Stop Stressing About Microplastics And Check Your Blood Pressure

A heart attack can feel like lightning out of a clear sky, but the body usually leaves a long trail of clues. We’re talking about the slow, quiet build of cardiovascular disease and why so many people are shocked when something finally happens even though the risk factors have been stacking for years in blood pressure readings, cholesterol numbers, blood sugar trends, sleep quality, stress load, and daily movement.

We dig into two of the most important global studies in heart disease prevention and stroke prevention: Interheart and Interstroke. Across dozens of countries, cultures, and health systems, the same patterns keep showing up smoking, hypertension, high cholesterol, diabetes, poor diet, physical inactivity, abdominal obesity, and chronic stress. One detail that changes how you think about your own health is the role of visceral fat: belly fat can be a stronger predictor than BMI, meaning “looking thin” doesn’t always equal being metabolically healthy. And when it comes to stroke risk, we highlight the standout driver that too many people ignore: high blood pressure and the long-term damage it does to blood vessels in the brain.

We also tackle the risk perception gap, why we worry about small, trendy threats while skipping the basics that move risk the most. Then we walk through how risk calculators like the Framingham Risk Score can help you translate lab results into real-world stakes, and how projecting yourself 10 years into the future can turn a number into motivation.

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Transcript

Welcome Back And Season Theme

SPEAKER_00 0:10

Yo, plant based buddies, welcome back to season three of the podcast. This is gonna be amazing. We'll be talking about all of the different pillars of lifestyle medicine, from nutrition to exercise to stress to sleep and everything in between. Yo, plant based buddies, welcome back to the podcast.

Why Heart Disease Feels Sudden

SPEAKER_00 0:29

Today's episode is about something that impacts almost every family at some point in their life. Heart disease and stroke are the world's top leading killer. As doctors, we often see very strange things either at the ER or in the clinic or in the hospital. Imagine a patient comes into the ER after having a heart attack or stroke, and they're completely shocked that it happened. Meanwhile, the team or the family doctor who has been following that patient for over two decades could have predicted this years ago. To the patient, it feels sudden, but to the doctor, it's almost like the end result of years of small risk factors that are adding up in the background.

A Real Case Of Stable Angina

SPEAKER_00 1:26

Just a few months ago, I diagnosed a patient with angina. Now, they described a type of chest pain that started while they were walking, it improved when they rested and then came back every time they started moving again. That's a pretty classic pattern of stable angina, but I sent him to the cardiologist and further testing confirmed significant blockages in the arteries, in the coronary arteries that supply the heart. The patient kept saying, I never thought that this would happen to me. But when we look in the patient's chart, there's the signs they've been there like for years. Their blood pressure was borderline and their blood sugar had gone from normal to borderline high. Their cholesterol was just a little bit elevated, but it had been for like 20 years. And over the years they gained a little bit of weight, and it was mostly abdominal or visceral fat. And as patients age, they exercise less often. And so all of these lifestyle habits together add up, and patients start feeling more stress, and their sleep quality gets worse. Now, none of these small things seem dramatic on their own. Whether you're everyone will go through stress, everyone will have a bad night's sleep. But it's when all of these risk factors add up together. Nothing taken individually is that alarming, but taken together, everything adds up. And this is exactly how chronic disease actually develops. Develops slowly over weeks and months and years, and sometimes for decades, without really giving obvious symptoms.

Interheart Study And The Big Nine

SPEAKER_00 3:34

And that's the point of this whole episode is to talk about why two major studies, the inter-heart and the interstroke study, they change how we think about heart disease and stroke prevention around the world. Now, the things that I'm going to share today aren't going to be earth-shattering, they're not going to be revolutionary. But before these studies, most people actually believed that heart attacks and strokes were due to genetics or bad luck. So researchers really wanted to ask the question: what happens if we look at cardiovascular disease across the entire world and search for the common factors that connect the people who develop these conditions? And the results of these studies were quite impressive. The interheart study that was published in the Lancet in 2004, that study looked at more than 15,000 people who had experienced the first heart attack, and they compared them to nearly 15,000 people without heart disease acting as control groups. They looked at this data over 52 different countries. A very wide population was represented. And even though participants came from all over the world, from different cultures, from different backgrounds, the same risk factors kept appearing over and over again. Smoking, high blood pressure, high cholesterol, diabetes, abdominal obesity or visceral fat, fat that is deposited inside of your organs or abdominal cavity. The other factors were poor diet, lack of physical activity, and chronic stress. Now, taken together, these nine risk factors explained about 90% of heart attack risk worldwide. Now, I mean, that number is enormous, and it showed that heart disease doesn't happen randomly. And in most cases, it develops after years of repeated stressors that are placed on the body that that, like I said, taken individually, are not that alarming, but together creates inflammation, increases aging at a cellular level.

