Stopping a Pandemic

“Cardiovascular disease kills more people each year than COVID-19 at its worst. We know how to prevent it. We just need the political will.” Tom Frieden

Although COVID-19 is the most aggressively reported pandemic of our lifetime, it is neither the deadliest nor the most preventable.

That distinction goes to cardiovascular disease (CVD), a pandemic so common it is invisible, so routinely lethal it seems normal, and so ingrained in the fabric of modern society it seems natural.

Every year, cardiovascular disease kills twice as many people, at a younger average age, as COVID-19 has at its worst, and since 2020, there’s been a surge in fatalities from heart disease and stroke in the U.S. And, cardiovascular disease is the leading cause of lower life expectancy among African Americans.

Some basics facts…in the first two years of the pandemic, COVID-19 killed nearly 900,000 people in the U.S., says Tom Frieden, M.D., chief executive, Resolve to Save Lives.

In those same years, heart attacks and strokes killed more than 1.6 million. Globally, COVID-19 killed more than 10 million people in the first two years of the pandemic; in the same two years, cardiovascular disease killed more than 35 million globally.

The leading drivers of cardiovascular disease related heart attacks and strokes are:

  • Tobacco use,
  • Hypertension,
  • Artificial trans fats consumption, and
  • Air pollution,

and all are preventable.

Related medical costs and productivity losses approach $450 billion annually, and inflation-adjusted direct medical costs are projected to triple over the next two decades if present trends continue.

Cardiovascular disease can be prevented

Tobacco

Tackling these killers—tobacco use, hypertension, artificial trans fat, and air pollution—doesn’t require making radical changes in society. Americans still very much lived in the same country after we reduced the number of fatal car crashes by outlawing drunken driving, promoted child development by eliminating lead in paint and gasoline, and prevented food poisoning through regulations making food safer. But it does mean regulating companies that sell tobacco and unhealthy foods and cause air pollution so that they are forced to share some of the costs of the enormous harms they cause.

The first priority is to end the epidemic of tobacco use. Once people start, especially those who start young, the addictiveness of nicotine in tobacco makes it extraordinarily difficult to stop. Although smoking rates are now at the lowest level ever measured in the U.S., more than 35 million adults still smoke tobacco, each day 1,600 kids try their first cigarette, and tobacco kills nearly 500,000 Americans every year.

The way to reduce smoking is to rally our collective will to do something about the problem. Increasing taxes on tobacco can save millions of lives by using high prices to suppress demand. Rigorous studies have proved that tobacco has a negative price elasticity: For every 10% increase in price, consumption declines by about 4% and by about 8% for children and lower-income groups. About half of that decrease is from people quitting and the other half from people cutting down on the number of cigarettes they smoke.

Sodium and Hypertension

The most important single step to prevent high blood pressure is to reduce your sodium consumption

Kaiser Permanente’s research has shown that it is possible to achieve 90% blood pressure control. Closely related, the World Health Organization (WHO) recommends consuming no more than 2 g of sodium per day (5 g/d salt). Unfortunately, the average salt intake globally is between 9 and 12 g/d.10. High sodium intake is the leading cause of hypertension and is responsible for 2.3 million deaths per year.

Reducing sodium intake reduces blood pressure which in turn lowers cardiovascular disease risk.

Artificial trans fats

Artificial trans fat is a harmful compound that increases the risk of heart attack and death. It can be eliminated and replaced with healthier alternatives without altering taste or increasing cost.

Artificial trans fat is estimated to cause 540,000 deaths every year, globally. Elimination of artificial trans fat has substantial health benefits. Eliminating the use of artificial trans fat in foods in Denmark reduced deaths from cardiovascular disease. In New York State, people living in counties with artificial trans fat restrictions were 6% less likely to be admitted to the hospital after suffering a heart attack or stroke.

Air pollution

Cardiovascular disease stubbornly remains the leading cause of preventable death in America and globally. Political will to combat this silent pandemic and public education are the two best remedies.


References:

  1. https://www.nejm.org/doi/pdf/10.1056/NEJMp1110421
  2. https://www.wsj.com/articles/stopping-a-pandemic-deadlier-than-covid-11648220259
  3. https://www.ahrq.gov/workingforquality/about/agency-specific-quality-strategic-plans/nqs2.html

Small Rewards Work Best for Exercise

Micro rewards increase gym visits by 16%. Combine a few successful strategies, such as:

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One in Sixty Rule — It means that for every 1 degree an aircraft veers off its intended course, it misses its target destination by 1 mile for every 60 miles it flies. Further you go, further away from your goal or destination you get. It is true in life too.

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