Heart disease, also known as cardiovascular disease, is a condition that impacts people worldwide.

So, what is heart disease?

According to the American Heart Association [AHA] (2019), heart disease includes various conditions where the heart and blood vessels become damaged due to artery, vein and blood vessel narrowing from plaque accumulation. The buildup decreases blood flow and an increases the risk of clotting which can stop the heart from receiving blood. When the heart and blood vessels are unable to circulate the blood as needed, problems and even death can occur.

People with heart disease may experience at least one of the following conditions (AHA, 2019):

Heart failure. Blood does not pump as it should.

Heart attack. Blood is blocked from reaching the heart causing the area of the heart that is not receiving blood to begin to die.

Stroke. Blood vessels that feed the brain are blocked due to a blood clot or hemorrhage from a vein bursting. Most times, this is due to high blood pressure.

Irregular heartbeat. This may cause the heart to beat too fast or too slow which causes an imbalance in blood flow throughout the body.

Heart disease physical risk factors:

The highest risk factors for heart disease are high blood pressure, high cholesterol, and smoking.

Other risk factors include:

  • Poor Diet.  Can lead to high blood pressure and high cholesterol.
  • Overeating. Can lead to excess weight and obesity.
  • Obesity. Can lead to high blood pressure and high cholesterol.
  • Diabetes. Damages the veins and heart due to poor circulation.
  • Smoking.  Damages the veins and heart due to poor circulation.
  • Excessive alcohol use. Various types of alcohol abuse have been strongly associated with heart attacks from clots, disease of the heart muscle (cardiomyopathy), hardened arteries, and more (American Addiction Centers, 2019).
  • Little to no regular exercise.  Regular exercises increase blood flow.
Is heart disease hereditary, lifestyle or both?

Many times, information on diseases and conditions will state statistics based on ethnicity, gender and race. This can lead people to believe that if it runs in the family, most likely they are susceptible to getting the condition. Yet, how much heart disease is hereditary, how much is it lifestyle or a combination of both?

Let’s look into this a little further.

Heart disease can be hereditary because family genes are passed down through generations, causing a person to be more susceptible to certain conditions. However, in most cases, healthy lifestyle choices, can change the course of their future.

Then why do so many people seem to end up with the same conditions?

Other factors are not talked about as much but really should be discussed for a clearer and better understanding so that better choices might be made. These other factors are environmental and emotional/mental:

Heart disease emotional and mental risk factors:
  • Stress
  • Depression
  • Anxiety
  • Loneliness
  • Guilt
  • Shame
  • Trying to fill an emotional void
Heart disease environmental factors:
  • Family and culture traditions
  • The company you keep
  • Peer Pressure
  • Low income
  • Unsafe environments to participate in physical activities
  • Servings of large portions of food
  • Celebrations and special occasions with excess food and substances

As mentioned before, heart disease is a worldwide problem.  Below are examples of countries where heart disease is a leading cause of death.

In the United States alone, 1 out of 4 deaths is due to heart disease. Risk factors include Obesity and excess weight, diabetes, high blood pressure, high cholesterol, little physical activity, excessive alcohol use (CDC, 2017).  
Bulgaria. Heart disease and cancer make of four-fifths (80%) of all deaths; daily smoking of tobacco (28%), physical inactivity (31%), and high blood pressure (36%) (World Health Organization, 2018).
Canada. Heart disease is the second leading cause of death. High blood pressure affects 1 in 5 adults, high cholesterol and diabetes are also contributing factors. The good news is a study done from 2001-2013 shows a decrease in heart disease-related deaths of 23%. (Keep up the Good Work!) (Heart and Stroke Foundation of Canada, 2018; Public Health Agency of Canada, 2017).
Poland. Heart disease leads to 30.45% of deaths. Leading risk factors include abdominal obesity (83.3%), obesity or excess weight (68%), high blood pressure (65.1%) and high cholesterol (33.3%) (Koltuniuk, A. & Rosinczuk, J., 2016; World Life Expectancy, 2017).
Ukraine. Heart disease is the leading cause of death. One big factor is the quality of medical care depending on geographical area and socioeconomic status (The World Bank, 2011).
As you can see, these are staggering numbers! And the risk factors can be greatly reduced by changing lifestyle habits.

