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I get what you're saying but on the flipside, heart disease is primarily not age-related. Something like 80%-90% of cases are preventable through lifestyle choices. And it's the number one cause of death.

Cancer at #2 is more age-related. But that too is fairly preventable. Roughly 50% of cancers are thought to be related to poor lifestyle choices.

Point being - these are major causes of early death.



1. Death isn’t preventable. We will all die, so if you prevent one cause of death in old age, you will just die of another cause of death. Sure it might extend your life a little bit, but I feel it’s entirely rational to seek out information on causes of immediate death as more relevant than causes of long term death. The probability of living much older than 100 is virtually nil. Probably good to have information on both though.

2. It’s possible they are major causes of early death, but I can’t figure that out from the article and it would be nice if the article provided that information.


Although we should remember that “old age” is long. Someone can die at 72 from heart disease and people might just call that dying of old age when that person could have easily lived another decade or two if they made different lifestyle choices. That would be more of an “early death” than a centenarian dying in a car accident. The suddenness is irrelevant.


> We will all die, so if you prevent one cause of death in old age, you will just die of another cause of death.

I can tell you're quite young :-)

Old age is pretty broad, and you really need to start worrying at some point in your 40s. Although death due to these is rare at that age, you'll likely end up knowing 1-3 people who will die of these at that age. And a lot more in the 50s.

There's a huge difference between dying in your 60s (perhaps right before retirement), and dying in your 80s. Lumping all of these people into "old age" is likely a byproduct of the same biases that cause journalism to not report on it.


Would you rather die by heart attack, cancer, or misadventure?

Chances are, one of the three is going to happen. The longer you live, the more the first two are likely.

Death by misadventure is possible at any point however!


Fatal heart disease is in fact primarily age related.


If a person dies from being a daily smoker for 30 years - is that primarily an age-related cause of death? Or does it just take a long time for the damage you've done to finally catch up?

A habit (or habits) that slowly damages your body and significantly shortens your life span is quite different from the natural march of aging that eventually gets us all.

Heart disease is the same as smoking in 80% of cases. The other ~20% are primarily genetic and much harder to avoid.

https://www.nhlbi.nih.gov/news/2023/numbers-know-healthy-hea...


Age and health feed into a ton of the top killers.

Diet and exercise reduces the risks of a lot of health related deaths.

It really is simple math for most people. Reduce your calories, limit your salt, and eat more vegetables.


Stipulate that, and fatal heart disease is still in fact primarily age related.


Right. But what age it happens at can (often) be shifted.

Same for stroke, kidney disease, diabetes, cancer. Those all usually hit older ages and have an age-related component, the risk of them at any age group is reduced by diet and exercise. Those two things can be true.

Of course there are outliers in each.


The claim was "heart disease is not primarily age related". This is a thread about causes of death. If we interpret that claim as "fatal heart disease is not primarily age related", it's straightforwardly false.


Though age also indexes the area under the curve of lifetime exposure to the risks, so it becomes a trivial claim to say that it's age related since it's one of the two axes.

If you have a heart attack at age 50 but with lifestyle intervention (or PCSK9 loss-of-function genetics) you instead would have had it at age 90, then "primarily age-related" is an insufficient claim in this thread.


And I did not dispute your claim, I added to it.

Age is the primary factor and health is generally the secondary factor. Both contribute.


> limit your salt

There's some dissention as to whether this actually helps lengthen life for most people (the salt myth). You shouldn't ignore your doctor, but neither should you blindly accept poor science.


> There's some dissention

Yeah, that always happens. There's people that think you should only eat fruit or that coffee enemas are the way to perfect health.

But the fact remains that there are multiple studies with strong links of higher sodium intake to heart attacks. Further, globally pretty much all major medical organizations (especially in countries with well functioning health systems) agrees on limiting salt intake.

There will always be a few studies that show that "actually you should eat 20g of salt a day!" and to me, that is the bad science.

The medical consensus by both studies and the experts is that you should limit salt. Telling someone "but those studies were all bad" doesn't convince me that the counter studies are good, but instead convinces me that the counter studies were likely flawed. If there were more studies that reinforced the bad studies, that might be something to talk about. But as it stands, we have just a noisy minority (suspiciously selling books...) that is making a claim without the significant studies to back their media tours.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9174123/


Yeah...

Unfortunately the link you chose is crappy. It is a qualitative study debunking the claim "some researchers have propagated a myth that lower sodium might increase the risk of CVD, This article analyzes the eight articles as a case study" (paraphrased). Too little salt is not the issue, why would that paper be useful?

The clear advice is to lower salt intake, but from what I can tell statistical data doesn't show that doing that actually lengthens life. Admittedly, cause and effect is difficult science, even in well funded large population studies. Correlations and case studies are much easier science.

Personally I don't have a horse in the race because I have a relatively low salt intake: I don't like the taste of over-salting and I also try to avoid high-salt foods because they are often crappy industrial foods (correlation).

I did google for papers before making my original comment, but I struggled to find any papers I liked. I remember that one paper in particular was a meta-study: I really really hate those.

