For a great deal of human history, the heart was thought to be the epicenter of emotion. The equation of the heart with feeling survives still in much of our everyday speech: we can make heartfelt speeches, our hearts can be made of gold or stone, we wear them unabashedly on our sleeves, and when searching for the essence of a situation we seek the heart of the matter.

Science has long since divested emotion from the heart and relocated it to the brain, but it’s easy to see why the heart-as–the-essence-of-life metaphors endure. The pulsing vitality of the heartbeat is subtly visible and audible under the right conditions. In times of great excitement, we see its presence in others through a flushed complexion and heaving shoulders, and we hear it loudly in our own bodies as an audible thumping in our ears. When we pass, the beating of our hearts fall silent and our pulses cease. Without advanced neurology, observation would lead us to believe the heart is the core of both human feeling and life.

The heart, as we understand it now, is more like the engine of a car. Navigational decisions in a car are directed by the steering wheel and pedals, making the driver’s seat (or in the near future, the CPU) the “brain” of a vehicle. The engine, by comparison is much more like the human heart: it draws vital fluids into itself and uses them to create force and motion in all of the adjoining components of the car — the engine is the very thing that animates the vehicle, even if it is a slave to the whims of the driver.

Much like a human heart, engines run better for longer if they are properly maintained, not overly taxed, and given the purest fluids to utilize. Unfortunately, routine heart maintenance eludes most Americans — almost 14 million adults in the US have heart disease. This mostly avoidable disease is the number one cause of mortality, and accounts for more deaths than the second through seventh leading causes combined. An epidemic of faulty engines on this scale would crush the automotive industry, but this very human problem with disastrous consequences is not only well documented, it is growing.

What’s that noise? — Heart disease basics
There are many conditions that fall under heart disease generally, but one type is more prevalent than most. Coronary artery disease is the narrowing of blood vessels over time by atherosclerosis. This simply means that plaque is slowly accumulating on the walls of blood vessels, making them less elastic and strong, and restricting or even blocking flow — a cardiac emergency we often call a heart attack. Plaque is composed of cell waste products, LDL cholesterol, fat, and other substances that form these hard deposits.
Road safety — How do I know if I am at risk?

Just like you can hear the thumping in the engine building before a major breakdown or feel a slight change in performance when your fuel injector is starting to gum up, there are various warning signs that you may be on the road to a cardiovascular crisis:

• Age: As we age, our arteries naturally harden and become less flexible. Heart muscle and the organ’s ability to move blood through your system also deteriorate with age.
   
• Alcohol: Immoderate alcohol usage can increase blood pressure and weaken blood vessels as well as increasing fats in the bloodstream. Overuse of alcohol can weaken your body and its systems in general.
   
• Diet: A diet high in fatty or high-cholesterol foods directly contributes to substances in the blood stream that form plaques. High sodium levels in the body also directly correlate to hypertension.
   
• Fitness: Inactivity weakens your body in general, but is especially bad for cardiovascular strength. Obesity from lack of fitness increases blood pressure. Type 2 diabetes increases many of the risks of cardiovascular disease.
   
• Genetics: If obesity runs in your family or a close relative has had heart disease, your risk is assessed much higher.
   
• Sex: Men are at a higher risk of heart disease in general. Women’s risk spikes after menopause.
   
• Smoking: Smoking increases blood pressure and contains carcinogens and other substances that damage your cells and cardiovascular tissues.
• Stress: High, prolonged levels of stress increase blood pressure and increase heart rate.

Owner’s manual — What can I do to reduce my risks?
Unfortunately, our bodies don’t come with owner’s manuals, and we often treat our cars more cautiously than we do our own bodies. The following advice from experts in the field can help keep you at peak performance and lower your risk of
heart disease:

• Premium fuel only: What you put into your body has a direct and significant impact on cardiovascular health. Low salt, low cholesterol, and low fat foods are key to preventing plaque build up. Diets high in fiber, plant protein, and rich in nutrients and minerals provide your body with pure, clean energy and the resources to build a resilient system.
   
• Regular maintenance: Don’t let your body collect dust like the Buick sitting idle in grandma’s garage. Having a regular fitness program that keeps you active helps maintain a healthy weight, builds muscle strength, and increases resilience. Aerobic exercise specifically strengthens the heart and blood vessels, so be sure to include regular exercises that get your heart rate elevated.
   
• Drive defensively: Limiting stress, or actively taking steps to reduce stress, can go a long way toward not just keeping your heart rate and blood pressure lower, but also make your life a bit happier in general. Quit smoking, or seek help in the form of a smoking cessation program. Limit alcohol consumption and drink responsibly, or stop drinking altogether.
   
• Consult a mechanic: See your physician to help you assess your risks of cardiovascular disease and work with them to create a prevention plan or a strategy to lower controllable risks.

The end of the road
Prevention is the strongest medicine; once you have heart disease, you always will. If you are at risk or want to avoid potentially being so, make a plan now and take steps to limit your chances of developing heart disease. If you already have heart disease, work with your physician and other medical professionals to develop a strategy to reverse some of the damage and control future risks to get your life back on track.

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