Healthcare Crisis

We hear far too often that the US and across the globe is in a healthcare crisis (Council on Foreign Relations, 2014). However, in the U.S. portion sizes are larger than ever, smoking marijuana has become legal in most states, “yet marijuana smoke contains many of the same toxins, irritants, and carcinogens found in cigarette smoke — a known contributor to heart disease as well as cancer (Harvard Health Publishing, 2019),  there is an increase in families who struggle financially and unhealthy food are, many times, cheaper than healthier foods. A large percentage of families are not being adequately educated on what these risk factors are doing to the heart (Carroll, 2017; Jin & Smith, 2015). There is a reduction in free, safe physical activities for many families of a lower income to participate in to increase physical fitness levels (Jin & Smith, 2015). In addition to the breakdown of the family unit which is causing an increase in depression, poverty, and other problems; as well as an increase in behaviors and lifestyle patterns that promote heart disease (Dong, Price & Sanchez, 2004).

Bottom line

The bottom line is there is a worldwide problem of heart disease where people regularly and excessively smoke tobacco and other substances, misuse or abuse alcohol, and eat poorly and in excess for various reasons. It is important for the public to understand the truth about what they are doing to their bodies that increasing the risk for heart disease. The public also must be attentively aware of habits and choices and the consequences that follow because these habits could very well be shortening life. There are so many other healthy ways to manage or overcome what drives so many behaviors that put the body at risk for heart disease. People need to understand that they have more control over their health than they may realize. The public must educate themselves, be proactive and take charge of their own health and wellness.  They also need to be regularly informed on the health risks associated with lifestyle choices that can be avoided or at least minimized to some extent. Efforts must be made to ensure that the public is able to sift through the mixed messages by the media to combat issues that increase the risk of heart disease.

How occupational therapy can help with cardiovascular disease

There are many ways that occupational therapy can assist in helping people to live healthier lives reducing the risks associated with heart disease. Since each person is unique, an individualized assessment would be taken to determine what key factors have led to or are contributing to performance patterns that are increasing the risk for heart disease or have already led to a heart condition (American Occupational Therapy Association [AOTA], 2014). Occupational therapy will assess habits, roles, routines, rituals and other factors such as nutrition, stress, levels of depression and/or anxiety, coping strategies, assessing work/life balance, socioeconomic status, activity patterns and choices, relationships and more that could be adjusted to increase health and wellness for the individual (AOTA, 2014).

For more information, please contact Life Wellness at Christa@OTWellness.com.


American Addiction Centers. (2019). Increased Risk of Heart Attack from Alcohol Abuse. Retrieved from https://www.alcohol.org/effects/heart-attack/

American Heart Association. (2019). What is cardiovascular disease. Retrieved from https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68, S1–S48. http://dx.doi.org/10.5014/ajot.2014.682006

Carroll, M.D. (2017). Prevalence of Obesity Among Adults, by Household Income and Education — United States, 2011–2014. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/mmwr/volumes/66/wr/mm6650a1.htm

Centers for Disease Control and Prevention. (2017). Heart disease facts. Retrieved from https://www.cdc.gov/heartdisease/facts.htm

Council on Foreign Relations. (2014). The emerging global health crisis. Non-communicable diseases in low to middle income countries. Retrieved from https://www.cfr.org/report/emerging-global-health-crisis

Dong, C. Price, R.A. & Sanchez, L.E. (2004). Relationship of obesity to depression: a family-based study. International Journal of Obesity. 28, 790–795. Retrieved from https://www.nature.com/articles/0802626

Harvard Health Publishing. (2019). Marijuana and heart health and what you need to know. Retrieved from https://www.health.harvard.edu/heart-health/marijuana-and-heart-health-what-you-need-to-know

Heart and Stroke Foundation of Canada. (2018). Heart. Condition risk factors. Retrieved from https://www.heartandstroke.ca/heart/risk-and-prevention/condition-risk-factors

Kołtuniuk, A., & Rosińczuk, J. (2016). The prevalence of risk factors for cardiovascular diseases among Polish surgical patients over 65 years. Clinical interventions in aging, 11, 631–639. DOI:10.2147/CIA.S105201

Public Health Agency of Canada. (2017). Heart disease in canada. [PDF]. Retrieved from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html

The World Bank. (2011). Stopping the mortality crisis in ukraine. Retrieved from https://www.worldbank.org/en/news/feature/2011/06/08/stopping-mortality-crisis-in-ukraine#:~:targetText=Ukrainians%20have%20a%20high%20risk%20of%20dying%20prematurely.&targetText=Cardiovascular%20disease%20is%20the%20leading,half%20of%20the%20disease%20burden.

World Health Organization. (2018). Bulgaria – world health organization. [PDF]. Retrieved from https://www.who.int/nmh/countries/bgr_en.pdf?ua=1

World Life Expectancy. (2017). World health rankings. Poland: Coronary artery disease. Retrieved from https://www.worldlifeexpectancy.com/poland-coronary-heart-disease

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