Advice on coronary heart disease Coronary artery disease Coronary artery disease occurs when the main blood vessels supplying the heart become damaged. Cholesterol deposits in the coronary arteries and inflammation are often the main causes of this disease. What can I do if I have a high cardiovascular score in myHealthScore? myHealthScore determines the genetic risk of having coronary artery disease, but in addition to this genetic factor there is another part of the risk related to environmental factors, lifestyle habits, etc., thus, it is considered a multifactorial disease. If myHealthScore result is high, although we cannot modify genetics, there are many other factors that we can modify to reduce the risk of coronary artery disease, such as changes in life style or habits. In order to assess your overall risk taking into account genetics and environment, Veritas provides you and your specialist with a risk calculator. Other calculators are available, and you can use your result in any calculator that accepts this type of information. Some of the factors related to life style and habits that have a positive influence on reducing the risk of coronary artery disease are: 1.- Increase physical activity An active lifestyle reduces the risk of cardiovascular disease; in fact, it is estimated that 30% of coronary artery disease is due to physical inactivity. According to WHO (World Health Organization) recommendations, in adults: Perform regular physical activity.Perform 2 and a half to 5 hours of moderate-intensity aerobic physical activity, 1 and quarter to 2 and a half hours of high-intensity physical activity, or an equivalent combination of both per week.Perform muscle-strengthening activities of moderate or greater intensity involving all major muscle groups 2 or more days per week. 2.- Quit smoking About 20% of deaths from cardiovascular disease are due to smoking 3.- Lower body weight, improve diet In people who are overweight or obese, reducing body mass index helps reduce cardiovascular risk. It also helps prevent or control diabetes, high blood pressure and cholesterol. Weight loss reduces the likelihood of premature death by approximately 20%. There are two main ways to achieve weight loss: Reduce caloric intake.Increase caloric expenditure through exercise. The recommendations for a healthy diet are: Base the diet on vegetables, fruits, whole grains, beans, legumes, nuts, vegetable proteins, lean animal proteins, skinless poultry, fish and seafood.Limit sugary drinks, alcohol, sodium, red and processed meats, refined carbohydrates such as added sugars and processed grain foods, high-fat dairy products, highly processed foods, tropical oils such as coconut and palm oil.Avoid trans fats and partially hydrogenated oils that are generally found in some baked and fried foods on the market (processed foods). 4.– Control of cholesterol levels, blood pressure and blood sugar. Controlling these 3 parameters helps reducing cardiovascular risk: 1.- Cholesterol Cholesterol is a necessary molecule for the organism as it is the main component of cell membranes and the raw material of hormones, among many other functions. In order to circulate through the body, it binds to proteins called lipoproteins, the most familiar being HDL and LDL. Cholesterol comes from two sources: food of animal origin and synthesis in the body itself. Regarding the cardiovascular health, we differentiate between good and bad cholesterol: HDL = GOOD: High-density lipoprotein is known as “good” cholesterol. It helps prevent LDL from sticking to artery walls and reduces plaque buildup. This process can reduce the risk of heart disease and stroke.LDL = BAD: Low-density lipoprotein is known as “bad” cholesterol, the type of cholesterol that deposits within the vessels’ walls and can clog them.Triglycerides: This is the most common type of fat in the blood, constituting the main form of energy storage. Elevated triglyceride levels increase cardiovascular risk.Total cholesterol: HDL level + LDL level + 1/5 of triglyceride level = total cholesterol level. 2.- Blood sugar The carbohydrates and sugars we ingest in our diet are metabolized and converted into glucose (simple sugar). Glucose enters the bloodstream and its levels are controlled through the production of insulin. This hormone facilitates the passage from the blood to the tissues to be used by the cells as a source of energy. Not all foods increase blood glucose at the same rate; foods with a higher glycemic index increase blood glucose levels very quickly, which is detrimental. Regular consumption of high glycemic index foods increases the risk of developing insulin resistance, also known as prediabetes. To reduce and control blood sugar levels it is recommended: Quit smoking, in addition to increasing cardiovascular risk, it can make prediabetes and diabetes more difficult to control.Control body weight, so that prediabetes or diabetes are easier to control.Maintain a healthy diet rich in vegetables, fruits, whole grains, legumes, nuts, vegetable proteins, lean animal proteins such as fish and seafood. Limit sugary drinks and foods, red or processed meats, salty foods, refined carbohydrates and highly processed foods. Regular exercise helps to control the disease. 3- Blood pressure The heart functions as a pump that circulates blood throughout the body to deliver oxygen and nutrients. Circulating blood pushes against the walls of the blood vessels. The strength of pushing is called blood pressure. When it is too high, the heart works harder and increases the risk of cardiovascular disease. Systolic: The higher number represents the systolic blood pressure, which measures the pressure in the arteries when the heart muscle contracts.Diastolic: The lower number represents diastolic blood pressure, measuring the pressure in the arteries when the heart rests between beats. According to the European Society of Cardiology guidelines, blood pressure is considered high when the systolic and diastolic pressure values are greater than 140 / 90 mmHg, respectively. Hypertension diagnosis The diagnosis of hypertension should be made by a health professional, if you have hypertension here are some recommendations to help control it: Follow a healthy diet: fruits, whole grains, beans, legumes, nuts, vegetable proteins, lean animal proteins such as fish and seafood. Limit sugary drinks and foods, red or processed meats, salty foods, refined carbohydrates and highly processed foods.Exercise more: Physical activity helps control blood pressure, weight and stress levels.Control your weight: If you are overweight, even a slight weight loss can reduce high blood pressure.Nicotine-free: Whenever you smoke, vaporize or use tobacco, nicotine can cause a temporary increase in blood pressure.Get good sleep: Little sleep (less than 7 hours) and poor quality sleep are associated with high blood pressure. References: Global health risks: mortality and burden of disease attributable to selected major risk. Geneva: World Health Organization; 2009 https://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf, accessed 30 September 2019).Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine 2020;54:1451-1462.Tobacco and coronary heart disease. WHO Tobacco knowledge summaries. 22 September 2020Guía para que las personas dejen de fumar. Washington, D.C.: Organización Panamericana de la Salud; 2020. Licencia: CC BY-NC-SA 3.0 IGO.https://www.healthy-heart.org/keep-your-heart-healthy/keeping-a-healthy-weight/Williams B, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. European Heart Journal 2018;39:3021–3104.https://www.healthy-heart.org/keep-your-heart-healthy/blood-pressure/https://www.healthy-heart.org/keep-your-heart-healthy/cholesterol/https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8https://www.ncbi.nlm.nih.gov/books/NBK355295/