HEART HINDRANCES

From your height to how much you snore, these are the unknown factors that increase your risk of a heart attack or stroke, writes Emily Craig

Smoking, an unhealthy diet and a lack of exercise are all bad habits that harm the heart. But beyond these obvious red flags, there are other habits and characteristics that can dramatically raise our risk of suffering a heart attack or stroke.

VAPING

While smoking is one of the main factors that raise the likelihood of heart disease, vaping isn’t a risk-free alternative, according to fresh research presented at a conference this week.

Researchers who monitored the health of more than 175,000 people with an average age of 52 for four years, found that vapers were 19 per cent more likely to suffer from heart failure than those who had never used e-cigarettes.

Dr Yakubu Bene-Alhasan, the study’s lead author, says: “More and more studies are linking e-cigarettes to harmful effects and finding that it might not be as safe as previously thought. It’s worth considering the consequences to your health, especially with regard to heart health.”

Earlier studies have suggested vaping increases blood pressure, heart rate and blood vessel constriction, all of which can harm the organ.

“Damage to the heart has not been removed by switching from cigarettes to vaping,” explains Francesco Cappuccio, a professor of cardiovascular medicine and epidemiology at the University of Warwick.

“The overload of nicotine causes the small blood vessels, mainly in the lungs, to become hardened, which leads to pulmonary hypertension — high blood pressure in the vessels in the lungs, which puts a strain on the heart,” he says. This can ultimately lead to heart failure.

Additionally, vaping can cause pulmonary fibrosis, which is when the lungs become damaged and scarred. “This causes the hardening of the lungs, reduced circulation and high blood pressure, which puts strain on the left side of the heart,” Cappuccio adds.

He labelled the “very rapid” deterioration in heart health among vapers “extraordinary”.

BEING PESSIMISTIC

The benefits of looking on the bright side of life were proclaimed by Monty Python decades ago, but doing so could actually benefit your health.

Researchers from University College London followed more than 350 patients who had been hospitalised after blood supply to their heart had been blocked, which usually occurs due to a heart attack or angina. Before being discharged, patients completed questionnaires that assessed their optimism and logged information about their lifestyle habits.

The findings, published in 2015, revealed that the most pessimistic patients were twice as likely to suffer from a heart attack, require heart surgery or die over the following four years, compared to those who were the most optimistic.

The team said their findings may be explained by lifestyle habits linked to pessimism. For example, the most pessimistic who were smokers were more likely to continue the habit following their hospital stay, while the majority of the most optimistic had ditched cigarettes.

“How emotions such as pessimism may affect health is not well understood but it is hypothesised that they may contribute to cardiovascular health through effects on stress, blood pressure, blood flow and by contributing to chronic low grade inflammation,” says Ioanna Tzoulaki, a professor of chronic disease epidemiology at Imperial College London.

BEING SHORT

For decades, scientists have known that there is a correlation between height and health, with studies suggesting that type 2 diabetes and Alzheimer’s are more prevalent among those who are short, while tall people are at greater risk of cancer and blood clots.

In another blow to those who are vertically challenged, a 2015 study from the University of Leicester found that for every 6.5cm drop in height from the average, the risk of coronary artery disease — when the arteries supplying the heart become narrow, raising the risk of heart attacks — increased by 13.5 per cent.

Until this paper, scientists had put the link between short stature and poor heart health down to other factors, such as short people being more likely to have had a lack of nutritious food during childhood or a poor socioeconomic environment.

But the more recent findings, based on genetic data from nearly 200,000 people, suggest that genes linked to short height raise the risk of coronary artery disease, while variants known to increase height protect against the condition.

“Shorter people are more likely to develop heart disease than taller people,” says Tzoulaki. “The association between height and cardiovascular disease may be mediated via lipid profiles, blood pressure, lung function, or heart rate.”

SNORING

Everyone snores sometimes, whether it’s down to being stuffed up with a cold or having a few too many glasses of wine. But regular snoring could be a sign of sleep apnoea — when breathing stops and starts during sleep. These repetitive breaks in breathing are thought to damage the heart and wider cardiovascular system and can lead to high blood pressure, strokes and heart attacks if left untreated. A Stanford University study, which looked at data from 766,000 adults in the United States aged 20 to 50, found that those who had sleep apnoea were 60 per cent more likely to suffer a stroke over the next decade, compared to those who were not regular snorers.

Sanjiv Narayan, a professor of medicine at the university and the lead study author, presented the findings at the European Society of Cardiology Congress in August. He said at the time: “Sleep apnoea is really common but we sort of ignore it because we think it’s trivial or just a little bit of a nuisance. Until now no one’s really shown the magnitude of the size of the risk for heart diseases.”

In the most severe cases, sufferers can have more than 80 apnoeas, which is more than one a minute. “It leads to continuous hypoxia — low oxygen in your blood and low oxygen in your brain,” says Cappuccio. “This is definitely a risk factor for cardiovascular disease, high blood pressure, diabetes, obesity, heart disease, strokes and heart failure. All those are associated with untreated obstructive sleep apnoea.”

“If you snore regularly, and your partner also says, ‘Oh, I see that you stopped breathing at night,’ definitely go and see the doctor,” he adds. Many cases can be effectively treated with a CPAP machine, which works by pumping air into the mouth or nose through a mask that is worn while sleeping.

VITAMIN D DEFICIENCY

If you’ve not been taking a vitamin D supplement for the last six months, you may be deficient in the so-called sunshine vitamin. As well as bone pain, muscle weakness and fatigue, a deficiency can also raise the risk of poor heart health. One study from researchers at QIMR Berghofer Medical Research Institute in Queensland monitored more than 20,000 people aged 60 to 84, half of whom took vitamin D supplements for five years.

Results, published in the BMJ last year, show that the rate of major cardiovascular events, such as heart attacks, strokes and heart surgery, was 9 per cent lower among those who took the supplement. The findings suggest that one case could be prevented for every 172 people who took a vitamin D supplement. However, Cappuccio urges against needlessly taking the vitamin, as it can push levels too high. “If you take too much without any need, you may develop an irregular heartbeat and atrial fibrillation,” he says.

MENOPAUSE

Menopause brings a litany of health woes, from hot flushes to sleeping difficulties. But it also increases the risk of heart attacks and strokes, according to a study presented this week at an American College of Cardiology conference. Researchers recruited 579 post-menopausal women and the same number of men who had a similar age and health. Each had two scans, one year apart, to check the levels of plaque in their arteries. Results showed plaque concentrations increased among women at twice the rate of men.

The team suggested the female sex hormone oestrogen protects the heart, meaning that when levels dip during the menopause, their risk of heart problems quickly accelerates.

“After menopause, women have much less oestrogen and shift to a more testosteroneheavy profile,” says Dr Ella Ishaaya, an internal medicine physician at Harbor-UCLA Medical Centre in Torrance, California, and the study’s lead author.

“This affects the way your body stores fat, where it stores fat and the way it processes fat; it even affects the way your blood clots.

“All of those [changes] increase your risk for developing heart disease,” she adds.

“Men have a greater risk of heart disease than women, up to the age of the menopause,” confirms Cappuccio. “Women’s risk increases after menopause. One of the major mechanisms is the lack of oestrogen, which seems to protect against cardiovascular disease in women at a younger age.”