Lifestyle

The Impact Of Lifestyle Choices on Cardiovascular Health

Smoking

Smoking is one of the most vital life choices to make to extend your time spent in good health. It is well known that it causes an array of negative health outcomes. The good news is that many of the negative effects can be reduced by quitting. Smoking cessation has been extensively studied and consistently shown positive outcomes and most importantly significantly reduces in mortality among cardiac patients. A meta-analysis of studies on patients recovery from heart attacks found that those who quit smoking had a 36% reduction in all-cause mortality compared to those who continued smoking and a study published in the Journal of the American Medical Association (JAMA) reported a reduced the risk of cardiovascular death by 50% within five years compared to those who continued smoking. This is as a result of reduced risk of a subsequent heart attacks by up to 30-40% and slows the progression of atherosclerosis and improves overall coronary artery health. This is in part due to reduced platelet (involved in blood clotting) activation and inflammation, both of which are critical factors in the development of heart attacks and strokes. Improvements in endothelial (lining of blood vessels) function and reduced thrombotic risk contribute to the long-term cardiovascular benefits of quitting smoking.

Those who quit smoking experience fewer symptoms of angina (chest pain from insufficient blood flow to the heart) and less severe episodes compared to those who continue smoking and this improvement in symptoms is often noted within weeks to months of cessation. Exercise tolerance and overall physical functioning is also improved.

The American Heart Association reports that smoking cessation can reduce stroke risk to that of a non-smoker within 5 to 15 years after quitting and over time, the cardiovascular risk of former smokers gradually approaches that of non-smokers. This was backed by The Framingham Heart Study showed that the risk of coronary heart disease (CHD) among former smokers decreased substantially within the first few years after quitting and continued to decrease with longer abstinence.

Other benefits to quitting – Did you know?

•Reduced anxiety and depression. Smoking cessation improves overall quality of life and reduces anxiety and depression
• Better adherence: Patients who quit smoking are more likely to adhere to other health-promoting behaviours, such as medication adherence, diet, and exercise
• Fewer Hospital Admissions: A study in the European Heart Journal showed that smoking cessation reduced hospital admissions for heart failure and other cardiac conditions, thus decreasing healthcare utilisation and associated costs.
• For those cardiac patients undergoing surgery (whether cardiac or otherwise) smoking cessation reduces the risk of postoperative complications such as infections, poor wound healing, and respiratory complications both in the short and long term.

Smog

Not exactly a lifestyle choice but its important to point out that environmental smog, particularly air pollution caused by fine particulate matter (PM2.5), has significant adverse effects on cardiovascular health. Chronic exposure to PM2.5 is associated with increased risks of hospitalization for conditions like ischemic heart disease, stroke, heart failure, and arrhythmias. A population-based study revealed that reducing PM2.5 levels to below WHO recommendations (<5 μg/m³) could lower cardiovascular hospitalizations by 15%. These adverse effects are caused by these particles triggering systemic inflammation, oxidative stress, and vascular dysfunction, contributing to cardiovascular disease progression.

Alcohol

Alcohol consumption following an acute myocardial infarction (AMI) has been widely studied, and its effects depend on the quantity and pattern of intake. Evidence is not straight forward but here is the current suggestions:
Light-to-Moderate Consumption Benefits: light-to-moderate intake (up to 1 drink per day for women and up to 2 drinks for men) may reduce all-cause and cardiovascular mortality post-AMI. The cardio-protective effect is thought to result from increased high-density lipoprotein (HDL) ‘good’ cholesterol, improved endothelial function, and reduced platelet stickiness.
Risks of Heavy Drinking: Chronic heavy consumption worsens cardiac dysfunction, increases the risk of arrhythmias, and can worsen long-term prognosis. Excessive drinking also raises blood pressure and promotes systemic inflammation, negating any protective effects seen with moderate drinking.

Fast Food

Fast food consumption has been strongly linked to an increased risk of cardiovascular diseases due to its association with poor dietary quality, high intake of unhealthy fats, and other metabolic effects. Fast foods are typically high in saturated fats, trans fats, sodium, and refined carbohydrates, which are associated with elevated blood pressure, dyslipidaemia, obesity, systemic inflammation and oxidative stress.
Fried Food and Major CVD Events: A meta-analysis showed that higher consumption of fried foods is associated with a 28% increased risk of major cardiovascular events and a 22% increased risk of coronary heart disease. This relationship appears to follow a linear dose-response pattern, meaning that greater fried food intake results in progressively higher risk.

Obesity and Metabolic Effects: Fast food consumption contributes to excessive caloric intake, leading to weight gain and central adiposity. These are strongly linked to insulin resistance, diabetes, and higher cardiovascular risk. Long-term intake also increases the likelihood of lipid imbalances (such as elevated LDL and reduced HDL cholesterol levels).

Shift Work

Please do not underestimate the detriments of night work on our bodies. Night shifts have been linked to a range of adverse effects on cardiac health due to disruptions in circadian rhythms, prolonged stress, and lifestyle factors such as poor sleep and unhealthy eating patterns.
Prolonged night shift work has been linked with an increased risk of coronary artery disease, hypertension, and atrial fibrillation. A meta-analysis highlighted that individuals with long-term night shift exposure had a 41% higher risk of ischemic heart disease and a 23% higher risk of other CVD-related issues compared to day workers!

