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Cardiovascular Disease: Brief History, Gender Disparities, and Nutrition.

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Category: Health & Wellness

Cardiovascular Disease: Brief History, Gender Disparities, and Nutrition.

Every 34 seconds someone has a heart disease-related event. The more you know about your heart health, the more empowered you will be to stay healthy.

Background on Cardiovascular Health

In 1948, the Framingham Heart Study, under direction of the National Heart Institute, embarked on a momentous research project. At the time, little was known about the causes of heart disease and stroke, but the death rates for cardiovascular disease (CVD) had become an American epidemic. The objective of the Framingham Heart Study was to identify the common factors that contribute to CVD by following its development over a long period of time, in a large group of participants.

Highlights from Framingham Heart Study

1960: Cigarette smoking found to increase the risk of heart disease
1961: Cholesterol levels, blood pressure, and electrocardiogram abnormalities found to increase the risk of heart disease
1967: Physical activity found to reduce the risk of heart disease and obesity to increase the risk of heart disease
1976: Menopause found to increase the risk of heart disease
1988: High levels of HDL cholesterol found to reduce risk of death
2010: Sleep apnea tied to increased risk of stroke

Gender Disparities

The majority of information regarding CVD has been based off of research with male participants. Here are some important statistics regarding variances by gender:

- In the United States, cardiovascular disease is the leading cause of death among adults of both genders.
- In 2/3 of the deaths from heart attack in women, there was NO history of chest pain.
- In men, a heart attack typically begins with the sudden rupture of a cholesterol-filled plaque in a coronary artery.
- In women, plaque is more likely to erode into the vessel wall, making women more likely to have smaller, nonfatal heart attacks.1
- Women are more likely to develop small vessel disease, rather than in the large, surface arteries. 
- Women who have a history of irregular menstrual cycles, estrogen deficiencies and polycystic ovary syndrome may have a higher risk of developing heart disease as they age.1
- Women can have normal angiograms even when they have ischemic heart disease.1


Diet is a crucial modifiable risk factor for CVD treatment and prevention. There are a few nutritional elements that have gained significant attention in the discoveries surrounding heart health.

Role of Dietary Fat

There is mixed information regarding fats and heart disease:

- One study concluded that total fat intake does not appear to be an important risk factor, while a diet high in trans fatty acids does increase rates of cardiovascular disease..2
- Reviews from 2014 and 2015 did not find evidence of harm from saturated fats.3,4
- Another review found that the greatest benefits occur from replacement of saturated with polyunsaturated fat.2,5
- A 2015 systematic review by the Cochrane Library found that reducing saturated fat intake resulted in a 17% reduction in cardiovascular events, and that replacing saturated fats with unsaturated fats in particular is beneficial.6,7
- A 2017 systematic review by the American Heart Association recommended decreasing saturated fat intake and increasing consumption of monounsaturated and polyunsaturated fats could lower risk of cardiovascular disease by about 30%.8
- Currently, worldwide dietary guidelines recommend a reduction in saturated fat.

Sugar and CVD

The main concern for this category is the destructive effects of added sugar, versus the benign qualities of natural sugars found in fruits and vegetables.

- Research has shown that drinking sugar-sweetened beverages can raise blood pressure and a high-sugar diet can stimulate the liver to release more detrimental fats into the bloodstream; both increasing heart disease risk.9
- One analysis found that participants who consumed 10% or greater but less than 25% of calories from added sugar, had a 30% higher risk of CVD mortality, while those who consumed 25% or more of calories from added sugar, nearly tripled their relative risk.10
- The positive association between added sugar intake and CVD mortality was found to be significant even after adjusting for risk factors such as blood pressure and cholesterol. A sugar-laden diet may raise your risk of dying from heart disease even if you aren’t overweight.10

While we have come a long way in CVD research and knowledge, there is still progress to be made. Understanding the risk factors and conditions associated with heart disease is an important step to take to prevent you or your loved ones from becoming a statistic.


1. Maas, A.H.E.M., and Y.E.A. Appelman. “Gender Differences in Coronary Heart Disease.” Netherlands Heart Journal 18.12 (2010): 598–602.
2. Willett, WC (July 2012). "Dietary fats and coronary heart disease". Journal of Internal Medicine. 272 (1): 13–24. 
3. Chowdhury, Rajiv; Warnakula, Samantha; Kunutsor, Setor; Crowe, Francesca; Ward, Heather A.; Johnson, Laura; Franco, Oscar H.; Butterworth, Adam S.; Forouhi, Nita G.; Thompson, Simon G.; Khaw, Kay-Tee; Mozaffarian, Dariush; Danesh, John; Di Angelantonio, Emanuele (18 March 2014). "Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk". Annals of Internal Medicine. 160 (6): 398–406.
4. de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS (Aug 12, 2015). "Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies". BMJ. 351(h3978). 
5. Astrup, A; Dyerberg, J; Elwood, P; Hermansen, K; Hu, FB; Jakobsen, MU; Kok, FJ; Krauss, RM; Lecerf, JM; LeGrand, P; Nestel, P; Risérus, U; Sanders, T; Sinclair, A; Stender, S; Tholstrup, T; Willett, WC (April 2011). "The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010?". The American Journal of Clinical Nutrition. 93 (4): 684–8.
6. Hooper; et al. (Apr 2016). "Reduced or modified dietary fat for preventing cardiovascular disease". Sao Paulo Med J. 134 (2): 182–3.
7. Hooper L, Martin N, Abdelhamid A, Smith GD (2015). "Reduction in saturated fat intake for cardiovascular disease". Cochrane Database Syst Rev. Jun 10(6).
8. Sacks, Frank M.; Lichtenstein, Alice H.; Wu, Jason H.Y.; Appel, Lawrence J.; Creager, Mark A.; Kris-Etherton, Penny M.; Miller, Michael; Rimm, Eric B.; Rudel, Lawrence L.; Robinson, Jennifer G.; Stone, Neil J.; Van Horn, Linda V. (2017). "Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association". Circulation: CIR.
9. Malik AH, Akram Y, Shetty S, Malik SS, Yanchou Njike V. Impact of sugar-sweetened beverages on blood pressure. Am J Cardiol. 2014 May 1;113(9):1574-80. 
10. Yang, Quanhe, et al. “Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults.” JAMA Internal Medicine, vol. 174, no. 4, Jan. 2014, p. 516.


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