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RISK FACTORS FOR
HEART DISEASE

Reducing Your Risk Factors

WHAT IS A RISK FACTOR?

A risk factor is a specific condition or behavior associated with the development of heart and blood vessel disease. The more risk factors, the greater chance you have of developing heart disease. Therefore, reducing these risk factors is the key to a healthier heart.

WHAT ARE THE RISK FACTORS?

There are risk factors that cannot be controlled or changed, and there are risk factors that can be controlled or changed.

 

Calculate your risk

Heredity
Family history plays an important part in our fate. According to some studies, if two immediate family members have had a heart attack (myocardial infarction) before age 55, the risk of developing heart disease is 5-10 times greater than in a family with no history. Heredity also influences several of the risk factors.

Age & Gender
Men and women can both develop heart and blood vessel disease, although hormones play a complex role in the picture. Estrogen delays the onset of disease in most women by about ten years.

  • One in nine women between the ages of 45-64 has some form of heart disease or stroke; this ratio soars to one in three at age 65 and beyond.
  • One in six men aged 45-64 has some form of heart or blood vessel disease; in men 65 and older the ratio decreases to one in eight.

These statistics suggest that the risk for men is higher in the earlier years, whereas women have a higher prevalence for heart disease after menopause.

Smoking
Smoking is a major cause of heart and blood vessel disease. Cigarette smoking is the most dangerous of the modifiable risk factors. Overall, smokers experience a 70% greater death rate from heart and blood vessel disease than nonsmokers; and heavy smokers (two or more packs per day) have a death rate two to three times greater than nonsmokers. Inhaling cigarette smoke produces temporary effects on the heart and blood vessels. The nicotine in the smoke increases blood pressure, heart rate, and the amount of blood pumped by the heart and the blood flow in the vessels in the heart. Other effects include narrowing of the vessels in the arms and legs. Nicotine is not the only bad element in cigarette smoke. Carbon monoxide gets in the blood which reduces the amount of oxygen available to the heart and all other parts of the body. Cigarette smoking also causes the platelets in the blood to become sticky and cluster which can harm the heart and blood vessels. No cigarettes are considered safe. Many smokers who have switched to low tar and low nicotine cigarettes smoke more or inhale more deeply to make up for the decreased nicotine. By inhaling more deeply, smokers may increase their risk of disease.

Regardless of how much or how long you have smoked, when you quit smoking your risk of heart and blood vessel disease gradually decreases. Ten years after quitting, for example, your risk of death from heart disease is almost the same as if you had never smoked. It is important to stop smoking before the signs of this disease appear. Don't wait until you have heart and blood vessel disease to quit - stop smoking now.

Hypertension
Hypertension is also known as high blood pressure. To help understand high blood pressure, you must first understand what blood pressure is.

As your heart beats, it forces blood through large blood vessels in your body called arteries. Arteries take the blood from your heart to all other parts of your body. As the blood is pumped through your body, it pushes against the arterial walls. Blood pressure is the force of your blood against the walls of your arteries. Normally, arteries are muscular and elastic. They stretch and contract as blood goes through them.

Your blood pressure consists of two numbers. The top reading is the systolic pressure (when your heart is contracting), the bottom number is the diastolic pressure (when the heart is relaxing). If your blood pressure consistently runs 140/90 or more, you may have hypertension (high blood pressure).

In many cases, the cause of hypertension is unknown but may include: family history of hypertension, gender, age, race, obesity, and a high salt/high cholesterol diet.

When the blood pressure is continually elevated, your heart has to work extra hard to pump. When high blood pressure occurs over a long period of time, the heart tends to enlarge as it has a hard time keeping up with the demands made on it.

High blood pressure may also contribute to hardening of the arteries of the heart and other vessels. High blood pressure may increase the possibility of strokes due to damage to the blood vessels that lead to the brain; may cause kidney damage, congestive heart failure; and may increase your risk for coronary artery disease.

Primary high blood pressure may not be cured but it can be controlled. Some treatments that your doctor may recommend to you include:

       Reducing the amount of salt (sodium) intake
Weight reduction
Stress reduction
Exercise
Regular doctor visits
Regular blood pressure checks
Stopping smoking

Blood pressure needs to be controlled long-term!

   

Cholesterol Levels
Reducing saturated fat and cholesterol in your diet will help to achieve lower levels of fat and cholesterol in your blood.

Cholesterol is the main lipid-like (fat) component of the fatty (atherosclerotic) deposits in heart arteries. Any increase in the total blood cholesterol level has been closely associated with coronary artery disease. Studies show that elevated cholesterol levels may be a familial trait; however, environmental factors such as diet, are most influential.

Cholesterol is a substance manufactured by the body, but may also be found in certain foods. Egg yolks, organ meats, shrimps, oysters, fatty red meats, lard, butter, and whole milk dairy products are high in saturated fats which may raise cholesterol blood levels in most people. Some vegetable oils, such as palm kernel oil, coconut oil and cocoa butter, are high in saturated fat.

