As we celebrate the season of love and exchange tokens of affection this Valentine’s Day, we must focus on the very source of that love, one of the most vital organs in our bodies – our beating hearts. When the heart stops, we die almost instantly. At NEM, we recognize the significance of a healthy heart for healthy longevity medicine and assist our clients in preserving that. Here, we aim to spotlight this awareness and emphasize the importance of initiating efforts today for a healthier optimal heart in the future.

What is a healthy heart?

healthy heart is one free of cardiovascular disease (CVD). CVD is a medical term referring to different disorders of the heart and blood vessels, e.g., coronary artery disease, cerebrovascular disease, and peripheral artery disease, all of which are mainly related to the formation of atherosclerosis. This condition develops when a substance known as plaque builds up inside the walls of the arteries. The most common heart disease is coronary artery disease (CAD), which occurs when plaque accumulates in the arteries supplying the heart, leading to the blockage of blood flow to the heart, resulting in a myocardial infarction or a heart attack. CAD is sometimes called coronary heart disease or ischemic heart disease (IHD). 

An optimal heart, on the other hand, is more than just an absence of a disease. The term “ideal cardiovascular health” was introduced in 2010 by the American Heart Association and defined as the absence of clinically manifested CVD and optimal levels of 4 health behaviors (smoking, physical activity, healthy diet, and healthy body weight, a proxy for energy balance) and 3 CVD risk factors (blood glucose, total cholesterol, and blood pressure) (Figure 1) (1). This perspective aligns perfectly with our stance as NEM. Still, we go further by including advanced lipoprotein biomarkers and specialized imaging diagnostics for the early detection of CVD to ensure optimal heart health for our clients.

Figure 1Life’s Essential 8: healthy diet, participation in physical activity, healthy levels of blood lipids, glucose and blood pressure, healthy weight, avoidance of nicotine, and healthy sleep. Adopted from (1).

As we age, it is less likely that we have ideal cardiovascular health and more likely that we develop CVD. We cannot stop the time, but we can do things to decrease the risk of CVD and slow down the aging processes within our bodies. Life’s Essential 8 refers to the comprehensive components of cardiovascular health (2). The eight components include various factors crucial for assessing and optimizing cardiovascular health, and NEM recognizes these as the minimum recommendations for all to follow. They consist of:

  • Healthy diet 
  • Participation in physical activity 
  • Avoidance of nicotine 
  • Healthy sleep 
  • Healthy weight 
  • Healthy levels of blood lipids 
  • Healthy levels of blood glucose 
  • Healthy blood pressure

Why maintaining a healthy heart is essential?

A healthy heart efficiently pumps blood throughout the body and supplies oxygen and nutrients to all the cells and organs. When the heart is healthy, it can perform this function efficiently, leading to better physical performance and overall health. It also contributes to improved quality of life and longevity. Therefore, caring for your heart is one of the best investments you can make for your health.

A healthy heart reduces the risk of heart disease. If left untreated, heart disease can lead to severe complications such as heart attack and heart failure.  

Cardiovascular disease – statistics, trends, and regional perspectives 

CVD is, unfortunately, very common. 

The prevalence of CVD is substantial, with one-third of adults over the age of 25 suffering from these diseases globally (3). Furthermore, annually, over 17.5 million people worldwide succumb to CVD, accounting for 30% of the total annual deaths (3). 

CVD remains the most common cause of death globally (4)

According to the Center for Disease Control and Prevention in the USA (5):

  • Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups.
  • Every 33 seconds, someone dies from CVD.
  • Every 40 seconds, someone has a heart attack.
  • 1 in 5 heart attacks is silent—the damage is done, but the person is not aware of it.
  • About 695,000 people died from heart disease in 2021—that’s 1 in every five deaths.
  • In 2021, about 2 in 10 deaths from CAD happened in adults less than 65 years old.

In Europe, CVD remains the most common cause of death, killing almost 4 million people every year (4). Approximately 44 % of all CVD deaths are due to IHD, and 25 % are due to stroke, making these two conditions the most common form of CVD.  

In Sweden, the age-standardized death rate from IHD,  the largest contributor to cardiovascular mortality, declined markedly, from 750 to 174 per 100 000 between 1980 and 2014 in men and from 404 to 94 in women (6). This is still higher than in some Mediterranean countries, and in men <65 years of age, the last recorded estimates show that 1 in 8 deaths (12.4%) was caused by IHD (6). Although these numbers are promising, IHD is still the top cause of death for both males and females in Sweden, according to the latest WHO data  (7).  

(Age-standardized death rates provide a more equitable way to compare mortality across different populations, considering the influence of age on death rates. Without using this standardization, it would be unclear if differing mortality rates were due to age or other factors.)

The connection between plaque formation, atherosclerosis, and ischemia

Atherosclerosis is characterized by the accumulation of plaque in the inner walls of arteries (Figure 2). Plaque is a buildup of cholesterol, calcium, and other substances. In the context of atherosclerosis, plaque formation can lead to the narrowing and hardening of arteries.

Accumulation of cholesterol and other lipids on the inner walls of the blood vessels

Figure 2: The progression from a normal blood vessel to a blocked artery typically involves several stages starting with the accumulation of cholesterol and other lipids in the inner walls of the blood vessels. Adopted from (8).

