Cardiovascular disease is still the second leading cause of death. Not surprising, given that less than 7 percent of Americans have good heart health. And that will not be very different in the Netherlands.

Every day in our country die a hundred people to cardiovascular disease. Another 105 people a day have a stroke. According to strategic policy advisor Raymond Wimmers of the Heart Foundation, the situation in our country is comparable to that in the US. There the American Heart Association Life’s Simple 7 introduced to improve the heart health of Americans. These seven simple health factors are smoking, diet, exercise, weight, blood pressure, cholesterol and blood sugar. “The variable sleep was recently added to this,” says Wimmers.

Used to be better

Looking at some of these factors, less than 7 percent of the adult population in the US has good heart health, according to recent research led by a team from the Friedman School of Nutrition Science and Policy of the United States. Tufts University† The researchers evaluated heart health based on blood pressure, blood sugar levels (pre-diabetes), blood cholesterol levels, obesity and the presence or absence of cardiovascular disease. Only 6.8 percent scored optimally on all five components. In addition, over the past twenty years, the figures for overweight and blood sugar have deteriorated considerably. In 1999, one in three adults had an optimal score for overweight, in 2018 that was only one in four. And in 1999, 60 percent of adults had no pre-diabetes, compared to less than 40 percent in 2018.

“These numbers are striking. It is very problematic that in the United States, one of the richest countries in the world, less than one in 15 adults has optimal cardiometabolic health,” said lead researcher Meghan O’Hearn. Together with others, she analyzed a nationally representative sample of approximately 55,000 people aged 20 or older who were followed from 1999 to 2018. They looked not only at sick or not sick, but also at lifestyle factors. “We need to shift the focus, because illness isn’t the only problem,” says O’Hearn, whose study in the Journal of the American College of Cardiology popped up. “We don’t just want to be disease-free. We want to achieve optimal health and well-being.”

Educational attainment

There were also significant health differences in gender, age, education level and ethnicity. For example, adults with a lower level of education were half as likely to have optimal heart health compared to the more highly educated. The difference between white and black Americans was also great. “This is really problematic. Social factors, such as food security, social cohesion, economic stability and racism, put people of different education levels, races and ethnicities at increased risk of health problems,” said researcher Dariush Mozaffarian.

Image of a human heart. Photo: Science Photo Library

The study also looked at the average level: who scored not well, but also not badly, when it comes to conditions such as pre-diabetes, pre-hypertension and overweight. “Much of the population is at a critical juncture,” O’Hearn said. “Identifying these individuals and addressing their lifestyles early is critical to reducing the growing burden of care and health inequalities.”

The consequences are not only great for personal health. “Its impact on national health spending and the financial health of the entire economy is huge,” O’Hearn said. “And these conditions are largely preventable. We can create policies to address these issues.”

The Netherlands

The situation is not very different in the Netherlands. We know, for example, that more than 53 percent of the Dutch population has a healthy weight, almost 32 percent is moderately overweight, 12.6 percent is obese and only half of the Dutch meet the physical activity standard. “Based on what we now know about the individual risk factors in the Netherlands, the cardiovascular health score in the Netherlands will not differ much from that of the American population,” says Wimmers. “With the aging population, the number of patients with cardiovascular disease will also increase, which will also have an effect on the average cardiovascular health score of the Dutch population.”

The Dutch Heart Foundation is also working hard to improve the lifestyle of the average Dutch person. “As the Heart Foundation, we have been working for years to improve the heart health of the Dutch. Our current strategy now focuses on healthy blood pressure, healthy cholesterol levels, not smoking and a better food composition, i.e. with less salt and fat.”

fat tax

Wimmers believes, however, that the government should also contribute to this. “It would help if the government really took steps in this direction. You should not expect much from the industry. Their revenue model is that they influence people to lead an unhealthy life, which makes them a contributor to poor heart health in the population.”

The government, on the other hand, can encourage healthy eating by, for example, introducing a subsidy for fruit and vegetables or by imposing an extra tax on unhealthy food. Of course, as a citizen you also know what is healthy and what is not. However, the sweet and greasy temptations are everywhere. Still, it is better to eat a snack tomato more often instead of that bag of chips. Because many diseases happen to you through bad luck, but your heart health is partly in your own hands.