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Heart Disease and High Blood Pressure
What is meant by heart disease?
The term “heart disease” encompasses various ailments that afflict the human heart which combined together are the leading cause of death in the United States. Basically, a heart disease or a cardiovascular disorder refers to any condition in which the heart’s ability function properly is impaired.
Obesity and heart disease
Obesity is linked to several chronic conditions such as diabetes, arthritis, hypertension and heart disease. Being overweight is an invitation to disease. Some of the reasons why obesity is bad for the heart include the fact that being overweight leads to an increase in blood cholesterol and triglycerides. There is a lowering of HDL or “good cholesterol” which is known to lower the risk of heart disease and stroke. Obesity can lead to diabetes which leads to a worsening of the risk of heart disease.
A waistline of 40-inch or more indicates an abnormally high percentage of body fat and increased susceptibility to heart disease. There is a direct correlation between a high body mass index and mortality rates related to heart disease. A high BMI can be independently responsible for deteriorating heart conditions or aggravate other risk factors.
The reason why obese diabetics need to worry about heart conditions is that in most cases, a heart problem may already have established itself in overweight people well before diabetes is diagnosed. This is because of regular plaque buildup over a period of time. Obesity-related high blood pressure can lead to left ventricular hypertrophy. This can progress to right ventricular dysfunction, as is often the case in progressive heart failure. With respect to hypertension, increased body weight during early adult life carries more hazards than gaining weight during middle age.
Research has shown that there is a relationship between obesity (BMI ≥ 30) and accelerated coronary atherosclerosis in young men but not women. Increasingly, young people are falling prey to obesity-related conditions. Another fact to consider is the location of body fat; there is evidence to show that central adiposity is related to high blood cholesterol independent of the total body fat. It leads to an increase in triglyceride levels and a lowering of HDL cholesterol. Central adiposity has also been found to be a dominant risk factor for Type 2 diabetes. Although the onset of diabetes is usually in middle age, an increasingly obese young population is beginning to get affected by the disease. The duration for which a person has been carrying excess body weight is also a consideration.
Types of heart conditions, their causes, and symptoms -
- Cardiomyopathy – This is characterized by a weakening of the heart muscle or a change in its structure. The heart muscle may undergo hypertrophy, become thick and lead to impaired pumping of blood. Cardiomyopathy can be caused by alcoholism, drug abuse, chemotherapy, heredity, nutritional deficiency, viral diseases, etc. Symptoms include shortness of breath, swelling of feet. irregular breathing, and loss of appetite.
- Aortic stenosis – In this condition, the aortic valve does not open fully. This restricts the flow of blood from the lower chamber of the heart into the aorta. The condition if often congenital. Rheumatic fever, radiation treatment, calcium deposits around the aortic valve are some of the other causes. Symptoms include breathlessness when exerting, chest pain, giddiness, palpitations, etc.
- Arrhythmias – In this condition, the pulse is either too fast (tachycardia) or it beats too slowly (bradycardia). The problem occurs when there is impairment in the electrical impulses that coordinate the contractions of the heart muscle. Factors such as past history of heart conditions and abnormal endocrine secretions influence this condition. Substances such as amphetamines, drugs, cocaine, and psychotropics can cause this condition. Symptoms include chest pain, palpitations, change in the pulse pattern, fainting, etc. It is important to note that often you may not experience any symptoms of this condition.
- Coronary heart disease – Also known as coronary artery disease, in this condition constriction occurs in the small blood vessels that supply oxygenated blood to the heart. A build-up of plaque and fatty materials on the arterial walls narrows the arteries. This condition is known as atherosclerosis. Diabetes and high blood pressure both are major risk factors for coronary heart disease. Heredity, smoking, excessive fat around the waist are other factors.
- Heart attack – The medical term for this condition is myocardial infarction. It occurs when the heart muscle is starved of oxygen dueto blood vessels supplying it oxygenated blood becoming blocked. A blood clot in one of the coronary arteries is a common cause of this condition. Slow plaque buildup can block the arteries. Age, gender, family history, unhealthy cholesterol, chronic kidney condition, all play a role.
Heart disease risk factors
If we know the risk factors we can take active steps to try and mitigate the risks by means of diet and lifestyle changes. However there are three risk factors that are not in our hands. These are
- Age – A very high percentage of mortalities associated with heart disease occur in people aged 65 years and above.
- Gender – Men are more susceptible to heart disease as compared to women. They also suffer heart attacks earlier in life.
- Heredity – This is another factor that we can do nothing about. Race and heredity can combine to form a serious threat to an individual. If there is a history of heart trouble in a person’s family, then there is an increased chance that he will be susceptible to it. African-Americans and Mexican-Americans are more vulnerable to heart conditions.
Because the above-mentioned risk factors cannot be controlled by an individual, it is important to be aware of the other risks and to try and eliminate them if possible. Other than obesity, other risk controllable risk factors include:
How to prevent heart disease
It is important to be aware of the steps that we can take to prevent heart disease and if already afflicted by a heart condition we should work to bring in lifestyle changes that can help us keep the condition from getting worse.
- Stop smoking – If you are a smoker, you increase your risk to heart disease manifold, stop smoking. It leads to a hardening of the arterial walls which increases the chances of heart attack. Carbon monoxide in the smoke takes the place of oxygen in the blood and makes your heart work harder to oxygenate the body. Your risks increase manifold if you are an obese smoker.
