At the heart of health – BSDHT

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  Posted by: The Probe      1st October 2018

 

 

 

Cardiovascular diseases (CVDs) are still the leading cause of death around the globe. They account for approximately 31 per cent of deaths worldwide – that’s around 17.7 million people every year.[1]

The saddest part of this is that many CVDs are preventable with some simple lifestyle changes. The main risk factors are unhealthy diet, lack of physical activity, tobacco use and alcohol abuse, as well as the effects of behavioural factors that cause raised blood pressure, raised blood glucose and obesity.[2] Here’s a snapshot of some of the evidence in the area..

 

Diet

A review paper[3]has suggested that the ideal diet to reduce risk of CVDs should focus on whole grains, fruits and vegetables, legumes, nuts, fish and poultry, with moderate dairy intake and a low amount of refined grains, added sugars and trans-fat, as well as red and processed meat. Traditional Mediterranean diets seem to be the best for heart health.

 

Exercise

The association between exercise and CVD risk has been established for some time. The literature supports a dose-response relationship between physical activity and CVD morbidity and mortality – more exercise, lower CVD risk – although it is unknown whether a threshold exists at which activity levels convey greater risk.[4]Regular exercise can have a major effect on several other risk factors for CVD as well – it helps to reduce body weight, blood pressure and bad cholesterol, while also increasing insulin sensitivity.[5]

 

Tobacco

Cigarette smoking has been established as a cause of various CVDs, including coronary heart disease, cerebrovascular disease (stroke), peripheral artery disease and abdominal aortic aneurysm. Smokers are also at double the risk of heart failure compared to non-smokers, plus, smoking tobacco can both induce and worsen serious cardiac arrhythmias.[6]Worryingly, even second-hand smoke can increase a person’s risk of CVDs,[7]although the risk is rapidly reversible.

 

Alcohol

A J-shaped relationship has been identified between alcohol consumption and CVDs, with an 86.3 per cent lower risk of CVDs observed in moderate drinkers thought to be due to alcohol’s effect on lipids, glucose, metabolism, inflammatory factors and blood pressure.[8]The term ‘moderate drinking’ still requires some clarification, though, as a 2017 study found those who drank less than 14 units a week actually had a lower risk of some – but not all – heart conditions.[9]While good news for those who enjoy the occasional glass of wine or beer, caution should certainly be taken as the risks of alcohol consumption still far outweigh the possible benefits.

 

Dental and heart health

As dental professionals, we are aware of the associations between dental and heart health. The link between periodontal disease and CVDs, in particular, has been the focus of research.There is some evidence to suggest that C-reactive protein is an inflammatory marker that can help to predict the risk of CVDs, but more studies are needed to confirm a casual relationship.[10],[11]In addition, a high dental calculus score has been associated with a higher incidence of angina,[12]so it seems that good oral hygiene remains crucial, regardless of the mechanisms by which CVDs and dental health are related.

 

Prevention

Prevention is always better than cure, so ensuring that patients are aware of the dangers and encouraging them to reduce potential risk factors is important. One study supported the idea that risk factors for CVDs can develop during childhood due to both genetic and environmental factors.[13]This further emphasises the need to educate people from a very early age for lower risks later on in life.

All members of the dental team can and should be involved with oral health education and making patients aware of the links between dental and systemic health. In fact, a joint effort is the only way to really get the message across effectively.

At the end of this month we celebrate World Heart Day – an event designed by the Wold Heart Federation to raise awareness of and help educate people on maintaining heart health. The campaign is asking everyone to make a promise to eat better and be healthier, and to do what we can to reduce the risk of heart conditions. Can you and your team make a promise to speak to more of your patients about the possible risk factors of CVDs? There are various useful resources available from the World Heart Foundation website including posters, social media posts, banners and leaflets, so why not make the most of them and remind your patients to look after their hearts this September?

 

 

For more information about the BSDHT, please visit www.bsdht.org.uk,

call 01788 575050 or email enquiries@bsdht.org.uk

 

 
[1]World Health Organization. Cardiovascular disease. Pub 2017. http://www.who.int/cardiovascular_diseases/en/[Accessed August 2018]
[2]World Health Organization. Cardiovascular disease. Key Facts. What are the risk factors for cardiovascular disease? http://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) [Accessed August 2018]
[3]Anand SS, Hawkes C, de Souza RJ, et al. Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system: A Report from the Workshop convened by the World Heart Federation. Journal of the American College of Cardiology. 2015;66(14):1590-1614. doi:10.1016/j.jacc.2015.07.050
[4]Carnethon MR. Physical Activity and Cardiovascular Disease: How Much is Enough? American journal of lifestyle medicine. 2009;3(1 Suppl):44S-49S. doi:10.1177/1559827609332737
[5]Myers J. Exercise and Cardiovascular Health. Circulation. January 2003;107:e2-e5. DOI 10.161/01.CIR.0000048890.59383.8D
[6]Nancy A. Rigotti, Carole Clair; Managing tobacco use: the neglected cardiovascular disease risk factor, European Heart Journal. November 2013:(34)42; 3259–3267
[7]He J, Vupputuri S, Allen K, Prerost MR, Hughes J, Whelton PK. Passive smoking and the risk of coronary heart disease–a meta-analysis of epidemiologic studies, N Engl J Med. 1999: (340); 920-926
[8]Djoussé L, Lee I-M, Buring JE, Gaziano JM. Alcohol Consumption and Risk of Cardiovascular Disease and Mortality in Women: Potential Mediating Mechanisms. Circulation. 2009;120(3):237-244. doi:10.1161/CIRCULATIONAHA.108.832360
[9]Bell S, Daskalopoulou M, Rapsomaniki E, George J, Britton A, Bobak M, Casa JP, Dale, CE, Denaxas S, Shah AD, Hemingway H. Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. March 2017;356:j909https://doi.org/10.1136/bmj.j909[Accessed August 2018]
[10]Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. The New England Journal of Medicine. 2004;350(14):1387–1397
[11]Mathews MJ, Mathews EH, Mathews GE. Oral health and coronary heart disease. BMC Oral HealthBMC series. 2016 (16)122https://doi.org/10.1186/s12903-016-0316-7[Accessed August 2018]
[12]Soder, B., Meurman, J. H., & Soder, P. Dental calculus links statistically to angina pectoris: a 26 year observational study. 2016. PloS ONE, 11(6): 1-8
[13]Daniels SR, Pratt CA, Hayman LL. Reduction of Risk for Cardiovascular Disease in Children and Adolescents. Circulation. 2011;124(15):1673-1686. doi:10.1161/CIRCULATIONAHA.110.016170
 


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