RODALE NEWS, EMMAUS PA—Euroaspire is not, as it sounds, the name for some petite, fuel-efficient vehicle. It is the acronym for European Action on Secondary and Primary Prevention by Intervention to Reduce Events. The large survey of women and men who had a heart attack, coronary artery bypass surgery, or angioplasty has been performed three times in Europe. The first and second surveys, (in 1995-1996 and then in 1999-2000) showed high rates of heart disease risk factors like hypertension and obesity in those surveyed six months or more after their heart attack or surgery. The third, performed in 2006-2007 and published just last week, revealed more of the same. Which means attempts to prevent further damage in heart disease patients have not improved in the decade-plus between the first and third surveys. And that’s despite a substantial increase in the use of medications to manage heart disease risk.
THE DETAILS: Just under 2,400 heart patients in eight European countries—Finland, France, Germany, Hungary, Italy, the Netherlands, Slovenia, and the Czech Republic—were surveyed about their lifestyles, including smoking, diet, exercise, weight, blood pressure, cholesterol, and diabetes. The report is considered a snapshot of preventive cardiology and where it stands today in those countries. The picture it presented? Not pretty. Mean body weight rose (by an average of about 10 pounds) from the first to the third survey. The percentage of patients who were overweight and those who were obese (more than a third) rose as well. Average blood pressure stayed about the same through all three surveys. It didn’t get worse, but it didn’t improve, either—despite large increases in prescriptions for all anti-hypertensive drugs. The number of patients with elevated cholesterol dropped in each successive survey, largely due to the increased use of statins (which, as we reported yesterday and last week, turn out to have unanticipated side effects). However, 42 percent of the patients taking cholesterol-lowering medication in the latest survey still had cholesterol levels considered too high by current guidelines. Finally, the frequency of self-reported diabetes increased from the first to the third survey, and the frequency of undetected diabetes was higher in the third survey than the first.
WHAT IT MEANS: We can’t depend on drugs to protect us from heart disease. But there aren’t enough resources available to help people make the healthy lifestyle choices that lower heart disease risk, especially in a culture of too many calories and not enough exercise. The study authors write, “Recommendations for lifestyle management remain the foundation of preventive cardiology: to stop smoking, make healthy food choices, and become physically active.” And yet, they point out, less than a third of patients in their study were able to access programs to help them make those changes.
The picture in the U.S., is similar, says Robert O. Bonow, M.D., chief of cardiology at Northwestern University Feinberg School of Medicine in Chicago. “Basically, what we’re seeing is what they’re seeing: People are less physically active, and so we’re seeing increases in obesity and overweight and, as a result of that, increases in diabetes and hypertension. Plus, these risk factors are occurring at younger ages. We now have teenagers who are obese, and this translates not only to more heart disease but also heart disease at a younger age.” And it doesn’t help that we get less face time than ever with our physicians these days. “It’s easier to prescribe medication than it is to spend a half-hour you don’t have talking about exercise and diet,” Dr. Bonow admits.
Here’s how you can help yourself, and your entire community, combat heart disease:
• Know the risk factors. It’s impossible to change your lifestyle if you’re not aware of what specifically you need to change. The American Heart Association has identified six major risk factors for heart disease that you can modify, treat or control by changing your lifestyle—the same six variables tracked by the Euroaspire study: tobacco use, high blood pressure, high cholesterol, physical inactivity, obesity and overweight, and diabetes. Reduce your risk factors, and you greatly reduce your odds of developing heart disease.
• Take matters into your own hands. If you’ve had a heart attack, or have an unhealthy cholesterol profile, hypertension, or other risk factors, there’s plenty you can do to lower your risk besides getting a prescription filled. Try the 24-day heart disease reversal program developed at the Duke Center for Integrative Medicine on Prevention.com. (Keep your doctor in the loop.) And check out the American Heart Association’s HeartHub for tools that will help you boost your own heart health.
• Create a health-promoting environment. It’s tough to change your lifestyle on your own. Make it easier on yourself—and on those around you—by working to change your environment. “Communities need to create more and safer public exercise facilities, for instance,” says Dr. Bonow. “They need sidewalks, so people looking to reduce the time they spend in their cars and increase the time they spend on foot can do so.” Start by approaching your neighborhood association, if you have one, then moving up to your local government.