Heart disease is a leading cause of death in Australia. According to the Heart Foundation, 43,603 deaths were attributed to cardiovascular disease (CVD) in 2013. It’s estimated that one Australian dies every 12 minutes from CVD. Coronary heart disease – or simply heart disease – affects about 1.4 million of us and is the single leading cause of death in Australia.
In 2013, heart disease was the primary cause of death for 19,766 Australians, encompassing 13% of all deaths that year. Heart disease kills 54 Australians every day, or one person every 27 minutes.
Cardiovascular disease is an umbrella term that includes heart, stroke, and blood vessel diseases. The Australia Government Department of Health explains, “The term commonly includes diseases such as coronary heart disease, heart failure, cardiomyopathy, congenital heart disease, peripheral vascular disease and stroke. Many of these conditions can be life-threatening.”
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CVD was the primary cause for 518,563 hospitalisations in 2012 and 2013, the Heart Foundation explains, and played some role in another 680,000 hospitalisations during the same time period. Overall, approximately one in six Australians is affected by CVD, or 3.72 million people.
The Department of Health attributes the increasing number of people living with cardiovascular disease to factors such as the ageing population and improved treatments, which enable people to live longer with CVD. There are several risk factors that contribute to heart disease. With the rising incidence of heart disease and other types of CVDs in Australia, education is key. Being educated about the factors that contribute to heart disease and understanding what lifestyle factors you’re able to control (and taking action to control them) can reduce your odds of developing heart disease.
We’ve put together this comprehensive guide to help you do just that: identify the leading factors that contribute to heart disease and what you can do to decrease your risk.
What you’ll find in this guide:
- Facts about heart disease
- Lifestyle factors vs. genetic factors
- High blood pressure
- High cholesterol
- Weight and obesity
- Physical inactivity
- Poor diet
- Habits: Alcohol and smoking
Facts about heart disease
In this section, we discuss statistics and facts about heart disease in Australia, including valuable resources with more information about the prevalence of heart disease and its impacts on Australians.
The Heart Foundation points out that nine out of 10 Australians have at least one risk factor for CVD, and one-fourth of Australians (25%) have three or more risk factors. Also known as coronary heart disease (CHD) or ischemic heart disease, heart disease is the most common form of cardiovascular disease.
Heart disease is more common among men than women in Australia. Data from 2011-2012, as reported by the Australian Bureau of Statistics, found that 5.5% of men were affected by heart disease compared to 4.5% of women. Heart disease also becomes more prevalent with age; 29.2% of Australians age 75 and older had heart disease in 2011-2012, but the group with the highest rate of heart disease is men age 85 and older, with 47.1% of Australians in this demographic impacted.
In addition to being the leading cause of death among Australians, heart disease is also a major cause of disability. Many people who suffer from heart disease require assistance with activities of daily living (ADLs) such as bathing and dressing, or they struggle with physical activity – even activities generally not considered physically intense, such as walking through a shopping centre.
No single risk factor determines whether any individual will develop heart disease, but a combination of risk factors can heavily influence the likelihood that a person will develop heart disease. Despite treatment improvements, prevention is still the best option. Healthy lifestyle choices can not only greatly reduce your risk of developing heart disease but can also help to make symptoms more manageable for those who have already been diagnosed.
Lifestyle factors vs. genetic factors
In this section, we discuss the differences between lifestyle risk factors and genetic risk factors that contribute to heart disease, including resources on how to identify your risk factors and what behaviour patterns can lower your risk.
According to NPS MedicineWise, heart disease is known as the ‘silent killer,’ because the signs and symptoms are not always obvious, sometimes until it’s too late. If you’re over 45 years old, ask your healthcare provider for your heart and stroke risk score, a percentage that indicates your chance of getting heart disease in the next five years based on both genetic and lifestyle factors that contribute to heart disease risk.
