Although heart disease is the leading “silent killer” with little or no advanced warning, it is also largely preventable - if you know the risk factors and make smart lifestyle choices. Choosing a heart-healthy diet, getting frequent cardiovascular exercise, not smoking, and effectively managing blood pressure and cholesterol can make a difference. In addition, regular check-ups with your primary care provider help maintain overall health so your heart stays strong for life.
Risk Factors You Can't Change
The risk factors on this list are ones you're born with and cannot be changed. The more of these risk factors you have, the greater your chance of developing coronary heart disease. Since you can't do anything about these risk factors, it's even more important for you to manage the risk factors that can be changed.
About 82 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks.
Both women and men experience heart disease and are at risk of heart attack. However, men have a greater risk of heart attack than women do, and they have attacks earlier in life.
Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. Heart disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans. Most people with a strong family history of heart disease have one or more other risk factors.
Risk Factors You Can Change
Smokers' risk of developing coronary heart disease is 2-4 times that of nonsmokers. People who smoke a pack of cigarettes a day have more than twice the risk of heart attack than people who’ve never smoked. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease. Cigarette smoking also acts with other risk factors to greatly increase the risk for coronary heart disease. People who smoke cigars or pipes seem to have a higher risk of death from coronary heart disease (and possibly stroke) but their risk isn't as great as cigarette smokers'. Exposure to other people's smoke increases the risk of heart disease even for nonsmokers.
As blood cholesterol rises, so does risk of coronary heart disease. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. A person's cholesterol level is also affected by age, sex, heredity and diet. Here's the lowdown on where those numbers need to be:
- Total Cholesterol: Less than 200 mg/dL
- LDL (bad) Cholesterol:
- If you're at low risk for heart disease: Less than 160 mg/dL
- If you're at intermediate risk for heart disease: Less than 130 mg/dL
- If you're at high risk for heart disease (including those with existing heart disease or diabetes): Less than 100mg/dL
- HDL (good) Cholesterol: 40 mg/dL or higher for men and 50 mg/dL or higher for women
- Triglycerides: Less than 150 mg/dL
High blood pressure increases the heart's workload, causing the heart muscle to thicken and become stiffer. This stiffening of the heart muscle is not normal, and causes the heart not to work properly. It also increases your risk of stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times.
An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous physical activity helps prevent heart and blood vessel disease. The more vigorous the activity, the greater your benefits. However, even moderate-intensity activities help if done regularly and long term. Physical activity can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people.
People who have excess body fat — especially if a lot of it is at the waist — are more likely to develop heart disease and stroke even if they have no other risk factors. Excess weight increases the heart's work because often the blood pressure is higher. It also raises blood pressure and blood cholesterol and triglyceride levels, and lowers HDL ("good") cholesterol levels. It can also make diabetes more likely to develop. Many obese and overweight people may have difficulty losing weight. But by losing even 10% from your current weight, you can lower your heart disease risk.
Diabetes seriously increases your risk of developing cardiovascular disease. Even when glucose levels are under control, diabetes increases the risk of heart disease and stroke, but the risks are even greater if blood sugar is not well controlled. At least 65% of people with diabetes die of some form of heart or blood vessel disease. If you have diabetes, it's extremely important to work with your healthcare provider to manage it and control any other risk factors you can. Persons who are obese or overweight should lose weight to keep blood sugar in control.
Other Important Factors
Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life, their health behaviors and socioeconomic status. These factors may affect established risk factors. For example, people under stress may overeat, start smoking or smoke more than they otherwise would.
Drinking too much alcohol can raise blood pressure, cause heart failure and lead to stroke. It can contribute to high triglycerides, cancer and other diseases, and produce irregular heartbeats. It contributes to obesity, alcoholism, suicide and accidents. Some studies suggest that the risk of heart disease may be lower for some people who drink moderate amounts of alcohol compared to nondrinkers. But remember, if you drink, limit your alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women. One drink is defined as 1-1/2 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. It's not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.
Diet / Nutrition
A healthy diet is one of the best weapons you have to fight cardiovascular disease. The food you eat (and the amount) can affect other controllable risk factors: cholesterol, blood pressure, diabetes and overweight. Choose nutrient-rich foods — which have vitamins, minerals, fiber and other nutrients but are lower in calories — over nutrient-poor foods. A diet rich in vegetables, fruits, whole-grain and high-fiber foods, fish, lean protein and fat-free or low-fat dairy products is the key. And to maintain a healthy weight, coordinate your diet with your physical activity level so you're using up as many calories as you take in.