessarily mean forgoing the so-called “good things in life.”

“I think that the kind of lifestyle that most of us want to have–physically active, enjoying ourselves, being able to enjoy a good glass of wine–is all possible,” adds Menkis, “but we have to choose to do it in moderation and ‘the right way.’”