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Home > Articles on Health > Who's at Risk?

Who's at Risk?

We all know that cardiovascular disease is the number one killer in North America—but who is at risk?

The figures are frightening. According to some estimates, 58.8 million U.S. citizens suffer from some form of cardiovascular disease (CVD), and in 1996, this represented 41 percent of all deaths. In Canada, in 1997, heart disease accounted for 36 percent of all deaths.

Although CVD is often thought to primarily affect men and older people, it is a major killer of women and people in the prime of their lives. More than half of all CVD deaths each year occurs among women, and it is the leading cause of death among Americans in middle age. The rate of premature deaths due to CVD is greater among African-Americans than among white Americans.

Cardiovascular disease (CVD)

CVD is a big subject. It encompasses illnesses concerning the heart and blood vessels, principally heart disease, high blood pressure, and stroke.

Heart disease

Heart disease (also known as coronary artery disease or coronary heart disease) occurs when the blood vessels that supply blood to the heart (the coronary arteries) are narrowed or blocked. This is generally caused by a hardening of the arteries (atherosclerosis) and encompasses ischemia (not enough oxygen to the heart, resulting in angina, or a pressing or squeezing chest pain), heart palpitations (irregular heartbeats), and shortness of breath. If the coronary artery is blocked, it results in a heart attack.

Heart disease is the single largest killer of American males and females, with those over the age of 65 most at risk. In 1997, African-Americans were most at risk, with a death rate of 156 per 100,000. This was followed by whites (98 per 100,000), Native Americans or Alaskan natives (76), Hispanics (71), and Asians or Pacific Islanders (55).

High blood pressure

Blood pressure is a measure of the force of blood against the walls of the arteries. It is read with two numbers, systolic and diastolic, which are often just referred to as "top and bottom." The top number, systolic, measures blood pressure when the heart is pumping out blood. The bottom number, diastolic, measures blood pressure between heartbeats, that is, when the heart is not pumping but at rest.

The usual cause of high blood pressure (hypertension) is an increase in resistance to blood flow through the smaller branches of the arteries, which carry blood from the heart throughout the body. Why this happens is unknown 95 percent of the time.

High blood pressure causes the heart to work harder than normal and increases the risk of heart attacks, strokes, kidney failure, damage to the eyes, congestive heart failure, and atherosclerosis.

High blood pressure was the primary cause of death of more than 42,000 Americans in 1997, and was listed as a primary or contributing cause of death in about 210,000 deaths.

One in four Americans has high blood pressure, and of these, 31 percent are not aware that they have it. More men than women have high blood pressure until age 55, and at this age more and more women begin to have it. By age 74, a higher percentage of women than men have high blood pressure. The incidence of high blood pressure among African-Americans is twice that of the white population; indeed, the prevalence of high blood pressure in African-Americans in the United States is among the highest in the world. As a result, compared with whites, African-Americans have a 1.3 times greater rate of nonfatal stroke, a 1.8 times greater rate of fatal stroke, a 1.5 times greater rate of heart disease death, and a 4.2 times greater rate of end-stage kidney disease.


A stroke occurs when a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged by a blood clot or some other particle. Because of this rupture or blockage, part of the brain doesn’t get the blood flow it needs. Deprived of oxygen, nerve cells in the affected area of the brain can’t function and die within minutes. And when nerve cells can’t function, the part of the body controlled by these cells can’t function either. The devastating effects of stroke are often permanent because dead brain cells aren’t replaced.

Stroke is the number three killer in the United States. In 1997, it killed 159,791 people and accounted for about one of every 14.5 deaths. Nearly 30 percent of the people who suffer a stroke in a given year are under age 65, and at all ages, more women die of stroke than men.

In 1997, strokes killed nearly twice as many African-Americans (42 per 100,000) as whites or Asians and Pacific Islanders (24 per 100,000) and more than twice as many Native Americans (20) and Hispanics (19).

What’s responsible and what to do

Why we have these cardiovascular problems is not a difficult question to answer: lifestyle. Cardiovascular diseases can be easily prevented through diet and a healthy lifestyle. Although some things we cannot change—our age, gender, and ethnicity—we can take active steps to reduce our risk by avoiding lifestyle decisions which lead to increased risk.

Smoking is perhaps the greatest risk factor. If you smoke, you have twice the chance as a nonsmoker of having a heart attack. Stop smoking!

Cholesterol levels are one of the bad boys of CVD risk. As LDL cholesterol (the "bad" cholesterol) levels increase, CVD risk increases. You can help maintain healthy cholesterol levels by watching your dietary cholesterol, eating healthy fruits and vegetables, and exercising.

Obesity is a major problem in North America, and a risk factor for cardiovascular problems. Those who are overweight are more likely to develop heart disease and stroke even if they have no other risk factors. Obesity has a negative influence on blood pressure and cholesterol and may lead to diabetes. The obvious thing to do is lose weight, which means to cut your caloric intake and burn more calories through activity.

A lack of exercise goes hand in hand with obesity. Regular aerobic exercise plays a significant role in preventing CVD, and even “easygoing” exercise is beneficial if done regularly. Exercise can help control blood cholesterol, diabetes, and obesity. Find something you like to do and do it!

Stress may also be a contributing factor to CVD. Research indicates that there is a relationship between stress and the risk of developing coronary heart disease. This may be because stress releases certain chemicals that can increase heart rate and raise blood pressure. Stress also contributes indirectly to CVD, as people under stress may smoke and drink more than those who lead a stress-free life. Strive for less stress in your family and work situations, and when stress does strike, listen to relaxing music, meditate, or pray. Find some quiet time.

Supplementing your diet

A healthy diet goes a long way in maintaining your cardiovascular health, but certain supplements can provide you with an additional edge.

Supplements (and foods) high in antioxidants may help prevent cardiovascular disease (CVD). This is because free radicals play a role in atherosclerosis, and antioxidants combat free radicals. Garlic and ginkgo biloba both aid circulation in general, and garlic has been shown to reduce cholesterol levels and decrease blood pressure. Coenzyme Q10 helps in the manufacturing of energy, and has been found to be useful in those with heart problems. Fish oil reduces triglyceride (a type of fat) levels and may help reduce incidences of coronary heart disease. Tocotrienols reduce cholesterol levels and may help prevent breast cancer.

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