Impact on Blood Pressure: Night shifts are associated with disrupted autonomic nervous system regulation (the automatic part of the nervous system that regulates blood pressure, breathing rate, bowel movement and heart rate), often leading to higher nighttime blood pressure. This nocturnal hypertension has been identified as a risk factor for left ventricular hypertrophy (where the heart muscle grows too large) and heart failure.

Chronic Inflammation and Metabolic Effects: Shift work can increase markers of systemic inflammation, like C-reactive protein, and disrupt lipid metabolism, exacerbating the risk of atherosclerosis and related conditions.

Circadian Misalignment: A misaligned sleep-wake cycle causes oxidative stress, impairs glucose tolerance, and negatively affects cardiovascular functions. These changes are compounded by inconsistent meal timing and insufficient recovery sleep.
Please read the section on sleep for more information.

Meditation

Meditation has shown promising evidence as a supportive therapy for cardiovascular health, particularly for patients with cardiovascular disease and those recovering from acute myocardial infarction mainly through stress modification. These findings will need further research to help promote meditation in cardiac rehabilitation but we are very much in favour of them because it is totally safe and helps to remind us to value our body and minds.

Meditation practices, such as mindfulness and compassion-based techniques, have been associated with significant reductions in stress, anxiety, and depression. A study on coronary artery disease patients found that meditation reduced depression by 44%, stress by 31%, and anxiety by 29%, while improving quality of life by 60% over four months compared to standard care alone. These improvements can enhance adherence to medical treatment and lifestyle changes crucial for cardiovascular recovery (e.g., post-AMI). Stress reduction via meditation may lower blood pressure, reduce inflammatory markers, and improve autonomic balance, all of which are beneficial for cardiovascular health.
Mindfulness meditation has been found to significantly improve emotional, physical, and social aspects of quality of life for heart attack survivors. In an eight-week program, patients practicing mindfulness reported sustained improvements in emotional function and reduced fear of physical activity, a common concern post-AMI. This suggests meditation could aid recovery by promoting healthier psychological coping mechanisms and reducing perceived vulnerability.
Meditation may counteract negative thought patterns, which often exacerbate the emotional toll of heart disease. By fostering present-moment awareness and positive mental focus, it helps patients feel more resilient and less at risk of recurrent cardiac events.

Cannabis

The impact of cannabis use following an acute myocardial infarction (AMI) depends on its frequency and method of consumption. Cannabis smoking, similar to tobacco, has been linked to an increased risk of recurrent MI and coronary events, which has attributed to elevated heart rate, blood pressure spikes, and pro-inflammatory effects, which can strain the cardiovascular system. The demonstrated risk increase is quite variable in research and not enough good quality data yet exists to give a better oversight but we would suggest avoiding smoking recreational cannabis (if using medical cannabis for other reasons a risk versus benefit discussion with your clinician would be appropriate).
Non-smoking methods, such as edibles or vaping, appear to carry less cardiovascular risk compared to combustion-related exposure. Ingested cannabis is associated with a lower cardiovascular impact likely due to the absence of toxins like carbon monoxide.

CBD Oil

Cannabidiol (CBD) has been gaining much more interest in recent years owing to its properties helping with anxiety, sleep and inflammation. Research into the potential cardiovascular benefits of CBD suggests several therapeutic effects, though clinical evidence remains in its early stages, particularly for specific heart conditions like myocardial infarction. CBD exhibits anti-inflammatory and antioxidant properties, which may help reduce oxidative stress, a critical factor in cardiovascular diseases such as atherosclerosis and coronary artery disease. It has been shown to inhibit the production of inflammatory mediators like IL-1β and TNF-α while promoting anti-inflammatory pathways (e.g., JAK/STAT signalling). These effects could mitigate vascular inflammation and protect against endothelial cell damage that contributes to CAD progression.

Experimental evidence indicates that CBD can promote dilation of blood vessels and reduce vascular tension by modulating certain receptors (CB1, TRPV1, and GPR55). Such vascular-relaxing effects could lower blood pressure, indirectly benefiting the heart by reducing strain on the cardiovascular system.
There may also be benefits for those with heart failure, with some data showing improved key markers, including brain natriuretic peptide (BNP) and metabolic measures such as the visceral-to-subcutaneous adipose tissue (VAT/SAT) ratio. These findings suggest that CBD might have a role in improving metabolism and cardiac remodelling.
Whilst the data is encouraging it is not sufficient to advise its use currently. CBD is generally considered safe and non-intoxicating so if you would like to use this as a nutritional supplement then there is no significant evidence to contradict its use.

We Care

As you can see there is no magic cure for better health: it is a commitment to both education and willpower. This engagement with lifestyle and its impact on our health is a relatively new discovery for many and it may mean breaking many life-time habits and embracing a new way of life. The good news is that these little changes we make add up to big changes and when balanced with good cardiac care and therapeutics we can aspire to living many more years in better health.