A risk score lower than 5% is considered low risk, 10% to 15% moderate risk, and over 15% considered high risk. Approximately one in seven people with high risk will develop heart disease within five years. You can also try the Australian Absolute Cardiovascular Disease Risk Calculator, which provides a risk score based your self-reported information.
Your risk of heart disease is influenced by a combination of factors, consisting of lifestyle factors (ones that you can change by adjusting your behaviour) and genetic factors (those you have no control over). You can lower your risk of heart disease by concentrating on reducing lifestyle factors through adopting healthier habits.
Lifestyle factors are the risk factors that are within your power to change. Lifestyle factors include things like smoking, drinking alcohol, diet and exercise, medication compliance (whether you take your prescribed medications as directed), and other health conditions such as depression. Small lifestyle changes, therefore, can help to lower your risk of heart disease.
Genetic risk factors are the factors outside of your control, such as your age, gender, and family history. While these factors certainly play a role, most Australians are more likely to have lifestyle risk factors such as body weight, an unhealthy diet, or a sedentary lifestyle.
The Heart Foundation reports that in 2014, only 11% of Australians reported high cholesterol as a risk factor, while just 7% reported having high blood pressure as a risk factor for heart disease. In that same year (2014), 12% of Australians (1.3 million) between the ages of 30 and 65 were told by a healthcare provider that they have a high risk of developing heart disease.
High blood pressure
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Blood pressure is the pressure your blood exerts on the walls of your arteries as your heart pumps blood through your body. Blood pressure is not a constant; rather, it fluctuates regularly depending on your heart’s needs at the time, which is based on what types of activities you’re doing.
High blood pressure, also known as hypertension, is expected to increase substantially in the next decade. The High Blood Pressure Research Council of Australia explains that hypertension is expected to increase 60% globally by the year 2025, affecting 1.6 billion people.
The Heart Foundation explains that a blood pressure reading under 120/80mmHg falls in the normal range, while a reading between 120/80mmHg and 139/89mmHg are considered in the normal to high normal range.
Consistent blood pressure readings falling above these thresholds indicate high blood pressure. According to Health Direct Australia, if you have a blood pressure reading of 140/90 or higher on three separate occasions, you have high blood pressure.
Interestingly, the same lifestyle changes that can lower your risk of heart disease can also help to control high blood pressure, such as a healthy diet, regular exercise, losing weight, abstaining from alcohol consumption (or reducing your intake), and quitting smoking if you’re a current smoker (and if you’re not, don’t start).
If you have been diagnosed with high blood pressure and lifestyle changes are not lowering your blood pressure to a safe and desirable level, there are medications that can help. Your healthcare provider will work with you to determine the right medication and dosage for your needs.
In this section, we discuss high cholesterol facts and information, as well as provide resources on the impacts of high cholesterol on heart disease risk and what steps you can take to minimise your risk.
According to CSIRO, cholesterol is an essential type of fat that is carried through the bloodstream. There are several types of cholesterol, and not all are bad. It’s the right balance of the different types of cholesterol that is key to good health. In 2011-2012, one in three Australians over the age of 18 had high cholesterol. The proportion of the population with high cholesterol increases in older age demographics; among Australians between the ages of 55 and 64, 47.8% had high cholesterol during the same time period.
High-density lipoproteins (HDLs) are generally considered the good type of cholesterol, while low-density lipoproteins (LDLs) are the more problematic type. The Better Health Channel explains, “Too much cholesterol circulating within LDL in our bloodstream leads to fatty deposits developing in the arteries. This causes the vessels to narrow and they can eventually become blocked. This can lead to heart disease and stroke.”
Your cholesterol levels are primarily determined by genetics, diet, and lifestyle. Approximately 75% of your body’s cholesterol is produced by your liver; the remainder comes from the foods that you eat.
The Dieticians Association of Australia suggests limiting foods that are high in saturated fats, such as fatty meats, processed meats (salami, sausage, etc.), snack foods such as chips, take-out foods and fast foods (particularly those which are deep-fried), and cakes, biscuits, and pastries. You should also aim for 30 to 60 minutes of physical activity each day, as physical activity can help to lower cholesterol and help you maintain a healthy weight. If you’re overweight, losing weight to reach a healthy weight range for your age and height is also helpful in reducing cholesterol.