Polyunsaturated fats, however, tend to lower the level of cholesterol in the blood. By partially substituting polyunsaturated fats for saturated fats and by increasing the amount of complex carbohydrates in the diet, it is possible to lower the levels of cholesterol and fat in the blood.

Recommendations:

Eat fish or poultry more than red meat, consuming not more than 6 ounces a day
When red meat (beef, pork, lamb) is prepared, trim all visible fat before cooking, serve small portions, and use select cuts
Remove the skin from poultry before cooking
Serve more "white" meat from poultry than "dark" meat
Use skim milk and skim milk products instead of whole milk or 2% milk and milk products
Consume no more than 3 egg yolks per week
Cook with liquid vegetable oils and use more polyunsaturated margarines (such as safflower, cottonseed, corn, and soybean)

 

Diet changes should never be drastic. You may harm your health by cutting essential foods from your diet. Keep changes in your diet moderate with careful use of saturated fats and cholesterol. Learn to read labels for hidden saturated fats.

For more information on weight reduction and nutritious meal planning, request a dietitian during your hospital stay or contact the National Heart Foundation.

Diabetes
High blood sugar is associated with an increased risk of developing coronary artery disease, whether it necessitates diet control, oral hypoglycemics or insulin control. Hyperglycemia (carbohydrate intolerance) may be defined as a fasting blood glucose greater than 130 mg/dl. As blood sugar increases, there is an acceleration in the thickening of the coronary artery basement membrane which predisposes the patient to early development of coronary artery disease.

Diabetes is associated with other risk factors including obesity, increased blood cholesterol level and high blood pressure. Regular checkups, adherence to a management regimen, and weight control are essential.

Obesity
Weighing more than 30 percent over your ideal weight can double your risk for developing heart disease. Other risk factors such as high blood pressure, high cholesterol and adult onset of diabetes may also be linked to obesity.

It is very important to control your weight. The following are some tips for weight control:

Check with your doctor or dietitian regarding how many calories you need a day
Have the dietitian instruct you on a proper diet
Avoid crash or fad diets as the weight loss is usually only temporary
Exercise regularly
Set realistic goals
Once you have achieved your goals, continue the new eating habits
Learn how to eat - not how to diet!

Lack of Exercise
 Your heart is a muscle and benefits from regular exercise like all the other muscles in your body.

Regular exercise of an aerobic type (exercise that increases your heart rate and breathing) can reduce the risk for heart disease by increasing the heartıs functional capacity, lowering the oxygen requirements of the heart, increasing the tone of other muscles, and stimulating circulation.

Improvements in fitness result from exercise of moderate intensity (50-75% of capacity) when done 15-30 minutes at least three times per week.

Good aerobic activities include brisk walking, jogging, running, bicycling, and swimming. Ask your doctor which activity is best suited to your age and physical condition.

Stress
Stress, as defined by Dr. Hans Selye, is "the nonspecific response of the body to any demand made upon it." More specifically, stress is defined by perception. If a person finds a job situation, or another personality particularly stressful, the feeling often will trigger a physiological response. On the other hand, studies have shown that when a job situation or another personality stimulate feelings of challenge or a positive reaction, these same physiological reactions do not occur. Therefore, when we talk about stress in relation to disease, we are looking at the more negative stress.

Physiological responses to stress include an increase in heart rate, an increase in blood pressure, and an increased rate of breathing. These symptoms are caused by the release of adrenaline, which also narrows your arteries, and results in a greater workload on the heart. If you are unable to control your stress, you may be at risk for high blood pressure and possibly injury to your artery walls which sets the stage for plaque deposits. Negative stress is a risk factor for the development of coronary artery disease.

Stress management is a learning process. First, you need to identify the particular cause of your stress. Second, you need to take steps to change those circumstances that are stressful whenever possible. Third, you need to relearn ways to cope with stress in your everyday life. The following are a few suggestions for coping with stress:

  • Do not waste energy being upset over little things. Remember that stress is our reaction to situations, not the situation itself. Often it helps to talk it out and get a different perspective of the situation while at the same time venting your concerns.
  • Escape from the stress for a period of time. Exercise, taking a walk before lunch to get rid of the morning's frustrations or taking a walk after work to help unwind, can be very helpful to reduce your stress.
  • Beware of the super-person urges. Set priorities, establish realistic goals and stop trying to do too much.
  • Take time to relax daily whether you learn relaxation techniques or just take time out for a favorite hobby.
  • Take it easy with criticism or arguments. Stand your ground on what you believe is right, but make allowances for the other party. Search for the "positives" of an argument, of a critical person, as well as your own positive qualities.
  • Finally, if stress seems out of control, discuss it further with your doctor or health care professional. They may be able to direct you to other sources for help such as support groups or professionals trained in stress management.

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    Courtesy of the American Heart Association

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