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  • Writer's pictureBen Ciesinski

Heart Disease & Human Nature

My sister sent me a text recently sharing that one of her classmate's from high school died of a heart attack. For reference, she graduated in 1999. Let's assume he was 41 or 42; he left behind 2 smallish children and a spouse. A common reaction would be, "wow, that's too young for a heart attack" or "very sad." Both of those would be appropriate. It is very sad, and it is too young for people to be dying of heart attacks.

My reaction was to wonder about his lipids, lifestyle, and anything else that might have contributed to the very unfortunate circumstances. (And sadness, particularly for his family. That's always what worries me the most about having a heart attack.)

You see, I live in a world of heart disease, largely from genetic conditions, attempting to chime in with supportive or educational words (more from my experience than anything else) in two Facebook groups - Familial Hypercholesterolemia (aka FH) and Elevated Lp(a). I read articles, listen to podcasts, and watch videos on what causes heart disease and what we can do to fight it. I continue to believe that we have a say in our health (genetics be damned!), and I'll keep preaching that until my last breath.

One of the most frustrating parts of this battle is the belief that lifestyle habits mean nothing for heart disease. While this is more difficult in genetic situations where the biggest concern tends to be lowering cholesterol, it should be embraced by the general public as heart disease continues to be the largest annual killer of humans. (Speaking to those with genetic conditions, here is a nice study suggesting that lifestyle choices do increase longevity with FH.)

I understand that life is difficult without worrying about health. All the day-to-day challenges, relationships, jobs/careers - these things cause stress and worry. And if you are a worldly-type, then global health issues, social unrest, and climate change are probably also on your radar. But let's keep in mind that our health is the one thing we have the most control over - yes, even taking into consideration our genetics.

Once we pay our respects to a lost classmate/friend/brother/sister/parent, take the time to grieve then find motivation in your own health.

Here are some simple suggestions that can improve your heart and overall health. (You may have heard these before.)

  • Move a lot: Exercise, walk, run around with children, hike, bike, lift heavy things. You don't need to be running a marathon every week, but you should be walking regularly. (Treadmills count.)

  • Don't eat crap: Try to mostly eat whole, real food. Be careful with excess sugar and alcohol.

  • Sleep for 7-8 hours per night. Sleep, despite its reputation for importance, is still underrated. It's when your body processes the actions of the previous day and prepares you for the next.

  • Manage your stress: Like sleep, highly underrated. If you have significant stress in your life, become like Ghandi or Thich Nhat Hanh. If you can't be like them, make changes to have less stress. Chronic stress is related to heart disease and almost every other major illness.

That's the lifestyle stuff. Generally speaking, we all know what we should be doing. Try for them all or try to improve any single thing in your life. Anything makes a difference. Really...anything.

What if you have a family history of heart disease, existing heart disease, or other concerns? Well, speaking in generalities and largely based on my own experience, I'd recommend the following:

  • Have your cholesterol checked annually: It's helpful to have a record of your cholesterol, starting around age 10 if there is reason for concern, or at least 18. I did not have cholesterol checked until around 30; I have no idea why that is. I sure wish anyone would have suggested I start earlier. Again, speaking in a generalities, HDL should be higher and LDL should be lower. Some people have higher LDL and no problems. But higher LDL is worth investigating just to make sure. They are probably also giving you a triglyceride number in that test, which should be low.

  • Have your Lp(a) tested at least once in your life, ideally sooner than later. You'll continue to hear more about Lp(a) levels as time advances, (hopefully from your doctor and not just me.) If elevated it is a marker for heart disease, particularly when combined with high LDL. It's important to know that some people have elevated LP(a)s and have no issues. If you find it is elevated, don't panic! Just do a little more testing to make sure the ole ticker is in good shape. At the moment, most people don't check for it unless you a) have heart disease, b) are really into functional medicine, or c) spend your free time learning about heart disease. (Raise your hand if all three! - I hope that is just me.)

  • Are you checking the above boxes? Find a cardiologist. Sometimes our medical system is better at diagnosis and treatment than prevention, and in that case, feel free to be your own advocate. I found a cardiologist initially through Zoc Doc; perhaps you ask for a referral from your primary doctor. But you can just find one (ideally that takes your insurance), explain your concerns, and you should be able to get the standard tests of a heart echo, EKG, carotid scan, and stress test. If there is further concern, the next step (generally) is a CT-Coronary. The CT should give you a calcium score and a reasonable look at the condition of your heart. If you choose just to get a corocnary artery calcium (CAC), know that a 0 score just means you have no calcium; it does not mean you have no unstable plaque. Well, at this point, I am getting into the weeds.

Ok, that's a pretty decent start to the subject. The takeaway is to care about your health, especially your heart. It's pretty important, and as far as I know, we just have the one. It's much harder after you have heart disease or (hopefully survive) a heart attack, so always better to practice good habits sooner than later.

As always, this is not medical advice. Speak with your doctor(s) before making life changes. I am always happy to attempt to answer any questions based on my personal experience or research.

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