More people are living with the risk of having a stroke or heart attack than they might realize; it is estimated that about 50 percent of adults over 60 are at risk of developing a serious cardiovascular condition. Cardiovascular or heart disease is the number one cause of death for individuals 65+.
My late husband, Claude, had several health issues that increased his risk of cardiovascular disease, including type 2 diabetes, cholesterol issues, peripheral artery disease, high blood pressure, periodic episodes of angina, and a tendency to gain weight around his middle. He also had sleep apnea, chronic allergy problems, and rheumatoid arthritis (RA). When I first met him in early 1997, he had these same health issues (except for RA), plus a lot of health-compromising stress. Nonetheless, he had a zest for life and did whatever he could to stay as healthy as possible. He made lifestyle adjustments that reduced his stress levels, tried to maintain a healthy diet, improved his sleep quality, and tried to stay active. He also took as many as 13 prescription medicines daily to manage his health risks.
Conflicting Medical Advice
During the last few years of his life, Claude was referred to five different specialists. Sometimes one doctor would change his prescriptions, and other doctors would prescribe them again. It was like everyone had a piece of the puzzle, but no one could show us the picture on the box or describe it. Without seeing “the big picture,” we didn’t always know what to ask or how to advocate for the best care.
The Picture on the Box: Metabolic Syndrome
Although we had never heard the term “metabolic syndrome,” my late husband did have health problems consistent with its description. A report from John Hopkins Medicine describes metabolic syndrome as a “cluster of risk factors specific for cardiovascular disease.” In a risk factor study, metabolic syndrome “was associated with 2.6 times greater cardiovascular disease mortality and two times greater all-cause mortality.”
As reported in Health Digest, “Insulin resistance is a hallmark of metabolic syndrome, playing a causal role in the development of each of the five major risk factors.” Genetics may influence insulin resistance. One report published by the National Library of Medicine stated that “heritability estimates for each metabolic syndrome trait exceed 50 percent.”
Metabolic syndrome is diagnosed “when someone has three or more of these risk factors: high blood glucose, low levels of HDL, high triglyceride levels, a large waist circumference or ‘apple-shaped’ body, and high blood pressure.” Any of these issues could be “a risk factor for cardiovascular disease,” but three or more increases the chance of developing a serious cardiovascular condition.”
Although we didn’t realize it, Claude was at a high risk of developing a serious cardiovascular condition. He did have two strokes, and then he had two heart attacks. The second heart attack was fatal.
Other Possible Contributing Factors
Stress and stress-reactive personalities, a Western diet, a sedentary lifestyle, and other issues related to chronic inflammation may contribute to metabolic or cardiovascular diseases.
Stress: Some researchers have reported that “persistent exposure to psychosocial stress is linked to an increased risk of metabolic disease.” In one study reported in Obesity Reviews, results suggested that “adults in high-stress groups had a 45% higher chance of having metabolic syndrome than adults in the low-stress groups.”
Personality: Some research in the past 20 years has suggested that personality type might be linked to greater cardiovascular disease risk. “The classic Type A personality — competitive, impatient, uptight — is a heart attack waiting to happen.”
Diet: Eating a diet that includes a lot of fried food, processed meats (like bacon and packaged lunch meat), red meat, and sweets can increase the risk of heart disease and type 2 diabetes. A Harvard Gazette report indicated that processed meat increased the risk of heart disease by 42% and diabetes by 19%.
When my husband was younger, he ate a lot of foods that could put him at high risk of heart disease. To the degree he would tolerate it, he later shifted to a heart-healthy diet – more fruits, vegetables, nuts, some whole grains, fish, healthy oils (like olive oil), and less red meat.
Artificial Sweeteners: Scientific Diet reports “a possible link between higher intake of artificial sweeteners and increased heart disease risk, including heart attack and stroke.”
Sedentary Lifestyle: Several studies have found a relationship between sedentary lifestyles and metabolic diseases. As one study concluded: “People who spend higher amounts of time in sedentary behaviors have greater odds of having metabolic syndrome.”
