Your Heart Is Working Every Day: What Are You Doing To Protect It?
Your heart has been beating since before you were born.
While you sleep, it works. While you eat breakfast, rush to work, sit in traffic, exercise, argue, laugh, worry, fall in love, grieve, celebrate and go about the ordinary business of being alive, it works.
Most of the time, you probably don't think about it. Until something happens. A pain in your chest. A strange flutter.
A doctor says your cholesterol is high. Someone you know has a heart attack. Suddenly, the organ that has been quietly keeping you alive every second of every day has your full attention.
But what if we didn't wait until our hearts frightened us before we started taking care of them?
For World Heart Day, perhaps one of the most useful things we can do is look beyond emergencies and ask a much more ordinary question:
What am I doing now to protect the heart I am going to need later?
Heart Disease Isn't Just Something To Think About When You Get Old
We often associate heart disease with old age. And yes, cardiovascular risk generally increases as we get older. But the conditions that eventually contribute to cardiovascular disease can develop over many years.
According to the World Health Organization, cardiovascular diseases remain the leading cause of death globally. An estimated 19.8 million people died from cardiovascular diseases in 2022, accounting for approximately 32% of deaths worldwide. Heart attacks and strokes accounted for the overwhelming majority of those deaths.
Here in the Caribbean, cardiovascular disease is hardly unfamiliar to us either.
We know people with “pressure”. We know people with diabetes. We know people taking cholesterol tablets. We know someone who had a stroke. We know someone who had a heart attack.
Sometimes these conditions have become so familiar that we almost treat them as an inevitable part of getting older. They aren't.
We cannot eliminate every risk. Age, genetics and family history are beyond our control. But there are also risk factors we can identify, monitor, treat and sometimes change long before an emergency occurs.
Know More Than Your Blood Pressure
In our first World Heart Day article, The Numbers You Should Know: Understanding Blood Pressure Before It Becomes A Problem, we talked about why knowing your blood pressure matters.
But blood pressure is only part of your cardiovascular picture. Blood glucose matters. Cholesterol and other blood lipids matter. Whether you smoke matters. Your level of physical activity matters. Your family and medical history matter. Diabetes matters. Kidney disease matters. And so do the medications you take and the health conditions you are already managing.
The WHO identifies raised blood pressure, raised blood glucose and raised blood lipids among the measurable factors that can indicate increased cardiovascular risk.
The goal isn't to become obsessed with numbers or frightened every time one changes. It is to stop moving through life completely unaware of them.
Your Everyday Life Reaches Your Heart
When we talk about preventing heart disease, the advice can become very predictable very quickly.
Eat better. Exercise. Don't smoke. Drink less. Lose weight. Stress less. Sleep more. All useful advice. But human beings don't live inside health brochures. We live inside jobs and families and budgets. We have cultural foods, caregiving responsibilities, chronic illnesses, neighbourhoods that may or may not be easy to walk through, demanding work schedules, financial pressure and periods when simply getting through the day consumes most of our energy.
Protecting your heart has to exist inside your actual life.
That doesn't make lifestyle choices irrelevant. The WHO identifies tobacco use, physical inactivity, unhealthy diets and harmful alcohol use among the major behavioural risk factors for cardiovascular disease. Air pollution is also recognised as an environmental risk factor.
But telling somebody to “live healthier” without acknowledging the circumstances in which they are trying to do it doesn't get us very far.
Sometimes heart health begins with changing what you realistically can.
Movement Doesn't Have To Look Like Exercise
The word exercise immediately makes some people picture a gym.
Weights. Treadmills. A trainer shouting encouragement while you reconsider every decision that brought you to this moment. But movement is bigger than organised exercise. Walk. Dance. Swim. Garden. Cycle. Do yoga. Play a sport. Take the stairs when that is appropriate for you. Walk around your house. Play outside with your children or grandchildren. Put on music and move while you're cleaning. And yes, go to the gym if you enjoy it.
Your heart doesn't need your movement to be fashionable.
Regular physical activity helps reduce cardiovascular risk. The challenge is finding forms of movement that are safe for you, accessible to you and realistic enough that you will actually keep doing them.
You do not have to become an athlete to become more active than you are now.
