At the heart of health
Cardiovascular diseases (CVDs) are still the leading cause of death around the globe. They account for approximately 31 per cent of deaths worldwide – that’s around 17.7 million people every year.
The saddest part of this is that many CVDs are preventable with some simple lifestyle changes. The main risk factors are unhealthy diet, lack of physical activity, tobacco use and alcohol abuse, as well as the effects of behavioural factors that cause raised blood pressure, raised blood glucose and obesity. Here’s a snapshot of some of the evidence in the area..
A review paper has suggested that the ideal diet to reduce risk of CVDs should focus on whole grains, fruits and vegetables, legumes, nuts, fish and poultry, with moderate dairy intake and a low amount of refined grains, added sugars and trans-fat, as well as red and processed meat. Traditional Mediterranean diets seem to be the best for heart health.
The association between exercise and CVD risk has been established for some time. The literature supports a dose-response relationship between physical activity and CVD morbidity and mortality – more exercise, lower CVD risk – although it is unknown whether a threshold exists at which activity levels convey greater risk. Regular exercise can have a major effect on several other risk factors for CVD as well – it helps to reduce body weight, blood pressure and bad cholesterol, while also increasing insulin sensitivity.
Cigarette smoking has been established as a cause of various CVDs, including coronary heart disease, cerebrovascular disease (stroke), peripheral artery disease and abdominal aortic aneurysm. Smokers are also at double the risk of heart failure compared to non-smokers, plus, smoking tobacco can both induce and worsen serious cardiac arrhythmias. Worryingly, even second-hand smoke can increase a person’s risk of CVDs, although the risk is rapidly reversible.
A J-shaped relationship has been identified between alcohol consumption and CVDs, with an 86.3 per cent lower risk of CVDs observed in moderate drinkers thought to be due to alcohol’s effect on lipids, glucose, metabolism, inflammatory factors and blood pressure. The term ‘moderate drinking’ still requires some clarification, though, as a 2017 study found those who drank less than 14 units a week actually had a lower risk of some – but not all – heart conditions. While good news for those who enjoy the occasional glass of wine or beer, caution should certainly be taken as the risks of alcohol consumption still far outweigh the possible benefits.
Dental and heart health
As dental professionals, we are aware of the associations between dental and heart health. The link between periodontal disease and CVDs, in particular, has been the focus of research.
There is some evidence to suggest that C-reactive protein is an inflammatory marker that can help to predict the risk of CVDs, but more studies are needed to confirm a casual relationship., In addition, a high dental calculus score has been associated with a higher incidence of angina, so it seems that good oral hygiene remains crucial, regardless of the mechanisms by which CVDs and dental health are related.
Prevention is always better than cure, so ensuring that patients are aware of the dangers and encouraging them to reduce potential risk factors is important. One study supported the idea that risk factors for CVDs can develop during childhood due to both genetic and environmental factors. This further emphasises the need to educate people from a very early age for lower risks later on in life.
All members of the dental team can and should be involved with oral health education and making patients aware of the links between dental and systemic health. In fact, a joint effort is the only way to really get the message across effectively.
At the end of next month we celebrate World Heart Day – an event designed by the Wold Heart Federation to raise awareness of and help educate people on maintaining heart health. The campaign is asking everyone to make a promise to eat better and be healthier, and to do what we can to reduce the risk of heart conditions. Can you and your team make a promise to speak to more of your patients about the possible risk factors of CVDs? There are various useful resources available from the World Heart Foundation website including posters, social media posts, banners and leaflets, so why not make the most of them and remind your patients to look after their hearts this September?
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