Cardio Vascular Disease (CVD) is the leading cause of death worldwide, taking an estimated 17.9 million lives every year – representing 32 per cent of all global deaths.
In Australia, 1.2 million adults had one or more conditions related to heart, stroke or vascular disease (2017-18)
There were:
• 56,700 acute coronary events (155 per day) in 2020
• 39,500 stroke events (100 per day) in 2020
CVD was the underlying cause of 42,700 deaths (25%) in 2021
These are sobering statistics we’ve probably all seen before and not taken a lot of notice.
But when your 91-year-old father is in heart failure and living in a rural Australian town with limited medical services, it hits home, and you jump to attention. Mind you, living in that rural town allowed him to escape COVID until June this year when a bout of COVID took a toll on this otherwise fit and healthy golf-playing nonagenarian.
Now, he desperately needed an echocardiogram to properly diagnose which side of his heart wasn’t working heart in order to treat it correctly, but the earliest he could get it was October when a Cardiologist visited the town. That was two months away.
My sister and I drove the 5 hours to him and, a few days later, brought a very fragile Dad back to a hospital close to us for treatment. He was tested and diagnosed immediately.
In the four days he was being treated, I came face to face with the reality of heart failure in the cardiac ward. We watched much younger Brian, in the opposite bed, resigned to a very limited future, and another patient very nervous about going home to a lonely life without family close by. My sister and I rarely left Dad’s side as top-quality treatment brought him back from the brink.
All he wanted to do was go on his planned fishing trip and then get home to play golf! I think he left the hospital humbled but grateful for his extended life and a few days with his siblings before heading home to a new normal.
I just spoke to him as he was preparing to head to golf with his next-door golfing buddy. He may not play today, but being on the course will be good for the soul. He knows every day counts more than ever now, and he intends to make the most of them
What is Heart Failure?
Heart failure is simply a condition that develops when your heart doesn’t pump enough blood for your body’s needs. It doesn’t mean your heart has failed, but it will need help to work properly.
Heart failure can be dramatic, as we experienced.
What are the signs?
Shortness of breath
Fatigue and weakness
Swelling in the legs, ankles and feet
Rapid or irregular heartbeat
Reduced ability to exercise
Very rapid weight gain from fluid buildup.
It’s scary.
Let’s roll back time
Heart failure is often a very long journey of decline that we can actually do something about.
Risk factors we probably all know about
Smoking
Biomedical risk factors - high blood pressure, high blood cholesterol
Insufficient physical activity
Poor diet and nutrition
Overweight and obesity
However, here’s some more sobering statistics:
99% of Australians have at least one of the six cardiovascular risks
• inadequate fruit and vegetable consumption (95%)
• insufficient physical activity (65.4%)
• overweight or obesity (65%)
57% had three or more risk factors in combination
Men (62%) were more likely than women (50%) to have three or more risk factors in combination
In the US, suboptimal vegetable consumption was estimated to result in about 200,000 deaths from stroke and more than 800,000 deaths from coronary heart disease!
So, budding Centenarians, it’s time to understand this powerhouse that is your heart and make friends with it.
One of the best ways to start is to take the Heart Age Calculator on the Australian Heart Foundation website.
It will ask for some details about your health, like age, height, weight, gender, smoker status, family history, current blood pressure and cholesterol, to calculate your heart age. I was pleasantly surprised that mine matches my chronological age. I thought about how I could have done better than my actual age, but my mother had a stroke in her 60s and died from a stroke at 78. So, with that history, I decided I was doing well and headed downstairs to put together a most colourful ‘fruit and vegetable’ lunch!
Most current advice focuses on the physical aspect of heart health. And, yes, you should eat well and exercise, but there is another aspect of the heart that needs attention and, I believe, is often overlooked - emotional stress.
Stress is noted as the main cause of hypertension, which in turn is a major cause of Atrial Fibrillation and the slippery slope of heart disease. Generally, physical exercise is Eustress, the good stress which builds resilience. But, chronic emotional stress silently leads to a loss of flexibility, an inability to adapt, and a brittle system that finally snaps.
Make friends with your heart
I have been measuring my Heart Rate Variability (HRV) for five years (see here) or (here) for my story in detail. HRV focuses attention on my heart. I can see trends in my data that alert me to problems well before they manifest into dis-ease. I can correlate the readings to what is happening in my life and take action.
Exercise improves HRV, but over-training shows up as stress until I back off. That’s the easy one to monitor and manage.
Emotional stress also shows up as reduced HRV and raised resting heart rate. More immediate warning signs to be addressed.
The past month has delivered emotional punches on a couple of fronts. I have tried to address this stress by keeping up a small but consistent exercise routine, extra breathing sessions to get my heart back into coherence and letting go of my weekly Substack for these couple of weeks. Today is the first day in a while that my HRV has settled back into its normal rhythm.
These experiences have certainly re-focussed my attention on heart health, especially emotional heart health and what I can do to keep my heart age the same as my chronological age.
Favourite Substack reads this week:
Processed Food, Fast Food, and Obesity: The Cardiac Chickens Are Coming Home to Roost by William H Bestermann JR MD
A Call To Enchantment by Mike Snowden, Everything is Amazing
No grand slams, plenty of age by Cindy O’Dell, Aging, not necessarily gracefully
Hi Robyn, I'm so glad to hear that your Dad is at least back to the course. He must be doing many things right - to be playing golf at age 91. My hat is off to him.
Thanks Robyn. This is an important post. If we live long enough most of us will develop this problem. In America it is very strongly related to too much belly fat. Age is a leading risk factor in those like your father. If we gain weight, abdlominal fat makes hormones that increase the blood pressure, heart size, and the likelihood of heart failure. Certain medication precisely block the effects of those hormones.
https://williamhbestermannjrmd.substack.com/p/heart-failure-is-a-metabolic-disease