Miskawaan Health Group

Heart Disease and Why the Cause Isn’t Always Obvious

Someone dies every 36 seconds in the USA from heart disease and it is the most common cause of death worldwide. 

Understanding who is at risk of heart disease is important. As with any medical condition, the earlier an intervention can be made, the better the long-term prognosis is. 

Recent research, however, suggests that we may be missing a significant portion of the population that is not exposed to the traditional risk factors but are still highly likely to develop the disease. 

Here we look at why the underlying cause of heart disease isn’t always obvious and how screening in can help to improve early detection rates.

Poor Lifestyle and Heart Disease

Heart disease is responsible for approximately 1 in every 4 deaths in the USA each year and it’s estimated that more than 18 million adults over the age of 20 in the United States have some form of cardiovascular disease they are currently living with. 

When someone is diagnosed with heart disease or suffers from a heart attack, we often assume it is down to a few, mostly lifestyle, causes. 

It could simply be age, of course, but more often it is deemed to have been a result of poor diet, lack of exercise, drinking and smoking, factors that lead to chronic high blood pressure and high cholesterol

While environmental factors do play a significant role in the development of heart disease, they may not be the true underlying cause.

Heart Disease Has a Genetic Component

The truth is that most cardiovascular diseases have a genetic component. Around 60 different genes have been identified to date that increases the risk someone will develop heart disease. Only half of these are related to high blood pressure and cholesterol. 

Essentially, a person’s genetic makeup can determine whether and when they are likely to develop a cardiovascular problem. The more of the 60 genes identified to date someone has, the more likely they are to be affected. Poor diet, smoking or stress are just primers that make the possibility of developing heart disease much higher.

Insulin Resistance

The most common abnormal gene in modern society relates to insulin resistance. This is a condition where your body is not able to process blood sugar efficiently and leads to conditions such as type 2 diabetes, hypertension and elevated cholesterol. All these play a role in the development of heart disease.

People With No Identifiable Risk Factor Are More Likely to Die

An interesting piece of research came out of Australia recently, published by Professor Gemma Figtree. This looked at more than 62,000 patients who had suffered a heart attack. The study identified that 85% of these individuals demonstrated at least one traditional risk factor such as diabetes, hypertension or were smokers. 

There were 15% who had no underlying risk factor associated with their heart attack. The stunning outcome of the research, however, was that these individuals were 50% more likely to die following a heart attack when compared to those with the aforementioned traditional risk factors.

The Role of Lipoprotein(a)

Lipoprotein(a) is a genetic abnormality that affects about 20% of the population and increases their risk of developing high cholesterol. These individuals are at a 70% greater risk of also developing heart disease than other people. 

Not only that, patients with this gene abnormality tend to develop more serious diseases and, when they do have a heart attack, are less likely to recover. Most studies to date have looked at patients who fall into the category of having at least one of the traditional risk factors such as smoking and obesity. 

However, some of these studies (including the aforementioned research by Professor Figtree) often don’t account for those who are genetically predisposed and are more likely to develop heart disease, even if they have an exemplary lifestyle.

Screening Tests and Treatment for Heart Disease

One way to screen people effectively would be to run a coronary calcium score for men over 50 and women over 60. This is the most suitable risk predictor for heart disease and can be combined with lipoprotein(a) tests in addition to monitoring high blood pressure and cholesterol levels. 

A coronary calcium score, together with taking measurements of lipoprotein(a), could give physicians the opportunity  to more effectively determine which patients are more susceptible to developing heart disease and prevent them from having a major heart attack.

The content above is based on the information featured in the article linked below. 

The author of the article is Dr Ross Walker, one of Australia’s most esteemed cardiologists and a member of the Miskawaan Medical Advisory board.


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