- Physical activity – The significance of staying physically active cannot be overstated. It helps burn calories, keep bodyweight in check, and reduces the chances of your body developing conditions such as diabetes and high blood pressure that put an extra strain on the cardiovascular system.
- Get screened regularly – Regular health screenings are important, if you are vulnerable to heart-related risks then timely screenings are crucial to get figures on blood sugar levels, cholesterol, BMI, blood pressure, etc. Children with a family history of heart disease should also be checked periodically.
- A heart-healthy diet – A very important aspect of keeping heart disease at bay. Consult your doctor and come up with a diet plan that includes food items beneficial to your heart. Do not exceed the recommended fat intake, including the saturated fatty acids intake. Go easy on butter, margarine and shortening. Get into the habit of reading the labels of food items that you purchase, particularly snacks that are fried or sweet. Items fried in hydrogenated oil contain trans fats which are bad for the heart. Get your proteins from legumes, lean meat, low-fat milk, and such products. Make a list of food items good for the heart and try to include them in your menu. Fish contain omega-3 fatty acids that reduce triglycerides. Eating vegetables and fruits will give your body the required vitamins and other nutrients. These are easy to digest and contain beneficial fiber. By incorporating recipes with fruits and veggies in your diet you can reduce your intake of fatty meats.
Treating heart conditions
Heart ailments are treated through drugs and surgical procedures. The doctor will prescribe medicine based on your condition; some drugs such as beta-blockers help reduce the heart rate and lower blood pressure. Angiotensin-Converting Enzyme (ACE) Inhibitors are drugs that expand blood vessels and decrease resistance. As a patient you should look to educate yourself on the medicine prescribed. Be aware of the side effects, some medicines may cause constipation and swelling in the legs. Find out if there are any potential risks to the drug.
Some medical procedures to treat serious heart conditions include
- Angioplasty – It is a procedure to remove the fatty tissue that may be blocking a coronary artery. At the end of the surgery, a stent is left in the narrowed blood vessel to prevent the vessel from constricting.
- Bypass surgery – This is performed on patients suffering from angina pains. It involves grafting a blood vessel at a point that is between the aorta and the narrowed portion of the coronary artery.
- Cardioversion – This procedure attempts to restore abnormal heart rhythm. It uses a defibrillator to apply electric pulses to the chest wall in order to restore the heart’s normal rhythm.
- Ablation – The procedure aims to correct abnormal heart rhythm by using radiofrequency energy to ablate or destroy the part of the heart that is responsible for the abnormal electrical impulses.
Bariatric surgery for obese heart patients
There is an intrinsic link between obesity and several concomitant conditions that include heart disease. Weight loss can help the heart in a big way and bariatric procedures have been shown to be very successful in achieving significant and sustained weight loss. This surgery is a major treatment alternative for obese individuals that cannot possibly hope to achieve any meaningful loss in weight through dieting and exercise. Research has shown that there is a significant drop in predicted cardiovascular risk for patients that have undergone bariatric surgery as compared to obese individuals that have not. Weight loss after surgery reduces the strain on the heart, brings down the severity of diabetes, and lowers the risk of heart failure. Biochemical markers and indicators for heart disease, for example cholesterol, show a drop after surgery. However, there is still not enough evidence to prove that weight loss surgery can actually prevent cardiovascular events.
The objective of bariatric surgery is to induce weight loss by restricting the amount of food intake, the amount of food that can be metabolized, or both. It has been noted that post surgery, the walls of the blood pumping left and right ventricles show reduced thickness and their capacity to hold blood during the resting phase of the heart is improved.
Surgery options include adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS), and vertical sleeve gastrectomy (VSG).
Heart disease and high blood pressure are related health conditions. High blood pressure indicates that your heart is straining to pump blood throughout your circulatory system and can lead to health disorders such as heart disease.
| Gastric Bypass % of Patients |
Gastric Banding % of Patients |
|
|---|---|---|
| High Blood Pressure Resolved | 75.4% | 38.4% |
Heart disease is an umbrella term for several diseases that affect the heart and the circulatory system. Heart disease can be quite serious and fatal. You may want to compare bariatric surgery’s high resolution rates for heart disease to the long-term effects of these conditions.
People living with morbid obesity are at risk for developing heart disease and high blood pressure, including conditions such as:
- Coronary artery disease which occurs when the coronary arteries become hardened and narrowed by fatty material; there are rarely any signs or symptoms, so many people with this disease have lived with it for years before the first onset of symptoms, such as a “sudden” heart attack
- Heart attack which occurs when the heart’s blood supply is interrupted and can damage or completely stop the heart
- Angina which occurs when the heart does not get enough blood and feels like pressure or squeezing in the chest, shoulders, arms, neck, jaw, or back
- Arrhythmias which are irregular heartbeats, depending on the type, arrhythmias can lead to death
- Heart disease including bleeding along artery walls, hardening of the arteries, and heart attack
- Stroke which is an interruption or blockage of blood to the brain
- Kidney damage and kidney failure due to damaged blood vessels and which can require a kidney transplant or dialysis
- Vision loss due to blocked blood vessels to the eye
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