Who needs to worry about heart disease? All of us
This month is National Cholesterol Month - but many of my patients don't think they need to worry about it. I've lost count of the number of times patients have told me that we've got heart disease sussed in the UK and it's cancer that's the biggest killer now
Well, of course cancer is important - but cardiovascular disease is still the biggest single killer in the UK, responsible for 32% of deaths. That's despite the fact that in the last 50 years, deaths from heart disease have more than halved, from 166,000 a year in 1961 to about 80,000 a year today.
One of the major reasons for the drop in heart disease has been the fall in smoking rates - from 45% of adults in 1974 to about 18% today. Increased awareness of (and treatments for) raised cholesterol, and improvements in diet, have also played a significant part. But as smoking has dropped, rates of obesity have risen - and obesity is closely linked with heart disease and stroke. Today, one in four UK adults are obese and more than two thirds are overweight or obese. In the USA, more than one in three adults (78.6 million) are obese, and the annual medical cost of obesity-related disease in the USA is over $147 billion. 47.8% of non-Hispanic blacks, 42.5% of Hispanics and 32.6% of non-Hispanic whites are obese, while among non-Hispanic Asians the figure is just 10.8%.
Some people criticise the Body Mass Index, or BMI, calculator used to define weight ranges. It's not ideal if you're very muscular, and it doesn't take account of the increased risks associated with being an 'apple' rather than a 'pear' shape, but it's still a good estimate for most people of the risks they are putting themselves at from their weight. For instance, your risk of developing type 2 diabetes rises steadily and predictably with your BMI, starting to increase in men once BMI is over 25 and in women even earlier.
More worrying still, childhood obesity continues to rise, too. By the time they enter primary school, one in 10 children are obese and one in five are overweight or obese. By the time they leave primary school, those figures have risen to one in five obese and one in three overweight or obese. In the USA, the percentage of children aged 6-11 who are obese had more than doubled since 1980, from 7% to 18%. If we don't tackle childhood obesity - and this week's debate on a sugar tax is an excellent example - we are sitting on a time bomb which could crush our health services.
If you want to know how high your risk of a heart attack is, you can get a cholesterol and blood pressure check and then you or your doctor can add the figures to a heart risk calculator. The two calculators used most commonly in the UK are the QRISK® calculator and the JBS3 calculator - they use slightly different factors but results are usually similar. Factors which might influence your risk of heart attack include age; gender; blood pressure; smoking; total and HDL ('good') cholesterol levels; family history of heart disease; and whether you are on treatment for high blood pressure or have other medical conditions such as diabetes, chronic kidney disease or rheumatoid arthritis.
Regardless of your risk, improving your diet can stack the odds of a long and healthy life in your favour. For cholesterol in particular, the Ultimate Cholesterol Lowering Plan®, produced by the cholesterol charity HEART UK, is based on the Portfolio diet which saw cholesterol levels in some participants drop by over 20%.
Of course, there's more to heart disease than cholesterol, and everyone has different guilty secrets where their health is concerned. By entering your personal data at Patient's MyHealth check, you can get personalised advice and track your progress. So do yourself a favour and make a commitment to a healthier you.