Think of your heart as the engine of your body. Just like a car engine keeps everything running smoothly, your heart pumps blood throughout your body, delivering oxygen and nutrients where they’re needed. But just like an engine, your heart needs regular maintenance and the right fuel to stay in top shape. When blood vessels become inflamed—it restricts flow, leading to problems like heart attacks and strokes.

As a cardiac surgeon, I see the effects of these “engine breakdowns” far too often in Canadian men, many of whom could have prevented them with a few lifestyle changes. In Canada, someone dies every five minutes from heart conditions, stroke or related conditions. 9 out of 10 people are living with at least one risk factor for cardiovascular disease. 

In this article, I’ll explain why heart disease and stroke are so closely linked, outline the main risk factors, and share steps you can take to keep your “engine” running smoothly for years to come. Taking control now can reduce your risk so you can enjoy a healthier, longer life.

Why heart and stroke health are linked

Your heart is essentially a pump that keeps blood moving through your body. It requires a steady supply of fuel to keep running. In this case, that “fuel” is oxygen-rich blood, which delivers oxygen to your heart through blood vessels. 

When issues like high cholesterol, high blood pressure, or smoking cause inflammation in those blood vessels—a condition called atherosclerosis—they can become blocked. This blockage restricts blood flow, which can lead to a heart attack or a stroke.

Cardiovascular disease (CVD) is a term that includes both heart attacks and strokes because they impact the same system: your blood vessels. If blood flow to the heart is cut off, it results in a heart attack. If it’s cut off to the brain, it results in a stroke. 

These systemic issues affect multiple organs, not just the heart or brain. However, the heart is usually the first to react to a lack of oxygen going into the organs.

Key risk factors for cardiovascular disease

Knowing your risk level for heart and stroke can be life-saving. Since many of these factors are modifiable through lifestyle changes, making the necessary changes that have the most impact on you will give you some control over your heart health.

Here are the main risk factors:

Being male and over 40
Men face a higher risk of heart disease than women, especially at younger ages. Hormones offer some protection to women until menopause, after which their risk starts to catch up. However, the risk begins earlier for men, typically in the 40s, and grows with age.

Family history
Genetics play a huge role. If someone in your family had a heart attack at a young age, you should start screening for cholesterol and blood pressure as early as your 20s.

High blood pressure
Untreated high blood pressure, or hypertension, can cause wear and tear on your arteries over time. This damage can restrict or block blood flow, increasing your risk of heart attack and stroke. High blood pressure can be managed with medication and lifestyle changes, so regular monitoring is essential.

Diabetes
Diabetes, especially type 2, significantly increases your risk of cardiovascular disease. Poorly managed diabetes leads to higher blood sugar levels, which can damage blood vessels. Diabetes often occurs with other risk factors like obesity and high cholesterol, compounding the risk.

Smoking
This is one of the most significant risk factors that you can control. Smoking damages the lining of your blood vessels, making them more susceptible to blockages. If you smoke, quitting will drastically reduce your risk and is one of the best lifestyle changes you can make.

Poor diet and inactivity
A diet high in processed foods and low in fruits, vegetables, and whole grains, combined with a lack of physical activity, can lead to weight gain, high cholesterol, and high blood pressure, all of which contribute to cardiovascular disease. 

Excessive alcohol use
Excessive alcohol can cause high blood pressure, increase triglycerides and raise cholesterol to unhealthy levels in your blood, which often leads to heart disease. Canada’s Guidance on Alcohol and Health states that seven or more drinks per week significantly increase your risk of heart disease and stroke. 

Can stress cause a heart attack?

One of the questions I often get from patients is whether stress alone can trigger a heart attack. The answer is a bit nuanced. While stress itself doesn’t directly cause a heart attack, chronic stress can increase your risk over time. Here’s how it works.

When you’re under stress, your body goes into “fight or flight” mode. This response releases hormones like adrenaline and cortisol, which raise your heart rate and blood pressure. In the short term, this can help manage immediate challenges. But when stress becomes chronic, these repeated surges of adrenaline and elevated blood pressure put added strain on your heart and blood vessels.

Over time, chronic stress can contribute to several known risk factors for heart disease, including high blood pressure, inflammation and unhealthy habits like excessive alcohol consumption, overeating, or a sedentary lifestyle.

So, while stress alone is not a direct cause of heart attacks, its effects on the body create an environment where heart disease can develop or worsen. 

Can you have a heart attack without knowing?

For most men, a heart attack feels like what you’ve seen in the movies—sudden chest pain, discomfort in the left arm, or shortness of breath. However, not all heart attacks are this obvious. Some can appear as heartburn, fatigue, or even a “silent” heart attack, where there are no symptoms at all. Although rare, this is something that typically happens more often with women.

Even if you feel fine, if you have a family history of heart disease or other risk factors, it’s worth getting screened. 

The power of prevention and screening

Here’s what I recommend:

Get screened regularly
If you have any risk factors, start getting tested in your 20s. Regularly monitor your cholesterol, blood pressure, and blood sugar levels, especially if you have a family history of cardiovascular disease. Early detection gives you more options for managing risk factors before they lead to severe problems.

Quit smoking
This is one of the most impactful lifestyle changes you can make. Smoking increases the risk of cardiovascular disease and cancer and impacts lung health and overall well-being. Within 24 hours of quitting, your risk of heart attack starts to decrease.

Stay active
Aim for at least 150 minutes of moderate exercise each week. Physical activity improves heart health, lowers stress, and helps maintain a healthy weight. Everyday activities like walking the dog, doing chores around the house, or playing with your kids all count as exercise.

Choose heart-healthy foods
Incorporate more fruits, vegetables, lean proteins, and whole grains into your diet. Avoid processed foods, limit added sugars, and reduce unhealthy fats. A Mediterranean-style diet—rich in fish, nuts, and olive oil—has been shown to benefit heart health.

Manage stress
Chronic stress isn’t good for your body or your mind. Find stress management techniques that work for you, whether yoga, meditation, hobbies or simply taking time to unwind each day.

Using technology to track your heart health

Today, wearable technology like smartwatches makes it easier to stay aware of your health. Many devices can monitor your heart rate, count steps, and even take an ECG (electrocardiogram) to check for irregular heartbeats. 

Some devices track your oxygen levels or alert you if your heart rate is irregular. While these tools aren’t substitutes for medical checkups, they’re valuable for raising awareness and helping you stay motivated to make heart-healthy choices.

One feature I find particularly useful is the ability to track activity and set daily movement goals. You can even compete with family and friends, making it a fun and social way to stay active. In the future, these devices may become even more advanced, potentially helping to detect early signs of heart disease.

Final thoughts

Cardiovascular disease is one of the leading causes of death in Canada. Still, many cases are preventable with early screening, lifestyle changes, and a proactive approach. It’s never too early or too late to make simple changes that will lower your risk of heart attack and stroke.

Remember, if you’re at risk of heart attack and stroke, regularly monitor your cholesterol, blood pressure, and blood sugar levels. Prevention is key. High cholesterol, blood pressure and sugar levels can all be regulated if you know they are an issue.

If there’s one message I hope to leave with you, it’s this: don’t wait until something goes wrong to start taking care of your cardiovascular health. The sooner you start, the better your future will look. 

Are there any heart health topics you’d like to see us cover? Leave us a comment below or email your suggestions to [email protected].

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