Heart health is essential for everyone – regardless of age or background.
While a healthy diet and regular exercise are important, truly optimizing your cardiovascular health means looking beyond the basics and considering additional factors – including your family history, unique screening needs, pre-existing conditions, and the impact of gender on your risk.
We spoke with Dr. Catherine Collings, Cardiologist and Past President of the American College of Lifestyle Medicine, to uncover some of the most common questions when it comes to heart disease – and what you can do to minimize your risk.
Q: What are the best lifestyle modifications to prevent and treat heart disease?
A: Lifestyle modifications have a tremendous ability to prevent heart disease, treat, and reverse the trajectory of established disease at any stage, from mild to severe. This is what I find so optimistic about the intersection of cardiovascular disease and lifestyle medicine. Of the six pillars of lifestyle interventions that impact heart disease, optimizing one’s eating pattern is the most important. As an exercise physiologist and a cardiologist, I recognize that we can’t “exercise off” suboptimal food choices. Eating a whole-food, plant-predominant diet (free of ultra-processed foods) will yield excellent cardiovascular outcomes.
Q: How does heart disease differ in men vs. women?
A: Heart disease in women at older ages often resembles heart disease in men. On the other hand, younger women can present with less typical symptoms and have fewer typical risk factors. Unfortunately, awareness of these less typical features is still not widespread, resulting in women receiving suboptimal care in emergency and preventive settings. All symptoms resembling heart disease should be promptly attended to regardless of age, sex, gender, or orientation. Speak up for yourselves!
Q: For the average healthy and young adult, what is one piece of advice you want them to be aware of regarding their heart health?
A: Begin a stepwise approach to building healthy lifestyle changes now. Heart disease isn’t a disease of age itself – it’s a disease of accumulated years of lifestyle habits. There has been a recent trend of rising prevalence of heart failure in younger individuals, so it’s important to make young adults aware that lifestyle is essential now and at older ages.
Q: How do you suggest individuals with a greater risk of heart disease stay on top of their health?
A: If you have a family history of heart disease or diabetes, you are at a greater risk. Smoking, obesity, high lipid levels, and inflammatory conditions can put someone at greater risk as well. Pre-eclampsia and pregnancy-related diabetes or hypertension are signs of early heart disease. Individuals with these conditions should have regular cardiovascular care and optimize their health around the Six Pillars of Lifestyle Medicine.
Q: Can someone “change”’ their cardiovascular risk, even with a family history of heart disease?
A: On the genetic side of the equation, we know that lifestyle changes the expression of genetic propensity through epigenetic modifications of DNA. Epigenetics is the study of how our environment influences our genes – including what we eat and our physical activity level. An unfavorable lifestyle can cause epigenetic changes in someone without a family history and increase their cardiovascular risk. Still, on the positive side, a favorable lifestyle can lead to epigenetic changes in someone with a family history and massively lessen their risk.
About the Expert
Cardiologist & Past President of the American College of Lifestyle Medicine
https://www.catecollingsmd.com/