Welcome, my name is Dr. Warrick Bishop. I'm a cardiologist, an author and a keynote speaker. I'm CEO of the Healthy Heart Network. I'm all about trying to help people live as well as possible for as long as possible. Heart disease is huge in Australia. Every 20 minutes someone suffers a heart attack. Most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand blood pressure, weight, cholesterol for better health. If you enjoy this podcast, I would be honoured for a five-star review. You can share it with your family and friends. It may well save someone you love. Hi, Warrick Bishop here and welcome to my podcast and videocast station. I really do appreciate that you take the time to tune in and listen. Today I hope you find this an informative podcast. I'd like to talk a little bit around risk factors related to heart disease. Now, I've talked about heart disease before and it's more than just what goes on with coronary arteries. Remember, heart disease can be related to the arteries being blocked and causing problems therefore with the muscles, but heart disease can be an electrical problem. Or a valve problem can even be a problem that's directly linked to the muscle. So let's talk about risk factors that could impact the different types of heart disease that we are aware of. Let's start with the ischemic heart disease or the old bog-standard coronary artery disease, which is the process of build-up of cholesterol, which we call plaque aura. To be more precise, atherosclerotic plaque within the arteries. So ischemic heart disease, coronary artery disease, same thing. Process, one of cholesterol building up in the arteries. Well, obviously cholesterol can be an important risk factor for this. And in particular in some families who have very high cholesterol, there's a significant history of premature. coronary artery disease and when we say premature coronary artery disease if you think about that that sort of defines that most people are going to get coronary artery disease at some stage and they tend to. One in four people die from coronary artery disease so it's pretty common. So when we say premature coronary artery disease we're almost expecting that people will get coronary artery disease at a certain age. These people with family histories of very high cholesterol and heart-related issues. For men, often 50 or less years of age, and for women, often 60 or less years of age, these are people with familial hypercholesterol, emia familial within families, hyper-increased cholesterol pertaining to the chemical cholesterol, emia pertaining to being in the blood, familial. hypercholesterolemia. Well they're the extreme end of the spectrum but as we wind back elevated cholesterol levels can still be linked to increased risk of heart attack. It seems that probably the most significant risk factor is age and that would tell us that to a large degree the development of atherosclerosis or plaque within the arteries is a response to wear and tear within. the arteries that wear and tear is really an aging process if you like it occurs in spots within the arterial system and it's driven by one of the most important things that we measure on a regular basis blood pressure so we do need to keep a close eye on blood pressure because the higher the blood pressure the greater the wear and tear the greater the chance of plaque ending up in the arteries but other things will drive plaque ending up in arteries as well. Things like diabetes will influence the likelihood of wear and tear within the arteries. Being of a male sex will put you about a decade ahead of your female counterparts in terms of risk of heart problems related to the arteries as well. Being overweight doesn't help at all, and often this will link to increased high blood pressure, again driving the process. Exercise is tremendous. It seems to reduce risk of heart attack, but lack of it doesn't help at all. Importantly, we're finding more and more that there are risk factors such as depression, and we see socioeconomic status and... mental state is becoming very important in our evaluation of risk factors. When we think about other components of heart-related issues, perhaps the valves, we can think of congenital issues leading to valve problems. In particular, the aortic valve can be affected when people are born with a bicuspid aortic valve. Bi meaning to, cuspid meaning cusps. of their aortic valve as opposed to the normal three leaflet or tri cuspid valve if you think of a mercedes-benz sign looking down on a normal tri leaflet aortic valve which is closed looks a lot like that mercedes-benz sign a balanced star with three cusps all neatly closing together. Some people can be born with two cusps and they tend to wear out quicker. Turns out I have a bicuspid aortic valve so I'm keeping a bit of an eye on my valve as I'm getting a little bit older. We can also have congenital problems with our mitral valve where it can be a little bit floppy and can prolapse. And that over time can lead to wear and tear and subsequently failure of that valve where it prolapses more and more and eventually leaks more and more, giving rise to a regurgitant problem. Valves can also be affected by infection, particularly if a bacterial infection settles on the valve, it can be very destructive in the local area and can lead to that valve failing. When we think about other issues related to heart problems, we also think of the electrical system. And when we think of the electrical system in the heart, we try and break that down into electrical problems arising in the top chambers of the heart, that is the atria, or electrical problems arising in the bottom chambers of the heart. When we think of the atria-related electrical problems, well... One of the most common is atrial fibrillation. And what's a risk factor for that? Well atrial fibrillation is closely associated with age. So as you get older your risk gets greater. But if you want to add an extra couple of components in there and you want to really make sure you get atrial fibrillation then drink plenty of alcohol. Let your blood pressure run way too high and be obese. These things will almost certainly drive you to a point of atrial fibrillation. And if you do, through alcohol, hypertension and obesity and age, end up with atrial fibrillation, it's going to be very, very hard to undo that spaghetti. So look after yourself. Keep the alcohol consumption at low levels, sensible levels. Keep that blood pressure well under control and keep a sensible weight. When we think about electrical problems within the ventricle, this is concerning. Sudden cardiac death can arise from ventricular rhythms and probably the most sinister and concerning type of electrical rhythm from the ventricle is from a damaged heart. One that's gone through a myocardial infarction or a heart attack where there's been scar tissue arising within the heart and that scar tissue ends up being a focus. for an abnormal rhythm. That abnormal rhythm being ventricular tachycardia and even more concerningly ventricular fibrillation which would lead to sudden cardiac death. Occasionally there'll be families where sudden cardiac death has been a feature at a young age and these people would be potentially carrying risk for an electrical abnormality. giving rise to sudden cardiac death through ventricular fibrillation. When we think about myopathic issues in regard to the heart and heart disease and the risk factors there, probably the most important is to think about hearts that can dilate and stop working properly. We call that dilated cardiomyopathy, hearts that just dilate and don't pump properly. We also think about hearts that thicken up and become stiff. So two, and we call that hypertrophic or increased thickness or increased growth of heart, hypertrophic cardiomyopathy. Those two myopathies will tend to have a family predisposition. So very important to ask and explore whether there are family conditions within. a family pedigree when someone presents. And if you are aware that within your family there are particular heart-related issues, please go and get checked out and talk to your doctor about it. So there's risk factors in general terms. Your heart appreciates you looking after yourself in any way possible with good diet, good sleep, good exercise, age. I'm afraid you can't sidestep that one, but if you can age as well as possible, you will live as long as possible. I'm going to wrap that one up there. That was risk factors. If you have any queries or questions, drop us a note at info at Dr. Eric Bishop online. And I'm going to wish you the very best. For now, I hope you live as well as possible for as long as possible. And bye for now. Join the Healthy Heart Network and become part of our growing community. Do you want to know more about your heart health and know more about your risk of heart attack? For $5, get lifetime access valued at over $55. The Healthy Heart Network has been designed to support and help you understand your risk of heart attack, your risk level, where you are right now, and the positive steps you can take to reduce that risk. Check it out at www.healthyheartnetwork.com join the family button.
