Chances are you know someone who is living with heart disease or even someone who has suffered, or perhaps even died, from a heart attack. Heart disease is pervasive—to the point that it is both the leading cause of death in the United States and across the world. In 2019 alone, heart disease was responsible for 659,041 registered deaths in the United States and roughly 9 million deaths worldwide, or 23.1% and 16% of all deaths, respectively. Put differently, those numbers translate to one American having a heart attack approximately every 39 seconds.

February is American Heart Month. It is a time to raise awareness about the dangers of heart disease, help people focus on their cardiovascular health, and work to reduce their risk of heart attack, stroke and other related complications through changes to their diet and exercise.

What causes heart disease?

If you are a resident of Door County and get your water from a well, you know what can happen if you don’t also have a water softener. The naturally occurring lime in the water will adhere to the inside of your pipes and will begin to build up. Over time, the buildup will shrink the opening that the water passes through until it is completely blocked.

While “heart disease” can refer to several heart conditions, generally the term refers to coronary heart disease (CHD), also known as ischemic heart disease or coronary artery disease. Coronary heart disease follows a similar process to that of lime buildup in pipes: over time—usually a period of many years, even decades—and as blood passes through the arteries that supply blood and oxygen to the heart, vascular plaque builds up on the artery walls, narrowing the opening in the arteries and decreasing the flow of blood and oxygen to the heart.

Understanding plaque

Plaque is caused by cholesterol and is formed when we take in more cholesterol than our bodies can use and that excess cholesterol lodges in the wall of the artery. There are two types of cholesterol: 

• Low-density lipoprotein (LDL) cholesterol: referred to as the “bad” cholesterol. When LDL cholesterol lodges onto the wall of the artery, the body will send white blood cells to trap the cholesterol, which causes inflammation. In turn, the inflammation activates muscle cells in the artery, which multiply and encapsulate the cholesterol in the wall of the artery. This can cause problems in two ways: first, larger plaques can (as mentioned above) block blood flow to the heart; or, the cap covering the smaller plaques can break open and form a clot, which can lead to a heart attack or stroke. 

• High-density lipoprotein (HDL) cholesterol: referred to as the “good” cholesterol. HDL cholesterol will absorb and remove the excess LDL cholesterol in your blood, carrying it to your liver, where it is flushed from your body.

Symptoms of heart disease

Unfortunately, coronary heart disease is commonly a “silent” disease—the progression of plaque buildup often going unnoticed until a person has a heart attack or stroke, or develops heart failure or an arrhythmia.

Common symptoms of a heart attack include:

• Angina: or chest pain. This can feel like pressure, squeezing, burning or tightness, and often happens during physical activity. The discomfort or pain, which is generally felt behind the breastbone and sometimes confused with indigestion, can also occur in the jaw, throat, back, arms or shoulders. 

• Dizziness, physical weakness or feeling faint. These symptoms often occur with cold sweat.

• Nausea or vomiting. These symptoms are more common in women than in men.

• Shortness of breath. This symptom often occurs in conjunction with chest pain, but can also occur prior to the development of chest pain.

Common symptoms of a stroke, which is caused by a blocked artery (called an ischemic stroke) include:

• Sudden numbness or weakness. This usually occurs in the face, arm, or leg, and especially on one side of the body. In particular, look for drooping on one side of the face.

• Sudden confusion, trouble speaking, or difficulty understanding speech.

• Difficulty seeing in one or both eyes.

• Dizziness, loss of balance or lack of coordination, and difficulty walking.

• Severe headache with no known cause.

Common symptoms of heart failure, which occurs when the heart cannot pump enough blood and oxygen to support the organs in your body, include:

• Shortness of breath. Particularly when active or when lying down.

• Difficulty exercising.

• Rapid weight gain from fluid buildup. Particularly swelling in the feet, ankles, legs, stomach or neck veins.

• Rapid or irregular heartbeat.

• Fatigue and weakness.

• Continual cough or wheezing. Often accompanied by white or pink foamy mucus.

The primary symptom of a heart arrhythmia, or abnormal heartbeat, is a fluttering feeling in your chest—called a palpitation.

Preventing heart disease before it happens

According to the Centers for Disease Control and Prevention, the 3 key risk factors for developing heart disease are high cholesterol, high blood pressure and smoking, while additional risk factors include diabetes and obesity. Developing many of these risk factors can be prevented through lifestyle changes.

Eat a healthy diet. Perhaps one of the most important steps you can take to prevent heart disease is to eat a healthy diet. The American Heart Association (AHA) recommends the Dietary Approaches to Stop Hypertension (DASH) eating plan in order to reduce the likelihood of developing heart disease. Similar to the mediterranean diet, the DASH diet focuses on foods that are low in fat, LDL cholesterol, rich in protein and fiber, and includes foods that contain high levels of potassium, calcium and magnesium—all nutrients that help control high blood pressure. Foods that the DASH diet focuses on include:

• Fruits and vegetables
• Whole grains
• Fat-free or low-fat dairy products
• Fish
• Poultry
• Nuts

The DASH eating plan also limits red meats, sweets, added sugars, and sugar-sweetened beverages, and is also lower in sodium than a typical American diet, reducing the average American sodium intake from 3,400 mg to 2,300 mg a day, further helping to lower high blood pressure. Studies have shown that the DASH diet can reduce “blood pressure…within two weeks and…maintain [that reduction] for the next six weeks.”

Exercise regularly. Physical activity has numerous benefits. It strengthens your heart, improves circulation, reduces stress, and can help achieve weight-loss goals—all of which lower the risk of developing heart disease. For the best results, the AHA recommends:

• 30 minutes of moderate-intensity aerobic exercise 5 days a week, or
• 25 minutes of vigorous aerobic aerobic exercise 3 days a week, and
• Moderate- to high-intensity strength training 2 days a week

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February is a time for love. It is a time when we give our loved ones heart-shaped chocolates and heart-shaped cards. This February, give your loved ones (and yourself) an even better gift by making the changes and taking the steps toward a healthier heart and a happier you.