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Heart Disease Risk Factors
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Know Your Risks
Know your heart disease risk factors.

Learn to be heart-smart!


Cardiovascular disease can take many forms: high blood pressure, coronary artery disease, valvular heart disease, stroke, or rheumatic fever/rheumatic heart disease. According to the World Health Organization, cardiovascular disease causes more than 17 million deaths in the world each year. Cardiovascular disease is responsible for half of all deaths in the United States and other developed countries, and it is a main cause of death in many developing countries as well. Overall, it is the leading cause of death in adults.

In the United States, more than 80 million Americans have some form of cardiovascular disease. About 2,200 people die every day of cardiovascular disease. Cancer, the second largest killer, accounts for a little more than half as many deaths.

Coronary artery disease, the most common form of cardiovascular disease, is the leading cause of death in America today. But thanks to many studies involving thousands of patients, researchers have found certain factors that play an important role in a person's chances of developing heart disease. These are called risk factors.

Risk factors are divided into two categories: major and contributing. Major risk factors are those that have been proven to increase your risk of heart disease. Contributing risk factors are those that doctors think can lead to an increased risk of heart disease, but their exact role has not been defined.

The more risk factors you have, the more likely you are to develop heart disease. Some risk factors can be changed, treated, or modified, and some cannot. But by controlling as many risk factors as possible through lifestyle changes, medicines, or both, you can reduce your risk of heart disease.

Major Risk Factors

High Blood Pressure (Hypertension). High blood pressure increases your risk of heart disease, heart attack, and stroke. Although other risk factors can lead to high blood pressure, you can have it without having other risk factors. If you are obese, smoke, or have high blood cholesterol levels along with high blood pressure, your risk of heart disease or stroke greatly increases.

Blood pressure can vary with activity and age, but a healthy adult who is resting should have a systolic pressure below 120 and a diastolic pressure below 80.

See also on this site: High Blood Pressure/Hypertension

High Blood Cholesterol. One of the major risk factors for heart disease is high blood cholesterol. Cholesterol, a fat-like substance carried in your blood, is found in all of your body's cells. Your liver produces all of the cholesterol your body needs to form cell membranes and to make certain hormones. Extra cholesterol enters your body when you eat foods that come from animals (meats, eggs, and dairy products).

Although we often blame the cholesterol found in foods that we eat for raising blood cholesterol, the main culprit is the saturated fat in food. (Be sure to read nutrition labels carefully, because even though a food does not contain cholesterol it may still have large amounts of saturated fat.) Foods rich in saturated fat include butter fat in milk products, fat from red meat, and tropical oils such as coconut oil.

Too much low-density lipoprotein (LDL or "bad cholesterol") in the blood causes plaque to form on artery walls, starting a disease process called atherosclerosis. When plaque builds up in the coronary arteries that supply blood to the heart, you are at greater risk of having a heart attack.

See also on this site: Cholesterol

Diabetes. Heart problems are the leading cause of death among people with diabetes, especially in the case of adult-onset or Type 2 diabetes (also known as non-insulin-dependent diabetes). Certain racial and ethnic groups (African Americans, Hispanics, Asian and Pacific Islanders, and Native Americans) have a greater risk of developing diabetes. The American Heart Association estimates that 65% of patients with diabetes die of some form of cardiovascular disease. If you know that you have diabetes, you should already be under a doctor's care, because good control of blood sugar levels can reduce your risk. If you think you may have diabetes but are not sure, see your doctor for tests.

See also on this site: Diabetes

Click here for a brief article about fat consumption.

"Study Not a Green Light for Fat Consumption," Reynolds Delgado, MD

Obesity and Overweight. Extra weight is thought to lead to increased total cholesterol levels, high blood pressure, and an increased risk of coronary artery disease. Obesity increases your chances of developing other risk factors for heart disease, especially high blood pressure, high blood cholesterol, and diabetes.

Many doctors now measure obesity in terms of body mass index (BMI), which is a formula of kilograms divided by height in meters squared (BMI =W [kg]/H [m2]). According to the National Heart, Lung, and Blood Institute (NHLBI), being overweight is defined as having a BMI over 25. Those with a number over 30 are considered obese. You can find out your BMI by using the calculator below. Then, take that value and find your body composition in the table below the calculator.

Body Mass Index
  Body mass index (BMI) is a formula to assess your body weight in relation to your height. This formula gives a measure of your body composition and has been shown to be an effective predictor of body fat. To calculate your BMI, enter your height and weight below.

Enter your height in inches: or centimeters:
Enter your weight in pounds: or kilograms:
Your result:  

Body Composition Body Mass Index (BMI)
Underweight Less than 18.5
Normal 18.5 - 24.9
Overweight 25.0 - 29.9
Obese Greater than 30.0

See also on this site: Nutrition, Obesity

Smoking. Most people know that cigarette and tobacco smoking increases your risk of lung cancer, but few realize that it also greatly increases the risk of heart disease and peripheral vascular disease (disease in the vessels that supply blood to the arms and legs). According to the American Heart Association, more than 400,000 Americans die each year of smoking-related illnesses. Many of these deaths are because of the effects of smoking on the heart and blood vessels.

