Heart Disease: Not Just Your Father’s Problem

Sailors and Marines assigned to Navy and Marine Corps Intelligence Training Center run with students from Princess Anne Elementary School during an Adopt-A-School
program event at the 7th annual Beach Fun Run at Dam Neck Annex. (U.S. Navy photo by Mass Communication Specialist 3rd Class Indra Bosko/Released)

Heart disease is the number one killer of both men and women in the United States and worldwide.¹ Many young people think of heart disease, a form of cardiovascular disease, as something to worry about as you get older. However, it's not unusual to see young adults in their 20s and 30s exhibiting unhealthy behaviors that can contribute to the development of heart disease, such as smoking, poor diet, and lack of physical activity. They may assume they can stop the behavior and "right the wrong" before any damage is done. The truth is, although heart disease is normally diagnosed later in life, it is a progressive condition. By the time symptoms are present, damage has already occurred.

The Asymptomatic Attack

There are many forms of heart disease, the most common of which is coronary heart disease (sometimes called coronary artery disease). Coronary heart disease (CHD) occurs when the walls of the arteries supplying blood to the heart become narrow or hardened due to plaque build-up. The build-up is called atherosclerosis.² Atherosclerosis occurs over time; contributing factors can include modifiable risks such as³:

• Smoking
• Unhealthy diet
• Lack of physical activity 
• Being overweight or obese
• High blood pressure
• High cholesterol
• Type 2 diabetes
• Stress
• Heavy alcohol use

As the plaque accumulates, most will not experience any symptoms or have any indication that there is a problem. By the time an individual experiences symptoms, the plaque has often been building up for decades. For many people, the first sign of atherosclerosis is when the build-up has narrowed the arteries enough that the heart muscle does not receive sufficient amounts of blood and oxygen. This causes chest pain, or angina, and can lead to a heart attack. Heart attack symptoms vary, and women often experience more vague symptoms than men, such as nausea, back pain, extreme fatigue, or indigestion.⁴ Although lifestyle changes may be all some individuals need to treat atherosclerosis, others will need daily medications, medical procedures, or surgery.

Latest Findings

Current research is confirming what health professionals have believed for years – certain unhealthy behaviors in young adulthood have a negative physical impact on one's body, even though they may feel healthy and fit. The impact of an unhealthy lifestyle is not always immediately evident, and negative outcomes like cardiovascular disease develop over time. In fact, research has shown atherosclerosis to be present in the arteries of 20 and 30 year olds. Atherosclerosis was found to be more prevalent among study subjects with behavioral risk factors for heart disease, including high blood pressure, high cholesterol, and obesity.⁵

An additional concern for the military population is emerging research linking post-traumatic stress disorder (PTSD) and heart disease.^6-8 Although the reasons why remain unclear, studies indicate individuals with PTSD have a higher prevalence of heart disease, even when taking into account health behaviors that increase risk for heart disease such as smoking, depression, and obesity.^7,8 While PTSD is present in both veteran and non-veteran populations, it is much more common among veterans, particularly those exposed to combat.⁶ Ongoing research to understand the long-term effects of PTSD are continuing and will be important for both service members and providers.

A Pill-Free Prescription at Any Age

Although the numbers about heart disease seem grim, the good news is heart health can be improved at any age. Here are some tips for delaying or preventing heart disease:

• Eat a diet high in fruits and vegetables and low in saturated fats and salt.
• Participate in 150 minutes of moderate or 75 minutes of vigorous activity each week.
• Increase daily activity level (park far away from door, take the stairs, etc.).
• Maintain a healthy weight.
• Practice positive stress management techniques.
• Know your numbers. Talk to your doctor to ensure your numbers fall within the recommended ranges:
  • Total cholesterol less than 200 mg/dL with triglycerides less than 150 mg/dL
  • Blood pressure less than 120/80 mmHg
  • Fasting glucose (blood sugar level after you have not eaten for 8 – 12 hours) less than 100 mg/dL
  • Female waist circumference less than 35 inches
  • Male waist circumference less than 40 inches

For more information on how you can reduce your risk for heart disease, visit the Navy and Marine Corps Public Health Center's Heart Health Toolbox and check out the American Heart Association's "The Simple 7."  

References

1. The top 10 causes of death. World Health Organization Media Centre. http://www.who.int/mediacentre/factsheets/fs310/en/. Updated July 2013. Accessed January 15, 2014.

2. National Heart, Lung, and Blood Institute. What is coronary heart disease? http://www.nhlbi.nih.gov/health/health-topics/topics/cad/. Updated August 23, 2012. Accessed January 10, 2014.

3. National Heart, Lung, and Blood Institute. Who is at risk for coronary heart disease? http://www.nhlbi.nih.gov/health/health-topics/topics/cad/atrisk.html. Updated August 23, 2013. Accessed January 10, 2014.

4. National Heart, Lung, and Blood Institute. What are the signs and symptoms of heart disease? http://www.nhlbi.nih.gov/health/health-topics/topics/hdw/signs.html. Updated September 26, 2011. Accessed January 16, 2014.

5. Webber B, Seguin P, Burnett D, et al. Prevalence of and Risk Factors for Autopsy-Determined Atherosclerosis Among US Service Members, 2001-2011. JAMA. 2012;308(24):2577-2583. http://jama.jamanetwork.com/article.aspx?articleID=1487497. Accessed January 10, 2014.

6. Norris F, Sloan L. Understanding Research on the Epidemiology of Trauma and PTSD. PTSD Research Quarterly. 2013;24(2-3):1-13. http://www.ptsd.va.gov/professional/newsletters/research-quarterly/v24n2-3.pdf. Accessed January 16, 2014.

7. Vaccarino V, Goldberg J, Rooks C, et al. Post-Traumatic Stress Disorder and Incidence of Coronary Heart Disease : A Twin Study. Journal of the American College of Cardiology. 2013;62(11):970-978. http://www.sciencedirect.com/science/article/pii/S0735109713025060. Accessed January 15, 2014.

8. Boscarino J. A Prospective Study of PTSD and Early-Age Heart Disease Mortality Among Vietnam Veterans: Implications for Surveillance and Prevention. Psychosom Med. 2008;70(6):668–676. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552245/. Accessed January 17, 2014.