Visceral Fat Beats BMI

SPEAKER_00 6:21

Now, one of the most interesting findings with that was that belly fat turned out to be a stronger predictor of cardiovascular risk than BMI, body mass index. And that revealed a lot of the weaknesses that BMI has, because BMI doesn't tell the whole story. Someone can appear thin and have a normal BMI, but they're still carrying dangerous amounts of visceral fat around their organs. And sometimes another person with even a higher BMI can still have more muscle and actually have healthier metabolic markers, but according to BMI, they look worse. Now the body responds less to appearance and more to what is really happening internally over time. So you can look thin but still be metabolically unhealthy. Now honestly, I think people still still underestimate these risk factors and the potency they have to be causally linked with cardiovascular disease.

Stress As A Major Risk Factor

SPEAKER_00 7:44

Now one of the risk factors they found was stress. And now for years, stress was often treated as something like a secondary issue compared to things like cholesterol or smoking. But Interheart showed that chronic stress, depression, financial strain, and even social isolation were major contributors to heart disease around the world, even as much as the typical heart disease risk factors like cholesterol and high blood pressure that everyone knows. Now, stress impacts almost every single system of your body. It changes your hormones, it can increase inflammation, it can increase blood pressure, it can fragment sleep, impact your eating habits and your insulin resistance. Now, mental health and physical health are deeply connected. Now, a few years later, researchers did this same type of study in another large international study that they called interstroke.

Interstroke And Blood Pressure Damage

SPEAKER_00 8:50

Now, that study looked at over 13,000 people who experienced their first stroke, and it compared them to over 13,000 controls across 32 countries. Now, once again, the results were very similar. It's a very small number of lifestyle or metabolic risk factors that explain over 90% of stroke risk worldwide. But for strokes specifically, one factor stood out above all of the others. High blood pressure. The blood vessels in your brain are especially sensitive to long-term pressure damage. And that's why uncontrolled hypertension is still one of the biggest causes of stroke globally. Now, most people know their interest rates on their mortgage or on their credit cards or the price of gas, but most people still do not have any idea what their blood pressure number is. Now, in a perfect world, you'd probably keep your blood pressure more on the low side, not low enough, so that you become dizzy, but definitely as close to 120 over 80 or lower. And that just goes to show how something is as taken for granted as blood pressure can have a major impact on one of our leading killers, and yet people still step over dollars to pick up pennies. I say that all the time. This is a perfect example. If you're worrying right now about microplastics in your food, but you're not worrying about the fact that your blood pressure is borderline, then for me that makes no logical sense. And I agree that we should be minimizing the amount of microplastics that we ingest in our body. But relatively speaking, blood pressure is many folds more important than worrying about microplastics. Now, I don't want to make light of the situation. Humans are really bad at estimating risk, and that's called the risk perception gap. And I've talked about it online and on my podcast, but I think that awareness is key because when someone kind of recognizes, realizes that a behavior can lower a certain risk factor or sometimes disease or even all cause mortality by a certain percentage point. If that percentage point is 50% and you're worrying about a behavior that would give you a 1%, that's just you want to make sure, that's where we want to make sure that we're focusing on our energy where it has the best bank for your buck. Now, let's go back to the interstroke study. The interstroke study, same same concept as the inter-heart study. They looked at people who had strokes and tried to figure out what the common factors were. And there were smoking, physical inactivity,

The Risk Perception Gap

SPEAKER_00 12:35

poor diet, abdominal obesity, stress, diabetes, excess alcohol intake, and of course, the major driver of strokes, high blood pressure. But these studies they keep reinforcing a very important idea is that chronic disease is not just caused by one single event. It's more like the result of years of small repeated habits and exposures that slowly push biology to its limits, or even sometimes in the wrong direction. And what made these studies especially important was that they included people from all around the world, not just wealthier Western countries. And even despite differences in culture, income, language, or healthcare systems, the results stayed the same. Human biology works the same way almost everywhere on this planet. Blood vessels, they respond to smoking in the same way whether you're in Canada or in South America, and hypertension doesn't care about your feelings. Now, the interheart and the interstroke study, they give us valuable information and they help guide public policy and prevention and even what type of modern pharmaceuticals that we needed to create. Now, the interheart and the interstroke study, they really gave us valuable information. And that's why a lot of other researchers have looked at this same type of question. In 2023, a large study was published in the New England Journal of Medicine, and it estimated that five risk factors probably account for closer to about 50 to 60 percent of cardiovascular risk. But even that number is insane. Now, imagine that you discover that 50% of airplane crashes were preventable. Now, society would react immediately, but because heart disease develops over decades, people simply accept it as being part of aging, or it's runs in my family. Now, that is a big problem of chronic disease. The body sends us signals yearly during your annual blood test, where we also measure your weight, your body composition, your pulse, your breathing, your we can listen to your lungs and listen to your heart, look at your metabolic risk factors, and we can predict with a high level of precision the risk of you having a heart attack or a stroke. Now there's

