The Challenges of Cardiovascular Prevention

Everyone agrees that health is a precious asset—perhaps the most precious one. Isn’t that what we all wish for at the start of each New Year?

Most people rely on the continuous progress of modern medicine to cure them if something goes wrong. But wouldn’t it be better to prevent illness in the first place?

We often admire those who live to a ripe old age without serious illness, hoping to uncover their secret. But are we truly ready to take the necessary steps to safeguard our own health?

Life expectancy on the rise, early mortality on the decline

In industrialized countries, life expectancy has significantly increased over the past century.

This improvement is largely due to a sharp decline in deaths during childhood and early adulthood. Better sanitation, access to vaccines, and the discovery of antibiotics have also played a major role.

Living better with chronic diseases

Longer life expectancy is also supported by improved screening tools, more effective treatments, and evolving lifestyle habits — particularly a significant reduction in smoking across many segments of the population.

But a shadow remains

Despite these encouraging improvements, a troubling reality persists: while we are living longer, those added years are often spent in poor health.

According to the World Health Organization, the last ten years of life are, on average, marked by illness.

In other words, science has helped us live longer — but not necessarily healthier until the end.

A concerning situation

Worse still, the future may hold new challenges.

A few years ago, a well-known physician from Chicago issued a warning in a scientific journal: the impressive gains in life expectancy over the past 50 years could be wiped out by a new threat — the largest epidemic of chronic disease in human history.

According to him, the next generations may live shorter lives than their parents.

Obesity: a growing public health crisis

Since 1985, the rate of obesity among youth has steadily increased. While medicine can often manage the consequences of obesity in adulthood, the situation becomes far more complex when it begins in childhood or adolescence.

Complications appear earlier and are more difficult, time-consuming, and costly to treat.

Worrisome recent figures

Between 2017 and 2020, one in five Americans aged 2 to 19 was considered obese. Among children aged 6 to 11, fewer than one in four met the recommended 60 minutes of daily physical activity.

Among adults, the outlook is equally concerning: over 70% are overweight or obese. This growing imbalance represents a major challenge for public health.

A growing economic burden

In Canada, cardiovascular disease is the leading cause of hospitalization and surgical intervention, and accounts for the highest direct healthcare costs. Added to this are the long-term effects of early-onset obesity, which threaten to place unprecedented financial pressure on healthcare systems.

In the United States, the direct and indirect costs of these diseases were estimated at nearly $420 billion in 2020–2021.

“Everybody wants to go to heaven, but nobody wants to die”

This saying captures a common paradox: everyone wants to live a long and healthy life, but few are truly willing to make the necessary changes to achieve it.

Can we change this reality and hope for more healthy years, rather than years spent in illness and suffering? The answer is yes… but human nature often gets in the way.

When illness strikes, fear pushes people to act. But once the danger has passed, old habits tend to return.

A slow process and just the tip of the iceberg

Coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that disease doesn’t appear overnight. It results from a slow buildup of cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> plaques, called atheroma, within the arteries.
In many cases, the disease only becomes apparent after an acute event — such as a heart attack or unstable angina.

For the person affected, it’s a shock: pain, fear of dying, and a life suddenly turned upside down. Illness never comes at a good time.

Big promises, false reassurance, and a return to old way

After a cardiac event, the resolutions come quickly: “I’ll quit smoking!”, “I’ll start exercising again!”, “I’ll lose weight!”, “I’ll take better care of myself…” and so on.
The fear of death often motivates genuine promises — in the moment.

Thanks to today’s medical advances, such as angioplasty to quickly reopen blocked coronary arteriesThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that, many patients’ lives are saved.

But with a short hospital stay and a non-invasive procedure, many leave with the feeling that they are “cured.”

Old habits die hard

Unfortunately, this false sense of recovery leads many back to their former ways. Yet the disease is still present. The procedure only compressed the cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >> plaque against the artery wall — like flattening a road hazard without removing it.

Even after major surgery like coronary bypass — which creates new routes around blocked arteries — some patients return to the same harmful lifestyle.
The heart may have been repaired, but the way of living has not.

Underlying issues and lifestyle habits

Symptoms may fade, but coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that disease doesn’t simply go away. It often continues to progress silently—unless we choose to address the real issue: our lifestyle habits.

And that root cause is often our lifestyle.

Prevention: a key strategy

The only sustainable way to avoid (or prevent the return of) heart disease is through prevention.

That starts with a serious shift in how we live day to day. This is where the real battle takes place: preventing a first heart attack, avoiding the long-term consequences of early obesity, and reducing the risk of recurrence after a cardiac event.

Striking results

One might think that complex treatments are needed to protect the heart. In reality, the solution is often quite simple.

Here’s a striking comparison: the best medications reduce the risk of a heart attack by about 1%. But changing five lifestyle habits can reduce that risk by up to 85%!

These five pillars are:

Eating a healthy diet
Maintaining a healthy weight (waist circumference < 100 cm in men, < 88 cm in women)
Not smoking
Exercising regularly (at least 30 minutes a day)
Managing stress

So, why not start today?

Recommended reading: Healthy lifestyle habits

Benefits that go far beyond the heart

That’s not all. These changes also lower the risk of cancer and neurodegenerative diseases. In short, your entire body benefits.

What about genetics?

Many people believe: “Everyone in my family dies young — it’s just how it is.” But that’s not true.

Fascinating research has shown that healthy living can even influence our genes. Certain habits can activate protective genes and silence the ones that contribute to disease.

Yes, it’s possible — and it’s scientifically proven.