Research has shown that smoking increases heart rate, tightens major arteries, and can create irregularities in the timing of heartbeats, all of which make your heart work harder. Smoking also raises blood pressure, which increases the risk of stroke in people who already have high blood pressure. Although nicotine is the main active agent in cigarette smoke, other chemicals and compounds like tar and carbon monoxide are also harmful to your heart in many ways. These chemicals lead to the buildup of fatty plaque in the arteries, possibly by injuring the vessel walls. And they also affect cholesterol and levels of fibrinogen, which is a blood-clotting material. This increases the risk of a blood clot that can lead to a heart attack.

See also on this site: Smoking and Your Heart 

Physical Inactivity. People who are not active have a greater risk of heart attack than do people who exercise regularly. Exercise burns calories, helps to control cholesterol levels and diabetes, and may lower blood pressure. Exercise also strengthens the heart muscle and makes the arteries more flexible. Those who actively burn 500 to 3500 calories per week, either at work or through exercise, can expect to live longer than people who do not exercise. Even moderate-intensity exercise is helpful if done regularly.

See also on this site: Exercise

Gender. Overall, men have a higher risk of heart attack than women. But the difference narrows after women reach menopause. After the age of 65, the risk of heart disease is about the same between the sexes when other risk factors are similar.

Heredity. Heart disease tends to run in families. For example, if your parents or siblings had a heart or circulatory problem before age 55, then you are at greater risk for heart disease than someone who does not have that family history. Risk factors (including high blood pressure, diabetes, and obesity) may also be passed from one generation to another.

Also, researchers have found that some forms of cardiovascular disease are more common among certain racial and ethnic groups. For example, studies have shown that African Americans have more severe high blood pressure and a greater risk of heart disease than whites. The bulk of cardiovascular research for minorities has focused on African Americans and Hispanics, with the white population used as a comparison. Risk factors for cardiovascular disease in other minority groups are still being studied.

Age. Older age is a risk factor for heart disease. In fact, about 4 of every 5 deaths due to heart disease occur in people older than 65.

As we age, our hearts tend not to work as well. The heart's walls may thicken and arteries may stiffen and harden, making the heart less able to pump blood to the muscles of the body. Because of these changes, the risk of developing cardiovascular disease increases with age. Because of their sex hormones, women are usually protected from heart disease until menopause, and then their risk increases. Women 65 and older have about the same risk of cardiovascular disease as men of the same age.

Contributing Risk Factors

Stress. Stress is considered a contributing risk factor for heart disease because its effects on the heart are not completely understood. Also, the effects of emotional stress, behavior habits, and socioeconomic status on the risk of heart disease and heart attack have not been proven. That is because we all deal with stress differently: how much and in what way stress affects us varies from person to person.

Researchers have identified several reasons why stress may affect the heart.

  • Stressful situations raise your heart rate and blood pressure, increasing your heart's need for oxygen. This need for oxygen can bring on angina pectoris, or chest pain, in people who already have heart disease.
     
  • During times of stress, the nervous system releases extra hormones (most often adrenaline). These hormones raise blood pressure, which can injure the lining of the arteries. When the arteries heal, the walls may harden or thicken, making it easier for plaque to build up.
     
  • Stress also increases the amount of blood clotting factors that circulate in your blood, making it more likely that a clot will form. Clots may then block an artery narrowed by plaque and cause a heart attack.

Stress may also contribute to other risk factors. For example, people who are stressed may overeat for comfort, start smoking, or smoke more than they normally would.

Sex hormones. Sex hormones appear to play a role in heart disease. Among women younger than 40, heart disease is rare. But between the ages 40 and 65, around the time when most women go through menopause, the chances that a woman will have a heart attack greatly increase. From 65 onward, women make up about half of all heart attack victims.

See also on this site: Women and Heart Disease

Birth control pills. Early types of birth control pills contained high levels of estrogen and progestin, and taking these pills increased the risk of heart disease and stroke, especially in women older than 35 who smoked. But birth control pills today contain much lower doses of hormones and are considered safe for women younger than 35 who do not smoke or have high blood pressure.

But if you smoke or have other risk factors, birth control pills will increase your risk of heart disease and blood clots, especially if you are older than 35.  According to the American Heart Association, women who take birth control pills should have yearly check-ups that test blood pressure, triglyceride, and glucose levels.

Alcohol. Studies have shown that the risk of heart disease in people who drink moderate amounts of alcohol is lower than in nondrinkers. Experts say that moderate intake is an average of one to two drinks per day for men and one drink per day for women. One drink is defined as 1½ fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.), 1 fl oz of 100-proof spirits, 4 fl oz of wine, or 12 fl oz of beer. But drinking more than a moderate amount of alcohol can cause heart-related problems such as high blood pressure, stroke, irregular heartbeats, and cardiomyopathy (disease of the heart muscle). And the average drink has between 100 and 200 calories. Calories from alcohol often add fat to the body, which may increase the risk of heart disease. It is not recommended that nondrinkers start using alcohol or that drinkers increase the amount that they drink.

It is never too late—or too early—to begin improving heart health. Some risk factors can be controlled, while others cannot. But, by eliminating risk factors that you can change and by properly managing those that you cannot control, you may greatly reduce your risk of heart disease.

See also on this site:

See on other sites:

MedlinePlus
www.nlm.nih.gov/medlineplus/heartdiseases.html
Heart Diseases

American Heart Association
www.heart.org/HEARTORG/Conditions/HeartAttack/
UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp
 
Understand Your Risk of Heart Attack


Updated December 2013
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Texas Heart Institute Heart Information Center
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