Health
Heart disease: the invisible midlife disruptor
More than half of Australian adults have multiple risk factors for heart disease, yet most are unaware of them. Do you know your risk and how to reduce it?
By Sabrina Rogers
With heart disease now the second leading cause of death after dementia in Australia, why don't we care more about this silent killer that takes one Australian life every 18 minutes?
In a nutshell, we’re bored with it. Heart disease has been a leading cause of death for decades and it’s often mistakenly perceived as an “old” or male problem – even though it’s also the second cause of death in Australian women.
With more dramatic and seemingly newsworthy conditions such as cancer on the rise, heart disease has faded into obscurity. We’re just not as interested in talking about illnesses that require slow, everyday lifestyle changes. The threat seems less imminent, so we ignore it – often until it’s too late.
Here’s everything you need to know about what causes heart disease, how to prevent it, and the latest developments when it comes to diagnosing and treating it.
What is heart disease?
Heart disease is an umbrella term for conditions that affect the heart. They include:
- Coronary heart disease (CHD): The blood vessels supplying the heart become narrowed or blocked by plaque (which is mainly made up of fat and cholesterol), reducing blood flow and increasing the risk of angina and heart attack.
- Heart failure: The heart doesn’t pump blood to the rest of the body effectively.
- Heart valve disease: One or more of the heart’s 4 valves are damaged, which can disrupt blood flow to and from the heart.
- Arrhythmia: The heart’s electrical system is faulty and its pumping rhythm is affected. There are several types of arrhythmia, including atrial fibrillation (irregular heartbeat), tachycardia (fast heart rate) and bradycardia (slow heart rate).
If we want to get technical, it’s a subtype of heart disease known as ischaemic heart disease (when less oxygen reaches the heart due to CHD) that’s the second leading cause of death in Australia. So, the number of deaths would likely be even higher if we included all types of heart disease.
What are the risk factors for heart disease?
There’s no single cause of heart disease, but several risk factors increase your chances of developing it. These risks add up – the more you have, the higher your risk – yet more than half of Australian adults have three or more risk factors without realising they’re vulnerable.
Several health conditions increase the risk of heart disease, including:
- Type 2 diabetes
- High blood pressure
- High cholesterol
- Sleep apnoea
- Mental health issues including stress, depression, anxiety and social isolation
Many heart disease risk factors are related to lifestyle and are within your power to change. These include:
- Smoking: Smokers are 2 to 5 times more likely to die of a heart attack and twice as likely to die of a stroke.
- Alcohol: Regular or heavy alcohol consumption can increase your heart rate and blood pressure and weaken your heart, elevating your risk of heart disease.
- Diet: Eating too many foods high in saturated and trans fats, salt and added sugars can make heart disease more likely.
- Overweight or obesity: Being overweight may lead to a range of health conditions that can increase your chance of heart disease, including type 2 diabetes, high blood pressure, high cholesterol and plaque build-up in the arteries.
- Physical inactivity: Not only does lack of regular exercise increase the risk of heart disease directly, it also contributes to other risk factors including being overweight, high blood pressure and high cholesterol.
There are also some risk factors you can’t control, including:
- A family history of heart disease: Having a close family member who had a heart attack or stroke before age 65 increases your risk.
- Age: Heart disease risk goes up with age and is most common in people over 50.
- Sex: While heart disease is more common in men, women’s likelihood of developing it may be equal to men’s after menopause.
- Ethnic background: People of Aboriginal, Torres Strait Islander, Maori, Pacific Islander, South Asian and Middle Eastern descent are at higher risk.
“Men often show symptoms earlier, while women more commonly develop microvascular problems [affecting small blood vessels] or long-term cardiovascular effects of pregnancy complications such as pre-eclampsia or gestational diabetes,” says Heart Foundation Population Health Equity Lead Dr Radhika Arunkumar.
“Menopause adds another layer of risk because falling oestrogen leads to higher cholesterol and blood pressure, more abdominal weight and greater insulin resistance, all of which raise cardiovascular risk.”
How is heart disease diagnosed?
If you’re aged between 35 and 75 and don’t currently have heart disease, you can estimate your risk in minutes with the Heart Foundation’s online Heart Age Calculator. If the result shows that your heart age is higher than your actual age, you should see your GP.
