Advice | Ask a Doctor: How do I know if my heart is healthy?

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Advice | Ask a Doctor: How do I know if my heart is healthy?
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Advice by Sandeep Jauhar, MD: Lifestyle changes, non-invasive diagnostic tests and paying attention to your emotional health can all make a difference in your risk for heart disease.

When things go wrong with this vital organ, the outcome is often fatal. Cardiovascular disease claims 18 million lives — nearly one-third of all deaths — across the globe each year.Much of what we have learned about how to prevent heart disease comes from a study started in a small town in Massachusetts shortly after World War II. At the start of the Framingham Heart Study, researchers monitored approximately 5,000 healthy, mostly White patients between the ages of 30 and 59.

But as important as the Framingham Heart Study has been in advancing our understanding of heart disease, it does not tell the whole story. For example, Framingham risk models do not seem to apply equally to non-White ethnic groups. South Asians, for instance, have a very high prevalence of heart disease, even when they have 0 or only 1 Framingham risk factor. There may be novel risk factors in this and other populations.

Though some cardiologists advocate for a treadmill stress test to proactively evaluate risk, such tests typically only detect coronary blockages greater than 70 percent, which are unlikely to be present in patients who don’t have chest pains.Other cardiovascular risk factors are in the “psychosocial” domain. A massive amount of epidemiological data associates heart disease with chronic emotional disorder.

How does depression affect heart health? Possible mechanisms include elevating blood pressure, causing vascular inflammation, and increasing blood clotting. Unhealthy behaviors associated with depression, such as physical inactivity, smoking, and failure to take medications or adhere to medical advice, also probably play a role.

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