accompany ageing, like heart disease. By the 1950s, as people started living through infections and making it to their seventies in record numbers, cardiovascular diseases became the number one killer in the country for men and women. It is still the number one killer today, partially because the technological advances that increased life expectancy also led to modern conveniences that can undermine it: innovations like processed foods and devices that enable us to live sedentary lifestyles.
HOW WE GOT HEART SMART
Until the middle of the twentieth century, the causes of heart disease were an utter mystery to the medical community. Most theories were based on speculation; there was not enough meaningful data to provide any real insight into how to prevent the disease that was killing so many people in Western societies. Then in 1948, in the United States, the National Heart Institute (a part of the NIH) launched a study that is still recognized as one of the most important medical accomplishments of the era: the Framingham Heart Study. More than five thousand men and women between the ages of thirty and sixty-two from the town of Framingham, Massachusetts were selected to participate in the longitudinal study, which assessed the health of these individuals every two years over the course of several decades. (The study is still running; in 1971, another group of more than five thousand participants enrolled, the children of the original group; in 2002, the grandchildren of the original group signed up.) Through tracking such a large sample of participants over time, researchers learned that the common denominators of heart disease included high blood pressure, smoking, and high cholesterol levels. A model for later longitudinal studies, the Framingham study gave doctors a way to identify possible heart disease candidates and to develop preventative measures. It was also the first major study that included women, an important qualification that we will discuss in more detail later.
At the time that the Framingham study began, treatments for age-related diseases were mainly aimed at easing the symptoms and making the patient comfortable, not actually curing the disease. But in the 1950s, doctors gained new ground in surgery. Insights gleaned from surgeons in World War II allowed surgical procedures to become more specialized. Doctors better understood and had better access to diagnostic tools, anaesthesia, and blood transfusions. And the widespread availability of antibiotics made high-risk surgeries safer. Surgeons were more confident than ever, and their first order of business was the heart.
By the 1960s, heart transplant surgery was on its way. In the middle of the decade, a chimpanzee’s heart was put into a man. In the late 1960s, the first human heart was transplanted. Revolutionary techniques like these, along with the rise of coronary care units, the treatment of high blood pressure, and the improved medical response to coronary disease, were part of the West’s response to the threat that cardiovascular disease represented.
Between 1950 and the end of the twentieth century, although cardiovascular disease was still the number one killer of men and women, the number of such deaths dropped by half. At the same time, the study of cellular biology became more sophisticated. Better diagnostics and therapies stemmed from discoveries in biochemistry and physiology, such as the ultrasound and the CAT scan. Each development offered doctors and scientists the opportunity to utilize more sophisticated information about the human body. And as a result, in the West, human life expectancy got longer.
For human beings today, life may be getting longer still. We are starting to develop a much deeper understanding of the causes of many age-related diseases, how to treat their symptoms, and how to prevent some of these illnesses in the first place. Tests now exist that can screen for and accurately diagnose cancer and other chronic conditions before they progress to a fatal stage. Numerous medications are widely available to manage hypertension. And, just as we all now take it for granted that washing our hands is essential to limiting the spread of germs, there aren’t many people alive today who aren’t aware of the fact that smoking is bad for you.
It wasn’t an accident or a random mutation of our genes that bought us these extra years of holidays, vacations, birthdays, and anniversaries. These bonus years are the result of developing a better understanding of the world we live in and the dangers that are present. They are the result of the efforts of countless individuals striving at universities, hospitals, and other learning centres, all asking “why” every day. The knowledge we have gained over the past 150 years has allowed us to casually refer to our forties as “midlife” – and to be 100 per cent correct.
PLEASE TRY THIS AT HOME
Many doctors say that compliance is the hardest part of keeping people healthy – they can tell us to treat our bodies better or prescribe medications, but they can’t make us adhere to their advice.
Over the past several decades, public health officials have been working to raise awareness that habits like smoking, not getting enough exercise, and eating junk foods are unhealthy. Despite their efforts, nearly 20 per cent of American and UK adults still smoke. Nearly 70 per cent of adults are obese or overweight. Less than 40 per cent eat the recommended five servings of fruit or vegetables every day. These are all indicators that more people still need to hear, understand, and implement the message about making healthy choices.
The reality is that for a large percentage of Westerners, choices are limited. Cost, access to healthy foods, and education are real issues that perpetuate the obesity crisis. Many families subsist on fast food or processed foods, both of which are high in unhealthy fats and salt as well as loaded with hidden sugars and preservatives. One of our greatest challenges as a society and as individuals is turning education into action, and helping individuals remove the obstacles that make unhealthy choices cheaper and more accessible than healthy choices.
The bottom line is that our lifestyles affect our risk factors for disease. If our life expectancy numbers don’t continue to climb, and the next generation’s life expectancy is lower than that of their parents, it is going to be the result of what they have learned at home.
THE COSTS OF THE SILVER TSUNAMI
The ability to live longer, to spend more years on this planet and more time with our families and loved ones, is an amazing opportunity. But just as with any opportunity we seize, there are also consequences.
For the first time in history, there are now more people over the age of sixty-five than under the age of five living on this planet. Researchers call this phenomenon the silver tsunami.
The silver tsunami makes ageing a pertinent topic for every person, no matter when his or her birthday is. For most of human history, as we now know, people didn’t live to be very old, so young children tipped the scale of the population – there were always more kids around than old people. But all that is about to change, and it is imperative that we consider what the impact will be on a social and economic level so that we can figure out how best to navigate the coming tide.
The
