Risk Factors, Prevention, and Treatment

Heart attack and stroke share many similar risk factors such as elevated blood pressure, smoking, elevated cholesterol, diabetes, obesity, and physical inactivity (Figure 4). A family history of heart disease co-existing with diabetes can contribute to even greater risk.16 According to the WHO, tobacco use worldwide will contribute to the single greatest cause of death and disability with a projected 7 million deaths yearly by 2030.17 The chance of having a heart attack is doubled from smoking as few as one-to-four cigarettes daily.18 Obesity is another risk factor for several chronic conditions. Older women are heavier now than they were a decade ago. Approximately 62% of American women 20 years of age and older are reported overweight and 33% of the women are identified as extremely overweight.

Figure 4. Cardiovascular Disease – Risk Factors, Treatments and Connections to Oral Health.
Image: Cardiovascular Disease – Risk Factors, Treatments and Connections to Oral Health.

Fortunately, there are preventive treatment and lifestyle recommendations that can significantly reduce risk. Research indicates when smoking, obesity, stress, and physical inactivity are altered with lifestyle changes.19 Effective February 2007, the American Heart Association (AHA) released new guidelines to assist in reducing a woman’s lifetime risk of dying from CVD.7 The new guidelines from the AHA were published in the journal Circulation with related studies on women’s health. The guidelines were drafted by dozens of groups worldwide, including the American Academy of Family Physicians and the US government. In general, the guidelines aim to get women and physicians to focus on the long-term risk of high blood pressure, smoking, and lack of exercise or being overweight, even if a woman’s current health seems adequate. Some of the recommendations include:

  • smoking cessation
  • weight control
  • reduction of saturated fats
  • increased dietary intake of fruits, vegetables, and low-fat dairy products
  • moderate consumption of alcohol
  • daily exercise

They declare vitamins C and E, beta carotene, and folic acid supplements ineffective for ‘preventing’ heart disease.

Figure 5. Spotlight on a Finnish Study.
Image: Spotlight on a Finnish Study.

When lifestyle changes are inadequate, medications are often used to reduce risk, such as:

  • Calcium channel blockers (Calan®, Procardia®, Cardizem®) to dilate coronary arteries that in turn increase blood flow to the heart
  • Angiotensin-converting enzyme (ACE) inhibitors (Vasotec®, Prinivil®, and Zestril®) that aid in lowering blood pressure by inhibiting the formation of angiotensin II
  • Statins (Zocor®, Lipitor®) that block the enzyme (HMG-CoA) necessary for cholesterol production

Medications such as anti-hypertensives are frequently used to lower blood pressure.

In addition to these preventive and pharmaceutical approaches, new scientific breakthroughs are on the horizon. For example, research is being conducted on stem cell applications that actually repair the damaged heart muscle and improve cardiac function. According to the National Institute of Health, stem cells can create new blood vessels to supply the necessary oxygen to the heart.24,25 These medical advances may lead to significant reductions in cardiovascular disease for future generations.