Framingham Risk Score Explained

SPEAKER_00 15:26

something called the Framingham Risk Calculator. You can go online and download it or just type Framingham Risk Score in Google, and it'll ask you your cholesterol, your blood pressure, your age, your family history. There are better scores out there than the Framingham Risk that are used in Europe and in the States, but in Canada, that's still the recommendation, maybe a little outdated, but still is that recommendation that we use. So you can calculate your own Framingham risk score. Let's say you score 25%. Well, that means that you have a 25% risk of having a stroke or heart attack, a cardiovascular event within the next decade. Doesn't really mean that. It means that if we looked at a cohort, a population that has similar scores as you, 25% of them had a cardiovascular event. So it's a really helpful tool that helps us predict according to the risk factors that we already know. So let's say that you score 25% on your Framingham risk score. That means you have a one out of four chance of having a stroke and a heart a heart attack. Now, people are very poor at understanding what that means or projecting themselves into the future to see with the impact of a one out of four chance, which is immense, how it would impact their life. So, what I want you to do here is if ever you do go on Google and calculate your risk score, and it's 25% or higher or lower, just try to put that into context, into real practical, real life context. Project yourself in 10 years. I'm telling you that you have a one out of four chance of having a stroke or a heart attack. Now, project yourself in 10 years. Where do you see yourself in 10 years? Some people will say I see myself traveling the country, going on vacation, seeing my kids graduate, seeing my daughter get married. And now imagine that I

Make The Odds Feel Real

SPEAKER_00 17:52

told you that there's a 25% chance that a heart attack or a stroke might get in the way of you accomplishing these goals. And that's where the real power of something as simple as a Framingham risk calculator the information that it can guide is not just a number or a percentage. It's literal the odds of you not living the life that you've dreamed of. Now I always I always go back to this little trick with myself. When I, for example, when I trained for Ninja Warrior, I had the goal of qualifying for world championships. And although it was a really crazy feat at the time, my kids are young, we're in our early 40s, and it seemed like an impossible feat. But then I said to my wife, I said, project yourself in the future. Imagine when we're 60 and we're looking back at videos of us doing this crazy sport that led us to the world championships three consecutive years. Can you imagine when we're in our 60s watching this footage, seeing these photos? Can you imagine the pride? Well, some of that pride, I can feel it now, just even talking about that story. And I felt it then. That's what fueled most of my workouts. So I can tell you for 20 minutes that blood pressure, blood glucose, blood cholesterol, stress. I can name all of these risk factors, and still many people won't change. A lot of people hearing this today won't automatically go check their blood pressure. But hopefully, I most people understand it, it's really not about the blood pressure, and it's not about the cholesterol, it's about the life that you want to live, the future that you want to see, and whether or not you are having behaviors and habits that are either supporting and bringing you closer to that future, or pushing it away. Anyways, sorry about that tangent there. But moral of the story is you can have all the knowledge in the world and you can list off all of the nine risk factors in alphabetical order. But it's really finding your own internal motivators, your own personal why, the deep connection to why you care about your blood pressure. And that typically comes from something a lot bigger than you. And for some people it's so big they don't even see it. Now I regularly project myself in the future. And when I see frail or ill people that have that suffer from chronic disease related to behaviors that they've had over 30, 40 years, I just I don't want to be like that. I don't want to age like that. I don't want to become sick and it'd be my fault. Some people are unlucky and I'll I'll take bad luck like a champ, but I am for sure not gonna. Be responsible for not aging as gracefully as I can. Now these risk factors they can evolve for decades before they cause problems. So

Talk To Your Doctor And Wrap

SPEAKER_00 22:16

if you haven't done so already and you think it applies to you, consider having a conversation with your doctor. Tell them your family history. Ask for a blood test or checking your blood pressure. Talk to your doctor about your sleep or your stress levels. Right on. I hope this episode helped you understand that most of our top killers are related directly to behaviors and habits we have day in, day out. We do not and we do not question in society we have normalized a lot of very unhealthy behaviors. But there are some of you that are here listening to this podcast right now, looking for an answer, looking for a better way, and I hope that I can bring you closer to the future self you want to be. Cool. Right on. Thanks so much for listening to this ramble, and we'll see you next week.

unknown 23:18

Peace.

SPEAKER_00 23:24

Hey everyone, go check out my website, plantbased drjoules.com to find free downloadable resources. And remember that you can find me on Facebook and Instagram at Dr. JulesCormier and on YouTube at Plantbased Dr. Jewels.