Ischemia, on the other hand, refers to a reduced blood supply to a part of the body, often due to the obstruction of blood vessels. In atherosclerosis, plaque buildup can obstruct blood flow through arteries. As the plaque accumulates, it may eventually lead to significant narrowing of the arteries, reducing the amount of oxygen and nutrients that reach the tissues supplied by those arteries. If blood flow is severely restricted or completely blocked, it can result in tissue damage or death, depending on the affected area. For example, in the coronary arteries, ischemia due to atherosclerosis can lead to chest pain (angina) or a heart attack. In the cerebral arteries, it can lead to strokes.

The connection between high LDL cholesterol and Apolipoprotein B levels leading to plaque formation and atherosclerosis is well established. We do not want plaque in our arteries; the only way to prevent that is to keep our LDL-cholesterol and Apolipoprotein B in check. As cholesterol cannot be transported in the circulatory system on its own due to it not being water-soluble (cholesterol, being a lipid, is lipid-soluble), the body thus needs to make it water-soluble by attaching a protein around it, known as a lipoprotein (9). Simply put, lipoproteins create a lipid environment by surrounding the cholesterol, thus offering a lipid-soluble inside. At the same time, they remain water-soluble on the outside and can transport the cholesterol in the blood. An essential lipoprotein in a clinical context to be aware of is Apolipoprotein B, a key structural lipoprotein making up LDL cholesterol. Cholesterol-rich, Apolipoprotein B-containing lipoproteins are now widely accepted as the most important causal agents of atherosclerotic CVD, and you should know your value, which you do not get by a standard lipid panel (9). 

NEM recommends checking your Apolipoprotein B value.

Ask your doctor about it.

Key point

High LDL cholesterol and Apolipoprotein B levels are causing the development of atherosclerosis (10). That is a well-known fact with overwhelming evidence. Lowering LDL cholesterol and Apolipoprotein B would reduce the risk of myocardial infarction (10).

Heart attack comes suddenly, and some people die instantly from it. There is this common and very misleading perception that someone who dies from a heart attack was “fine” and “healthy,” and all of a sudden, their heart stopped, and they died. NO! They had atherosclerotic coronary artery disease long before that, with ongoing pathology in their vessels, but no medical action was taken.

Plaque formation starts early in life, even in our 30s. You can have a healthy lifestyle and still have early atherosclerosis. Elevated Apolipoprotein B and LDL cholesterol are asymptomatic until it’s too late.  

Do you know your cholesterol and lipoprotein levels?

According to the 1177 website, you can have your lipids checked if you already have CVD, type 2 diabetes, kidney disease, high blood pressure, are smoking, or are overweight or obese  (11). This seems very reactive as you already need to have CVD or other health problems to get your lipids checked in the first place. 

Additionally, in the reactive, aka “regular” healthcare setting, you will get your LDL cholesterol and Apolipoprotein B results based on local laboratory reference values that are not optimal to advise when proper medical treatment should start to lower your biomarkers. 

You need to measure your values and monitor trends – this is more important than having values within a reference range. 

How to be proactive with your heart health? 

Suppose you’re interested in taking a proactive approach to monitor your heart health and don’t want to wait to be categorized into specific risk groups. In that case, private laboratories offer lipid and lipoprotein measurements for a fee. Typically, you would need to visit your doctor, who will then request blood work. Once you’ve submitted your sample and received the results, you’ll receive a report and advice from a doctor. However, it’s important to note that these physicians often operate from a reactionary mindset. If your LDL is close to the borderline but not above it, they might consider your cholesterol “normal” with no cause for concern. In some cases, they may advise you to focus on exercise and a vegetable-rich diet if you’re approaching borderline high levels.

We at NEM think that more is needed, and more needs to be done. 

Our offering

The heart’s vital role in overall well-being and longevity underscores the importance of working toward and maintaining optimal heart health. As a member at NEM, you work with your healthy longevity physician to ensure your health data is optimal, not just “normal”. Our licensed physicians meticulously analyze the data based on a comprehensive health questionnaire, blood testing for various biomarkers, DNA analysis, and a biological age assessment. In addition to the areas described in this article, we go a step further in the screening and prevention of CVD. We refer our clients for advanced diagnostic tests to gain a more comprehensive understanding of their cardiovascular risk and detect the presence of atherosclerosis.

If these advanced diagnostics show signs of plaques, then your LDL cholesterol and Apolipoprotein B levels should be lowered sufficiently to prevent further worsening. When lifestyle interventions are insufficient to achieve this goal, our physicians will prescribe the appropriate medications to help reduce them to the desired levels. For each client, we identify areas for improvement and prescribe specific interventions through a personalized action plan.


Silviya Demerzhan, Ph.D.

Chief Scientific Officer, Nordic Executive Medicine
Medical review by: Dr. Mahir Vazda MD

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  3. Lu Z, Jiang H. Healthy heart, happy life. Indian J Med Res. 2014 Sep;140(3):330–2. 
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  10. Soppert J, Lehrke M, Marx N, Jankowski J, Noels H. Lipoproteins and lipids in cardiovascular disease: from mechanistic insights to therapeutic targeting. Adv Drug Deliv Rev. 2020;159:4–33. 
  11. 1177 [Internet]. [cited 2024 Jan 30]. Höga halter av blodfetter. Available from:–besvar/hjarta-och-blodkarl/blodkarl/hoga-blodfetter/