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.
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American Heart Association
Understand Your Risk of Heart Attack
Updated December 2013