Weight and obesity
Weight and obesity contribute to the development of a variety of health conditions, including diabetes, high blood pressure, high cholesterol, and other conditions which can increase your risk of heart disease (or frequently occur simultaneously in individuals who have heart disease). In this section, we’ll review the importance of maintaining a healthy weight and provide resources and strategies for losing weight or maintaining a healthy weight range.
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Heart disease shares many risk factors with other chronic health conditions including chronic kidney disease and type 2 diabetes. Being overweight or obese is one of several modifiable risk factors that increase an individual’s risk for all three health conditions, alongside physical inactivity, poor diet, and tobacco smoking.
The Australian Institute of Health and Welfare (AIHW) points out that excess weight and obesity, or a high body mass index (BMI), is the second highest contributor to the burden of disease, behind dietary risks and followed by smoking as the third highest contributor. And obesity is on the rise; the number of adults who are overweight or obese has increased by 10% since 1995.
The Dieticians Association of Australia reports on findings from the National Health Performance Authority report on overweight and obesity rates across Australia, which found that (in 2011-2012) 10.8 million adults were either overweight or obese. Among them, 4.7 million qualified as obese, which equates to about three in 10 adults.
Overweight and obesity has far-reaching impacts, not only by increasing the risk for many chronic health conditions but also outside of health. “Health problems related to excess weight impose substantial economic burdens on individuals, families and communities,” according to the National Health and Medical Research Council. “Data from the Australian Diabetes, Obesity and Lifestyle (AusDiab) study indicate that the total direct cost for overweight and obesity in 2005 was $21 billion ($6.5 billion for overweight and $14.5 billion for obesity). The same study estimated indirect costs of $35.6 billion per year, resulting in an overall total annual cost of $56.6 billion (Colagiuri et al. 2010).”
Lifestyle changes, the Dieticians Association of Australia explains, must be realistic, achievable, and maintained over time. Overweight and obesity may be influenced by a multitude of factors, such as eating more food than your body requires for energy, eating foods which are higher in energy, genetics, a sedentary lifestyle, and poor choices regarding weight loss such as highly restrictive diets or a cycle of losing weight with yo-yo diets followed by regaining the weight (sometimes leaving you with more weight than when you started).
According to Body + Soul, moderation is often the key, as many people find after experimenting with every possible diet plan and fad that they’ve learned about over the course of many years. The idea is not to deny yourself the foods you enjoy most, but to enjoy them in moderation. Exercise should be a healthy habit, not a punishment. Finally, learning to listen to your body’s cues to provide the right balance of vitamins, minerals, and other nutrients without overdoing it is the recipe for success and long-term weight loss or maintenance.
The University of Sydney prepared a comprehensive report, “A ‘state of the knowledge’ assessment of comprehensive interventions that address the drivers of obesity,” which goes into great detail about the different interventions aimed at reducing overweight and obesity and their effectiveness. The report was prepared for the National Health and Medical Research Council (NHMRC) by The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders at the University of Sydney in December 2010.
The Obesity Policy Coalition is an organisation aiming to influence policy and regulation changes to help prevent obesity. The organisation offers a variety of resources, including two helpful mobile apps to help you track your dietary habits and easily determine which foods are healthy choices.
With overweight and obesity contributing to the risk of heart disease and other chronic diseases, it’s no surprise that physical inactivity is also a key factor in your risk of developing heart disease. But it’s not just your weight that benefits from physical activity. In this section, we discuss the link between physical inactivity and heart disease and the benefits of staying physically active.
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Physical activity is any activity that gets you up and moving. Sedentary behaviour, on the other hand, is sitting or lying down, though the time you spend lying down while sleeping isn’t considered sedentary behaviour. Often, many people find that they have a more sedentary lifestyle than they think simply because they spend a great deal of time sitting while at work.