Heart-Healthy Food Does Not Mean Abandoning Caribbean Food
Some health advice has a remarkable ability to make eating well sound like punishment. Suddenly everybody is supposed to be eating salmon, quinoa, kale and something involving chia seeds while staring sadly at the pelau.
Our traditional foods are not automatically the enemy.
The Caribbean has an abundance of foods that can form part of a heart-conscious way of eating: beans and peas, ground provisions, vegetables, fruits, fish, whole grains, nuts and seeds, herbs and spices. And yes, there can still be room for roti, pelau, curry, callaloo, bake, doubles and the foods that connect us to home.
The conversation is often about the overall pattern.
How much salt are we consuming?
How frequently are we eating heavily processed foods?
How much fruit, vegetables and fibre are we getting?
How are our foods prepared?
What kinds of fats are we eating most often?
How large are our portions?
What are we eating occasionally, and what has quietly become an everyday food?
Heart health should not require cultural exile.
It may require us to look honestly at some of our habits, including the ways our diets have changed alongside greater availability of highly processed foods. But there is a difference between adjusting how we eat and deciding that everything Caribbean must disappear from the plate.
And About Stress...
“Reduce your stress.”
Lovely.
How?
Because the mortgage still exists. The children still need things. Your boss is still your boss. Your parents may need care. Money may still be tight. The relationship problem hasn't magically resolved itself. And telling yourself to stop stressing can become one more thing to stress about.
Heart health conversations need a more realistic understanding of stress.
We cannot always remove the things creating pressure in our lives. What we can sometimes do is create opportunities for our bodies and minds to recover from them.
That may look like movement. Rest. Prayer. Meditation. Breathing practices. Time outdoors. Therapy. Music. Yoga. Talking to somebody you trust. Setting a boundary. Getting enough sleep where possible. Asking for help. Or sometimes acknowledging that the problem isn't that you need to become better at coping. Something in your circumstances genuinely needs to change.
Stress management should not become another way of telling people to quietly tolerate lives that are overwhelming them.
Know Your Family History — But Don't Treat It Like A Prophecy
“My mother had pressure.”
“My father had a heart attack.”
“Everybody in my family diabetic.”
“Heart trouble does run in we family.”
Family history can tell us something important about cardiovascular risk. It does not tell us exactly what will happen to you.
If cardiovascular disease, hypertension, high cholesterol, diabetes or stroke appears repeatedly in your family, tell your healthcare provider. And where you can, learn a little more than “Daddy had heart trouble.”
How old was he when it happened?
Was it a heart attack?
Did he have hypertension or diabetes?
Did anyone have cardiovascular disease unusually young?
You cannot change the genes you inherited but knowing your family history may give you a reason to pay closer attention to the things you can monitor and manage.
Family history is information. It is not a prophecy.
Women, Your Heart Health Changes Too
Women's cardiovascular health deserves particular attention because for generations women's health has often been treated as though it begins and ends with breasts and reproductive organs.
Your heart belongs in that conversation too. And one important part of that conversation is menopause.
We tend to talk about perimenopause and menopause in terms of periods, hot flushes, night sweats, sleep, mood, weight, brain fog and sex. But something else is happening during this stage of life. Your cardiovascular risk profile can change too.
The American Heart Association's scientific statement on menopause and cardiovascular disease identifies the menopausal transition as an important period for cardiovascular health. Research has found changes in cholesterol, body composition, blood pressure, metabolic health and the blood vessels themselves during this stage of life. Earlier natural menopause, particularly before age 45, is also associated with greater cardiovascular risk.
That doesn't mean menopause suddenly “gives you heart disease”.
Age is part of the picture. So are genetics, existing health conditions, lifestyle and many other factors. But it does mean that the years around menopause are a very good time to stop thinking only about whether your periods have become irregular and start checking what is happening elsewhere in your body.
Know your blood pressure. Know your blood glucose. Know your cholesterol. Talk about changes in weight and body composition without reducing the entire conversation to appearance. And tell your healthcare provider if you experienced menopause unusually early.
There is another part of women's health history that can matter too.
Complications such as pre-eclampsia, hypertension during pregnancy and gestational diabetes are not necessarily medical history that becomes irrelevant once the baby is born. The American Heart Association recognises several adverse pregnancy outcomes as markers associated with increased cardiovascular risk later in life.