Edit: I asked Gemini, and it referenced this paper: https://www.jacc.org/doi/10.1016/j.jacc.2016.07.745 which seems fairly balanced: the first sentence is a soft "The relationship between lower sodium intake and total mortality remains controversial". I did a couple more follow-on prompts and Gemini referenced results from Britain lowering salt in processed foods "A 36\% decrease in mortality rates from stroke and ischemic heart disease (heart attacks) during the period of the salt reduction program.". https://g.co/gemini/share/42637d5a2dfb I feel embarrassed rereading my prompts since they show my ignorance and other problems, but the eventual AI results are interesting. Asking the right questions is hard...


> heart disease is primarily not age-related

Uh... it absolutely is? Not sure what you're trying to say here. All progressive diseases, including heart disease (cancer too) are going to be "age related" simply because they take time to develop.

And plaque-related heart disease, the big killer, takes a long time to develop. The statistics are really clear here. People under 30 simply don't die of congestive heart failure absent one of a handful of very rare disorders. It starts to show up in middle age and really takes off after 70.

They are preventable, sure. They are "early" deaths in that the sufferer would die before something else got them. But they absolutely skew toward the elderly. Heavily.


Not really - that's like saying that dying from smoking is primarily age-related, just because the damage you're doing takes time to accrue.

https://www.nhlbi.nih.gov/news/2023/numbers-know-healthy-hea...


Dying from smoking is age related! How many lung cancer deaths are there in 20-something chain smokers?

Honestly I think you're interpreting "age related" differently than the upthread discussion. The point is to renormalize a cause of death to something like "lost years of life". So if you have a preventable death (from smoking, say) that kills people with on average 10 years of life left, that should be less notable than one (maybe homicide) that kills people with 60 years to go on average.


I looked up the definition of age-related and it's true that I'm misusing that term.

My original comment was in reference to the OP's comment:

> I’m not really interested in how I’m going to die of old age, but what I have to worry about today to avoid an early death.

My point was just that heart disease is primarily not caused by natural aging (the 80% of cases).


> heart disease is primarily not age-related

not true. it is age related

dying at 85 from heart disease isn't the result of lifestyle choices, but dying at 50 from heart disease most likely is


I wonder what has a bigger impact on longevity, lifestyle choices or being a multi-millionaire with access to the best healthcare.


Just doing a quick check on this, lifestyle choices slightly edges out net worth.

Living what is called a "low-risk" lifestyle (don't drink, don't smoke, maintain healthy weight, avoid junk food) results in an average life expectancy of 90 (93 for women, 87 for men), compared to being in the top 1% which results in a life expectancy of 87 (86 for men, 88 for women).

The overall average life expectancy in the U.S. is 78 (76 for men, 81 for women).

https://pmc.ncbi.nlm.nih.gov/articles/PMC4866586/

https://www.abom.org/wp-content/uploads/2020/10/Impact-of-He...


Lifestyle choices have a far larger impact on average. The big gains in lifespan (and healthspan) come from delaying the onset of chronic disease rather than treating it after it occurs.


Despite their wishes, most people won't become millionaires. The part you can control is your own lifestyle. For the average person, this means your lifestyle will have more impact on your longevity than wishful thinking about one day being a multi-millionaire who can hire doctors to fix the problems you created by being sedentary, eating poorly, and overindulging on alcohol or other substances.


Wonder which is more realistic, address the horribly unhealthy eating patterns that are drilled into US citizens as soon as they start eating school lunches (if not before), or make all of us multi-millionaires with access to the best healthcare.


If you're a news agency, promise your viewers that if they just get angry enough then that free healthcare will be coming soon and then show them an ad from McDonalds and Eli Lilly.


You should also weight those with how practically attainable they are.


Being a "multi-millionaire with access to the best healthcare" in the US means that you sit in the same queues as everyone else.

The best you can do is concierge care, but that only expedites primary care everything in the US is about specialists.


Hahaha, huh?

If you have access to the best healthcare you definitely don’t wait in the same queues. You have direct access to the specialists, often at the best teaching hospitals too.

If you have Medicare, good luck.


I don't know what you think "direct access to specialists" is.

I have concierge medicine. I have two specialist appointments scheduled both take about 3mo.

I can see my PCP within 1 day. That is good. I can have blood drawn within 1 day. That's good.

Specialists, no advantage. This makes it not overly valuable, but what do you expect for 8k extra for year (on top of very good health care)?

I don't know how to access a higher tier of health. Perhaps at 100M+ of net worth it appears. IDK.


Like Stanford pulmonologist in less than a week for an asthma eval.

Meanwhile, my Mom waited months on Medicare for a heart eval due to arrhythmias.

Whatever plan you have, it doesn’t sound top tier?

This didn’t require high net worth, just a better plan through an employer - or you’re in an area with low specialist populations? Or some sort of low priority on a triage schedule?

If you have mm net worth, the specialists come to you - quickly - unless you really need the .001% specialist. and chances are you they don’t and it’s not worth it.

But even Kaiser had no issues giving less than a week access for anything important.




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