According to the Australian Bureau of Statistics (ABS), in 2011-2012 most adults spent an average of just 30 minutes per day participating in some form of physical activity. ABS explains, “Against the National Physical Activity Guidelines for adults ‘to do at least 30 minutes of moderate-intensity physical activity on most days,’ only 43% of adults actually met the ‘sufficiently active’ threshold.”
Another interesting finding is that adults who perceived their own health (based on their self-reported, self-assessed status) as “poor” are far less likely to achieve the recommended levels of physical activity, while those who assess their own health status as “excellent” are twice as likely to participate in recommended levels of physical activity or more.
Exercise is not just for the purpose of losing weight. “The benefits of physical activity extend much further. Regular participation in physical activity is known to reduce the risk of physical health problems such as cardiovascular disease and stroke, type 2 diabetes, hypertension, some cancers and osteoporosis,” according to the Australian Medical Association. Exercise also releases endorphins, resulting in improved mood, and it can help to reduce feelings of stress, depression, and anxiety.
The Australian Government Department of Health publishes Australia’s Physical Activity and Sedentary Behaviour Guidelines, a set of guidelines for individuals in different age demographics. These guidelines explain how much time you should spend each day being physically active for optimal health and are driven by research that links specific amounts of physical activity to health conditions such as heart disease.
Contrary to largely held beliefs, meeting the physical activity guidelines does not actually require hours of daily sweat sessions. Instead, a brisk walk for at least 30 minutes daily can provide significant health benefits – and it’s the most popular form of physical activity. However, the Better Health Channel advises anyone over the age of 40 who either has a pre-existing medical condition or has not exercised for a long time to consult with their healthcare provider before beginning any new exercise program.
The Heart Foundation provides some excellent resources on the benefits of a physically active lifestyle along with resources on building more physical activity into your daily routine.
Much like physical activity, dietary habits are often tied to weight loss, though the benefits of a healthy diet extend far beyond weight loss or healthy weight maintenance. In this section we discuss the benefits of a healthy diet and the risks associated with poor dietary habits.
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The food you eat is your body’s fuel, but it’s also your body’s source of essential vitamins and minerals that keep your physiological systems working at their best. The benefits of a healthy diet are many, as are the consequences of a poor diet, including an increased risk of heart disease, and symptoms such as fatigue, stress, and general malaise.
In fact, ABC Health & Wellbeing reports on research findings that link poor dietary habits not only to physical health but also to mental health; research finds that the quality of a person’s diet throughout their life has an impact on depression and dementia.
The Department of Health explains the impact of poor dietary choices on health, noting that certain genetic and socioeconomic factors can influence the quality of an individual’s diet. Women, for instance, are more likely to adopt healthy dietary habits than men, according to findings from the 2004–2005 National Health Survey. Australians living in poorer suburbs with a low socioeconomic status are less likely to have healthy dietary habits, as healthy food options are often less readily available and also less affordable.
“Many of the health problems due to poor diet in Australia stem from excessive intake of foods that are high in energy, saturated fat, added sugars and/or added salt but relatively low in nutrients,” explains Eat for Health. “These include fried and fatty takeaway foods, baked products like pastries, cakes and biscuits, savoury snacks like chips, and sugar-sweetened drinks. If these foods are consumed regularly they can increase the risk of excessive weight gain and other diet-related conditions and diseases.”
The Australian Guide to Healthy Eating is a useful resource to help you choose the best, most nutritious foods. A visual representation of how much of your daily intake should come from each of the five recommended food groups, this simple depiction serves as a guide to help you get the right balance of the vitamins and nutrients your body needs to thrive.
The Australian Dietary Guidelines provide a comprehensive resource on recommended dietary habits, including goal intake levels for salt, vitamins and nutrients, and more to help you reduce health risks associated with a poor diet and help your body function at its best. For a simplified explanation of how much of what kinds of foods you should eat each day, Health Direct provides a helpful breakdown along with examples of the best food choices for optimal health.
