Maintaining a healthy heart

The simple facts about heart disease is that it is one of the major causes of death in mature New Zealanders. There are also many simple ways in which we can all reduce our propensity to suffer from an unhealthy heart. Research in America shows half of all heart attacks and strokes occur in people with normal or even low cholesterol levels. One in four of these events strike people who don’t smoke or have high blood pressure, diabetes, or high cholesterol. People with high inflammation levels but low cholesterol have a worse survival rate than people with high cholesterol and low inflammation.

That said, it seems every day, the newspapers are full of reports on a new study where a scientist has revealed that something previously very healthy, was now a major source of disease and vice versa. It’s sometimes hard not to be cynical of continual changes in science and reverse decisions by medical practitioners. The question is: which way will you hedge your bet? You can either layer the butter on your toast in slabs as thick as your thumb, and pour double cream on your bread pudding; or you can swap the butter for a low-cholesterol spread and try fruit for dessert. Whatever you choose, do so wisely – and take a look at the statistics below:

The Statistics in New Zealand

• Cardiovascular disease (heart, stroke and blood vessel disease) is the leading cause of death, accounting for 40% of all deaths in 2000
• 22% of those deaths were from coronary heart disease (CHD), 8% from diseases of the heart and circulation, and 10% from cerebrovascular disease (stroke)
• Admissions to public hospitals for coronary heart disease totalled 29,456 in 2000-2001, 59% men and 41% women
• The death rate from CHD is more than twice as high for men than women
• In all age groups, deaths are highest for Maori, followed by Pacific people and lowest for those of neither Maori, nor Pacific origin2
• 56% Maori males and 55% Pacific males, who died from CHD were under the age of 65 years
• 34% Maori females and 33% Pacific females, who died from CHD, were under the age of 65 years
• For those of neither Maori nor Pacific origin, 16% of males and 5% of females, who died from CHD were under the age of 65 years

Risk factors you can’t change Age: 85% of all coronary heart disease deaths occur in those aged 65 years and over 2

Gender: death rates are higher for men than women
Ethnicity: some ethnic groups are at greater risk than others
Personal or family history of coronary heart disease

Risk factors you can change

• Nutrition: Approximately half of the adult population do not meet Ministry of Health Guidelines to eating at least two servings of vegetables each day. Most of us could improve our eating habits.

• Physical Activity: More than one-third of New Zealanders are inactive i.e. they take part in less than 2.5 hours of physical activity per week.

• A sixth of adults are sedentary and perform no physical activity at all3.

• Weight: Over half of New Zealand adults are overweight (includes obese) and one in five are obese. 1 31% of children are either overweight or obese.

• Smoking: The risk of coronary heart disease is two to three times higher in smokers, than non-smokers. In New Zealand, adult cigarette smokers smoke an average of 12 cigarettes per day. One-half of Maori adults smoke cigarettes and one fifth of non-Maori adults.

• Cholesterol: The higher the cholesterol the greater the cardiovascular risk. A 1.0mmol/l reduction in LDL-C leads to a 30 to 35% reduction in coronary heart disease and stroke.

• Blood pressure: One in five New Zealanders over the age of 15 years have a blood pressure over 160/95 or are on medication to lower blood pressure. A small drop (10mmHg for systolic blood pressure) in blood pressure is associated with a 30% reduction in risk of death from coronary heart disease.

• Diabetes: There is a strong association between blood glucose and cardiovascular risk.

• In people with diabetes, each 1% decrease in HbA1c is associated with a 7% reduction in heart attack over 5 years.

• Don’t have a cow: Anxious or depressed people have higher rates of heart disease.

• Stress management strategies such as meditation, prayer or counselling can reverse the effects of many stresses on our bodies by relaxing the blood vessels and improving blood flow.

Food choices Making food choices in the interest of health can be challenging. The Food and Nutrition Guidelines4 have been developed to promote a wide variety of foods low in fat, particularly meat and dairy fats, and salt. While these guidelines cannot guarantee health, they provide a base for us to menu plan.

1. Eat a variety of foods from each of the four major food groups every day:
– Vegetables and fruits
– Bread and cereal foods
– Milk and milk products, especially the low-fat varieties
– Lean meats, poultry, fish, eggs, nuts or pulses.

2. Prepare meals with minimal added fat (especially saturated fat) and salt.

3. Choose pre-prepared foods, drinks and snacks that are low in fat (especially saturated fat), salt and sugar.

4. Maintain a healthy body weight by regular physical activity and by healthy eating.

5. Drink plenty of liquids each day.

6. If drinking alcohol, do so in moderation.

 
Article submitted by Emma Sutcliffe.

1 From New Zealand Heart Foundation

2Sixteen New Zealanders die each day, or one person every 90 minutes, as a result of CHD

3New Zealand Guidelines Group, The Assessment and Management of Cardiovascular Risk. Evidence-based Best Practice Guideline, December 2003.

4New Zealand Heart Foundation