Think you are in the know on all the risk factors for heart disease? Here are some evolving ones to watch out for.
Except you’ve just arrived from a distant planet, you know what the age long heart disease risk factors are. They’re vivid or quantifiable measures like high blood pressure, coronary artery disease, diabetes, high cholesterol, obesity, physical inactivity, and smoking. They still major players in the development of heart disease so don’t disregard them. But the risk picture is gaining new dimensions, thanks to emerging (and often sneaky) influences that can harm your heart health.
In recent times, research has connected a host of other health and lifestyle issues with an increased risk of developing heart disease:
- Sleeping problems
- Pregnancy complications
- Emotional challenges
- Gum disease
- Chronic inflammatory conditions
“Most people are not aware of these evolving risk factors — they’re surprised when I ask questions about these issues,” says Nieca Goldberg, MD, a cardiologist and the medical director at the Joan H. Tisch Center for Women’s Health at the NYU Langone Medical Center.
Besides being important in their own right, these newer risk factors can have a further negative effect on your risk of developing heart disease when combined with each other or the traditional concerns. Here’s what you should know about these nefarious influences.
1. Mental Health Problems Can Lead to Heart Problems
Chronically negative states of mind — including depression, anxiety, anger, loneliness, or ongoing stress — can increase your risk of developing heart disease over time. A study in the May 2017 issue of Psychiatry Research found that people who suffer from depression and have low social support have an increased risk of developing heart disease over a 13-year period. And a study in the January 2018 issue of the International Journal of Geriatric Psychiatry found that loneliness increases the risk of cardiovascular disease for women, largely because loneliness is associated with depression.
Part of the connection may be due to the reality that if you’re in a lousy state of mind, you may be less likely to exercise regularly, stick with a healthy diet, take your medicine as directed, or take care of yourself in other ways, Dr. Fischman says. But part of the connection between negative emotions and an increased risk of heart disease also stems from increased levels of stress hormones, which reduce flexibility in the blood vessels, Goldberg explains.
If you find yourself struggling with negative moods, seek professional counseling, practice stress management (such as meditation), and exercise regularly, she suggests.
2. Inflammatory Diseases Can Also Affect the Heart
Similarly, autoimmune diseases like rheumatoid arthritis and lupus involve systemic inflammation, “which increases the buildup of cholesterol in the arteries,” Goldberg says. “In people with autoimmune diseases, we see a high incidence of high blood pressure and a higher rate of heart failure, which may be due to untreated hypertension.” That’s why it’s important for people with autoimmune diseases to get a cardiac evaluation, have their blood pressure checked at every doctor’s visit, and manage it if it’s high, she says.
3. Poor Sleep Quality Can Increase Blood Pressure and Stiffen Arteries
Sleep apnea, a disorder in which someone repeatedly experiences pauses in breathing while sleeping (and often wakes up gasping for air), is associated with high blood pressure and cardiac arrhythmias.
“If sleep apnea is treated, you get improvements in blood pressure,” Dr. Goldberg says.
And according to a study in the March 2018 issue of Atherosclerosis, generally poor sleep quality over a three-year period in people with classic heart disease risk factors is associated with increased arterial stiffness, which can increase the risk for heart disease.
Sleep quantity also matters: Sleeping less than seven hours per night can lead to higher blood pressure and belly fat, as well as increased levels of stress hormones in the body, Goldberg says. Too little sleep can also disrupt metabolism, causing cholesterol levels to be higher and making it harder to manage diabetes and hypertension if you have those conditions, notes David Fischman, MD, a professor of medicine and the director of the Interventional Cardiology Fellowship Program at Jefferson University Hospitals in Philadelphia.
4. Gum Disease Can Lead to Cardiovascular Disease
Believe it or not, moderate to severe periodontal disease (aka, gum disease) is associated with a significantly increased risk of developing cardiovascular disease, according to a study in a March 2018 issue of the Journal of Periodontology. Similarly, a study in the July 2017 issue of Atherosclerosisfound that the presence of numerous deepened pockets in the gums (a sign of periodontal disease) is associated with an increased risk of future cardiovascular disease. The underlying mechanism: inflammation, which is involved in gum disease and heart disease, Fischman notes.
This suggests that taking good care of your oral health (by brushing and flossing diligently and seeing your dentist regularly) could help protect your heart, too. If you have gum disease, be sure to get it treated: Research presented to the American Heart Association suggests that treating gum disease may help lower blood pressure, which can in turn reduce your risk of heart disease.
5. Pregnancy Complications Can Increase the Risk of Hypertension and Type 2 Diabetes
Women who have a history of gestational diabetes have a nearly threefold increased risk of developing ischemic heart disease, as well as higher risks of developing hypertension or type 2 diabetes over time, according to a study in a January 2018 issue of PLoS Medicine. By contrast, women who have preeclampsia, a pregnancy complication characterized by high blood pressure and protein in the urine, have a higher risk of developing high blood pressure and a twofold higher risk of developing cardiovascular disease by midlife, Goldberg notes.
That’s why “it’s important for women to have their blood pressure and blood sugar monitored with regular visits with their primary care physicians throughout their life cycle,” she says. If you’ve had gestational diabetes or preeclampsia, limiting your intake of simple carbohydrates, cutting back on sugar, and doing aerobic exercise regularly can help mitigate these risks, Goldberg says.