Habits: Alcohol and smoking
Most people are well aware of the detrimental health impacts of smoking and drinking alcohol in excess, yet factors such as stress and anxiety, or even depression lead many people to take up these bad health habits in spite of the risks. Smoking and alcohol consumption are both lifestyle factors that contribute to the risk of heart disease; in this section we review the statistics and information linking these behaviours to heart disease risks and offer tips for beating your habits.
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According to Quit Now, a service of the Australian Government, research has proven that smoking causes serious damage even early in life. Smoking leads to atherosclerosis, or hardening of the arteries, which in turn contributes to heart disease, stroke, and other forms of vascular disease. In fact, smoking is the leading preventable cause of death and disease in Australia. Back in 2003, more than 15,500 deaths were linked to tobacco use as a contributing cause.
Alcohol, likewise, plays a major role in the burden of disease in Australia. Excessive alcohol consumption, in particular, is linked to an increased risk of a developing a plethora of diseases, including cardiovascular disease, cancers, diabetes, liver disease, dependence, mental health conditions and even long-term cognitive impairment, and several others. Fortunately, statistics from 2010 to 2013 indicate that excessive alcohol consumption is on the decline among several age groups, including teens who are starting to drink at older ages than trends from a few years prior.
Alcohol leads to an increased risk of many different types of cardiovascular disease, from high blood pressure to high cholesterol, arrhythmia, and congestive heart failure or chronic heart failure, as well as stroke. However, there’s a widespread belief that alcohol in moderation can actually lessen the risk of heart disease, but recent research has shown that that’s not the case. “The National Heart Foundation has found a lack of consistent evidence to confirm that antioxidants in red wine can either prevent cardiovascular disease or be beneficial after a heart attack,” explains Alcohol Think Again. “They also hold the position that alcohol consumption should not be promoted for the prevention or treatment of heart disease.”
Many Australians understand the risks of smoking – or at least realise it’s bad for their health – yet when it comes time to quit, they have a multitude of excuses. Tobacco is highly addictive, so quitting is a challenge for many smokers. Excuses range from the belief that you will gain weight after quitting, that the damage has already been done, or that you won’t be able to handle the stress, among others. Most of these beliefs are myths, and there are coping mechanisms that can aid you in quitting without suffering adverse effects such as increased stress or anxiety.
Quit.org.au offers helpful resources to help you kick your smoking habit, including a confidential Quitline so you can reach out for support and advice to help you find the right coping mechanisms to eliminate your tobacco habit for good. Nutrition Australia also offers some helpful tips for people trying to quit smoking, including information on how water can help you quit.
There are several different approaches to quitting smoking, including the well-known “cold turkey” method, nicotine replacement therapy, and prescription drug therapy to help reduce cravings. Cancer Council Australia points out that one year after quitting, your risk of heart disease actually drops – rapidly.
Often, the two habits coincide: people who smoke may also consume alcohol in excess, or people who developed an excessive alcohol consumption habit eventually took up the smoking habit as well. It turns out that quitting smoking first can actually give you a boost in quitting alcohol as well, according to Lifehacker.
Ultimately, the best method for quitting alcohol, nicotine, or both is to develop your own custom plan that’s suitable for your lifestyle and your tendencies. The Huffington Post offers some practical, realistic tips to help you finally get on track to a healthy tobacco- and alcohol-free lifestyle.
With so many statistics and so much information, it’s easy to become overwhelmed by the many different factors contributing to your risk of heart disease. But the truth is that many of these risk factors overlap – and many are within your power to change. A few healthy lifestyle habits will benefit you in many of these areas; eating healthier, getting regular exercise, and quitting habits such as smoking and drinking can help you lose weight, reduce cholesterol, and help to reduce high blood pressure, which just happen to be other risk factors for heart disease. At the end of the day, it won’t just be your heart that benefits, but your overall mental and physical health as well.