After the age of 45, you should have a Heart Health Check with your GP every 2 years. It only takes 20 minutes and will help you understand your risk of having a heart attack or stroke in the next five years and what to do to lower it.
What are the latest treatments for heart disease?
“We now have far better tools to spot heart disease early,” says Dr Arunkumar. “These include calcium scans [that measure plaque in the arteries], advanced cholesterol tests and wearables that detect silent rhythm problems.
“Newer cholesterol‑lowering and metabolic medications offer stronger protection than ever, reducing the risk of heart attack and stroke. We recommend women speak to their doctor to consider hormone therapy that may help manage menopause symptoms and slow menopause-related changes.”
6 ways to keep your heart healthy
Making lifestyle changes can significantly reduce your risk of heart disease. Start with small, achievable steps and slowly build up from there. If you try to overhaul your entire lifestyle overnight, you’re likely to get overwhelmed and give up.
1. Quit smoking
Giving up smoking is one of the best things you can do for your heart health. Get support from Quitline on 13 78 48.
2. Cut back on booze
The World Health Organization has declared alcohol a Group 1 carcinogen (meaning it causes cancer) and says there’s no safe amount that doesn’t affect our health. If you choose to drink, have no more than 10 standard drinks a week or 4 in one day.
If you need help to change your relationship with alcohol, Hello Sunday Morning and the National Alcohol and Other Drugs Hotline offer free and confidential support and resources.
More on this: Rethink the just one drink mindset
3. Eat your heart out
A heart-healthy diet is high in:
- A wide variety of fruits and vegetables
- Whole grains (brown rice, wholemeal pasta and grainy bread)
- Plant-based and lean proteins (legumes, nuts, seeds, fish, seafood, and small amounts of lean poultry and meat)
- Unflavoured dairy products (choose reduced-fat if you have heart disease and full-fat or reduced-fat if you don’t)
- Healthy fats and oils (avocados, olive oil, nuts and seeds)
You should also limit foods that are high in saturated fats, trans fats, salt and sugar – more on this here and check out the Heart Foundation’s heart-healthy recipes for inspiration.
4. Move your body
Getting fit can feel overwhelming, but any movement is better than none. Start with a short walk or other form of exercise you enjoy a few times a week and build up from there.
Ideally, you should aim for 30 minutes of moderate-intensity activity such as brisk walking, cycling or swimming at least 5 days a week and some muscle-strengthening exercises at least 2 days a week.
Hate exercise? Here’s how to get over your aversion and make it a habit.
5. Aim for a healthy weight
Losing just 5 to 10% of your body weight – or 6 to 12kg if you weigh 120kg – can significantly improve your health and reduce your risk of heart disease.
Men should try to keep their waist size under 94cm and women under 80cm. The Heart Foundation has resources to help you get there.
6. Reduce stress and prioritise sleep
Chronic stress can affect sleep and poor sleep can cause mood changes. Added together, stress and lack of sleep can increase the likelihood of heart disease.
Try these tips to reduce stress and get a better night's sleep.
Protecting your heart can protect your brain too
“The heart and brain age together,” says Dr Arunkumar. “Poorly controlled blood pressure, cholesterol, blood sugar or weight in midlife can damage the blood vessels that supply the brain, raising the risk of stroke and dementia later on. High blood pressure is especially important.
“The good news is that midlife isn’t too late to start managing heart health through activity, sleep, stress control and healthy habits that also protect your brain. What’s good for the heart is good for the brain.”
Need support?
If you’re living with heart disease or care for someone who does, the Heart Foundation’s MyHeart MyLife program offers tailored information, expert guidance and practical tips. You can also join the MyHeart MyLife Facebook community to connect with like-minded people.
Remember, it’s never too late to take control of your heart health, so make an achievable plan and start today.
Feature image: iStock/arto_canon
The information on this page is general information and should not be used to diagnose or treat a health problem or disease. Do not use the information found on this page as a substitute for professional health care advice. Any information you find on this page or on external sites which are linked to on this page should be verified with your professional health care provider.
Tell us in the comments below: What heart-supportive lifestyle change do you find hardest to make?
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