In other words: A woman's reproductive history is also part of her heart-health history.
And if you're wondering about menopausal hormone therapy, this is another area where individual medical advice matters. Hormone therapy should not be treated as a DIY strategy for preventing heart disease, but neither should every woman be frightened away from appropriate menopause treatment by outdated blanket statements about cardiovascular risk.
Your age, timing of menopause, symptoms, medical history and individual risk factors all belong in that conversation with a qualified healthcare professional.
Women Also Need To Know What A Heart Attack Can Look Like
We've all seen the dramatic version.
Someone suddenly grabs the centre of their chest, cries out and collapses. A heart attack can look like that. But not always. And one myth needs clearing up: women can absolutely have chest pain during a heart attack. In fact, the American Heart Association says chest pain or discomfort is the most common heart attack symptom in women as well as men.
Women may also experience shortness of breath, nausea, lightheadedness, cold sweating, unusual tiredness or discomfort in the arms, back, neck, jaw or stomach.
The point isn't to make every bout of indigestion frightening. It is to understand that a heart attack does not have to look exactly like the version you have seen on television before you take symptoms seriously.
New, severe or concerning symptoms, particularly when several occur together, deserve medical attention.
Sometimes Protecting Your Heart Means Taking The Medication
Lifestyle gets so much attention in conversations about heart disease that medication can begin to feel like evidence that someone has failed. It isn't.
Sometimes lifestyle changes are enough to improve a risk factor. Sometimes they aren't.
Some people will need medication to control blood pressure, lower cholesterol, manage diabetes or treat an existing cardiovascular condition. Taking medication you genuinely need is not less virtuous than controlling something without it. And, just as we discussed in our blood-pressure article, don't stop prescribed medication because your numbers improved without discussing it with the healthcare professional managing your care.
The improvement may be evidence that the treatment is working.
Heart Health Is Not Entirely An Individual Responsibility
There is something else we need to acknowledge.
We cannot spend decades telling people to make healthier choices while ignoring whether healthy choices are affordable, available or realistic.
Can people access primary healthcare?
Can they afford medication?
Can they get nutritious food at prices their household can manage?
Are there safe places to walk and exercise?
Do working hours leave any space for rest?
Are people exposed to tobacco smoke or air pollution they cannot personally control?
Can somebody take time away from work to attend a medical appointment without losing income?
The WHO specifically recognises that supportive health policies and environments are necessary to make healthier choices affordable and available.
Personal responsibility matters. So do the conditions in which people are being asked to exercise it. We need both conversations.
Your Heart Does Not Need Perfection
This is the part of heart health we forget.
You don't have to transform your entire life by Monday. You don't have to eat perfectly. You don't have to become a marathon runner. You don't have to achieve the ideal weight before anything you do counts.
Start with information. Check your blood pressure. Do the blood tests your healthcare provider recommends. Learn your family history. Take the medication you need. Move more than you do now. Look at the foods you eat most often. Stop smoking if you can, and seek help if you need it. Pay attention to symptoms. Go for the check-up you've been postponing.
Make one change. Then another.
Because heart health is not one heroic decision. It is often a collection of ordinary decisions made over years.
Your heart has worked through every ordinary Tuesday you forgot it existed. Through heartbreak and laughter. Through illness and recovery. Through sleep, work, worry, celebration and everything in between.
You don't have to become afraid of your heart to start taking care of it. But every now and then, it deserves to be remembered.
Whisper To Your Heart
You have carried so much without thinking about the heart that has carried you through it all. You do not have to care for it perfectly. You only have to begin paying attention. Learn what you need to know. Make the changes you realistically can. Accept help when you need it. And remember that prevention is not about living in fear of what might happen. It is about giving yourself the best chance to keep living the life that is already happening. — Nadia Renata | Audacious Evolution
Affirmation
I choose to care for my heart with attention rather than fear. I can learn, make realistic changes, seek support and take small steps today that protect the life I want to keep living. — Nadia Renata | Audacious Evolution
If you’d like to sit with this a little longer, you can find more affirmations like this in my YouTube playlist; a quiet space to return to whenever you need grounding
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