Heart Health: Nothing to do with Love, but Important Nevertheless
From ancient times to present, the heart has universally been associated with love and emotion. Classical philosophers, including Aristotle (384 – 322 BC), proclaimed the heart to be the centre of reason, intellect and will, and many ancient religions described the heart as the root of the soul and the source of happiness. We now know it is in fact the brain, bathing in a dopamine-oxytocin neurochemical stew, that is responsible for the emotional responses and feelings associated with love. Physiologically, the heart has absolutely nothing to do with attraction or attachment, outside of perhaps beating a bit faster or palpitating upon seeing that special someone, and yet the symbol strongly persists in modern-day society.
The heart itself is simply a glorified pump. It circulates deoxygenated blood to the lungs to be oxygenated and subsequently pumps this blood to the rest of the body so that the oxygen can be used during metabolism to produce energy on a cellular level. Not a very romantic system, to say the least, but it is an elegant and efficient one. The heart in fact pumps the entire volume of blood within the body, about 5 L in a 70 kg individual, every minute, and it does so automatically with no driving stimulation from the brain. The neurological and hormonal inputs simply speed up or slow down the rhythm. So while the heart may not be the seat of the soul, it is arguably the most important organ of the body.
But as an organ, with tissues (most importantly being cardiac muscle) requiring oxygen to survive, if oxygen fails to arrive to the various areas of the heart, the muscle will begin to die and this vital pump will fail. This is the premise of coronary artery disease, otherwise known as heart disease, which occurs when plaques of cholesterol (‘atherosclerosis’) build up within the arteries serving the heart muscle. During physical exertion, the needs of the heart often cannot be met in this setting, and the muscle suffers temporary injury, resulting in the characteristic chest pain of angina pectoris that typically settles after resting.
Occasionally, the plaques can rupture and completely block off the artery, which severely impairs blood flow, resulting in a heart attack (‘myocardial infarction’). A life-threatening emergency, this requires immediate intervention, either with medication or more invasive catheterization and stenting to open the vessel. Characteristic symptoms include crushing chest pain with radiation of the pain down the left arm or into the left jaw, shortness of breath, sweating, and a sense of doom or feelings of anxiety. In women, however, the symptoms may be more subtle, vague or uncharacteristic. There have been reports of pain only within the left jaw or in the upper abdomen or just sudden shortness of breath, for instance.
As the leading cause of death of both men and women, responsible for one third of all deaths, prevention of coronary artery disease is crucially important. There are both non-modifiable and modifiable risk factors associated with the disease, however. Age greater than 45 in men and 55 in women, and a family history of a father/brother or mother/sister diagnosed before the age of 55 or 65, respectively, are non-modifiable factors associated with an increase in risk of heart disease.
Healthy Heart Habits
Unfortunately, there is nothing we can do about our age or genetics, but the good news is there are lifestyle risk factors that are within our control to modify. Let’s focus on 5 lifestyle habits that can help to keep your heart beating healthy:
- Smoking cessation.
This is the most important aspect in prevention, as smoking carries a 2 – 3 fold increase in risk of heart disease.
- Alcohol consumption.
Currently, it is recommended that women consume no more than 1 alcoholic drink per day, and men consume no more than 2 alcoholic drinks per day. Heavy regular drinking is associated with increased risk of plaque build-up within arteries (‘atherogenesis’), high blood pressure and damage to the heart muscle (‘cardiomyopathy’).
- Lowering LDL-cholesterol.
This can be achieved through diet, such as the Mediterranean Diet, and medication, known as statin therapy. The Mediterranean Diet is comprised of higher intakes of fruits, leafy green vegetables, and unsaturated fats (those high in EFA 3, 6 and 9) and lower levels of saturated fats, such as red meats.
- Physical activity.
Moderate intensity exercise 30 minutes/day for 5 days/week has numerous benefits on the body, but in particular has cardio-protective effects. Exercise lowers blood pressure, reduces adipose tissue and obesity, and reduces inflammation within the cardiovascular system.
- Diabetes mellitus (type II) and hypertension.
Both of these conditions can be improved with lifestyle factors, such as diet and exercise as discussed above, and there are many medications available to help control high blood sugars and high blood pressure. It is important to work closely with your family physician to help manage these damaging, and often silent, conditions.
So, even though the heart may not be the root of love or the seat of the soul, as Aristotle once purported, it is nevertheless arguably the most important axis of health and happiness! Simple lifestyle changes, such as walking briskly for 30 minutes a day and choosing fresh greens over processed foods, can have profound impacts on your heart health.
Medscape: Risk factors for coronary artery disease. https://emedicine.medscape.com/article/164163
University of Washington: Cardiac output. https://courses.washington.edu/conj/heart/cardiacoutput.htm
Kiechl, S. et al. Alcohol consumption and atherosclerosis: what is the relation? https://www.ncbi.nlm.nih.gov/pubmed/9596232
Zeki, S. Neurobiology of love. https://www.ncbi.nlm.nih.gov/pubmed/17531984
Aristotle. On the Parts of Animals.