Sleep Apnea: According to The Sleep Foundation, “Sleep apnea increases the risk of heart failure by 140% and coronary heart disease by 30%.” In 2014, The American Academy of Sleep Science estimated that over 25% of adults between the ages of 30 and 70 had sleep apnea. The Mayo Clinic suggests sleep apnea may contribute to insulin resistance.
Medications: Some medications can increase glucose levels. For example, according to the Mayo Clinic, Sudafed (which my husband took each spring for his allergies) can increase glucose levels.
Age: Particularly for older adults who have already developed Type 2 diabetes, glucose control may become more complicated with age.
Chronic Inflammatory Conditions: Rheumatoid arthritis is a chronic inflammatory condition and tends to run in families. My husband developed RA 3 ½ years before he passed. A meta-analysis found that 32% of RA patients also had metabolic syndrome. This finding could “double the risk of cardiovascular outcomes in this population.”
The Perfect Storm: Dangerous Prescription Side-Effects
Blood thinners with aspirin: About 15 years before he had two heart attacks, Claude had two strokes and was hospitalized. He was then prescribed blood thinners and aspirin together. Current medical reports suggest this combination can be fatal—especially for older adults because of the high risk of profuse bleeding.
High Blood Pressure Medicine: A recent study found that calcium-channel blocker blood pressure medicine like the kind my husband had been taking for several years “may be linked with a higher risk of a type of bowel condition called diverticulosis.”
Hydroxychloroquine: Prescribed for rheumatoid arthritis, this medicine can cause unusual bleeding, ringing in the ears, and hearing problems. My husband had all these problems when he started taking this medicine in 2019.
Serious Health Issues & Rural Healthcare
My late husband loved living in a rural area, and I believe it helped greatly with his stress levels. He also had a caring primary physician who did everything he could to provide good care for him. Nonetheless, we discovered that the availability of specialists, sufficient staffing at our local hospital, and other resources were limited.
Rheumatoid Arthritis: After developing RA in 2019, Claude began developing mobility issues and could not maintain his normal activity levels. He also started having difficulty going up and down stairs, risking falls. His doctor referred him to a good rheumatologist 60 miles away.
COVID: In 2020, Claude was diagnosed with pneumonia during an early COVID outbreak. Later, one of his rural doctors (who hadn’t been wearing a mask when seeing patients) tested positive for COVID and told Claude he had probably given him the virus.
Diverticulosis and Severe Bleeding: In 2021, Claude developed diverticulosis and nearly bled to death. He was transported from our rural hospital to one 150 miles away for treatment. By the time he reached the other hospital, he had lost so much blood that his body was in shock. Doctors at the receiving hospital didn’t think he would survive. His heart took a big hit, and his blood sugar spiked. (Heart attacks or high levels of stress to the heart can reportedly cause blood glucose to spike.) While in the hospital, he received insulin shots until his blood sugar stabilized.
A hospital doctor took him off the blood thinners and aspirins. He somewhat recovered but never got his energy back and could not return to some of his normal activities. He became much more sedentary. He also needed a lot more care – especially during the first few months after his health crisis. Later, another specialist (also one 60 miles away from our home) put my husband back on aspirin.
Two Heart Attacks: In May 2022, Claude had a massive heart attack on a Sunday, was sent home from the hospital on Tuesday, and died at home after a second heart attack on Thursday. My husband was a courageous, loving person who fought the good fight. I will miss him dearly for the rest of my life, as will his family and others who knew and loved him.
What I Now Believe
I now believe we must be more than advocates for our health care. When dealing with serious health issues, we’ve got to be knowledgeable enough to get the answers or help we need. Also, if our loved ones or we have a serious health issue, the availability of appropriate healthcare is essential.
Note: I have no medical background. What I have shared is based on personal experiences, and I am not offering advice. Seek appropriate medical advice if you have questions.