Coronary artery disease, also called heart disease, causes roughly 735,000 heart attacks each year in the U.S. and kills more than 630,000 Americans each year. According to the American Heart Association, over 7 million Americans have had a heart attack in their lifetime.
Because heart disease is so common and often is silent until it strikes, it is important to recognize the factors that put you at risk.
What Are the Risk Factors for Heart Disease?
There are several risk factors for heart disease; some are controllable, others are not. Uncontrollable risk factors for heart disease include:
- Being male
- Older age
- Family history of heart disease
- Being postmenopausal
- Race (African American, American Indian, and Mexican American people are more likely to have heart disease than white people.)
Still, there are many heart disease risk factors that can be controlled. By making changes in your lifestyle, you can reduce your risk for heart disease. Controllable risk factors for heart disease include:
- High LDL, or “bad" cholesterol, and low HDL, or “good" cholesterol
- Uncontrolled high blood pressure
- Physical inactivity
- Obesity (having a BMI greater than 25)
- Uncontrolled diabetes
- High C-reactive protein
- Uncontrolled stress, depression, and anger
- Poor diet
- Alcohol use
What Can I Do to Lower my Risk of Heart Disease?
Making changes in your lifestyle is a proven method for reducing your risk of developing heart disease. While there are no guarantees that a heart-healthy lifestyle will keep heart disease away, these changes will certainly improve your health in other ways, such as improving your physical and emotional well-being. Also, because some risk factors are related to others, making changes in one area can benefit other areas. Heart disease is preventable 80%-90% of the time due to lifestyle changes. Making these changes can help prevent heart attacks and strokes.
Here are some ways you can reduce your risk of heart disease.
Quit smoking. Smokers have more than twice the risk for heart attack as nonsmokers and are much more likely to die if they suffer a heart attack. Smoking is also the most preventable risk factor. If you smoke, quit. Better yet, never start smoking at all. Nonsmokers who are exposed to constant smoke also have an increased risk. Eliminating exposure to smoke is important.
Improve cholesterol levels. The risk for heart disease increases as your total amount of cholesterol increases. Your total cholesterol goal should be less than 200 mg/dL; HDL, the good cholesterol, higher than 40 mg/dL in men and 50 mg/dL in women (and the higher the better); and LDL should be less than 130 mg/dL in healthy adults. For those with diabetes or multiple risk factors for heart disease, the LDL goal should be less than 100 mg/dL (some experts recommend less than 70 mg/dL if you are very high risk).
It’s important to note that cholesterol values mean different things to different people. The difference depends on your own odds of having heart disease. Your doctor may use a calculator to help figure out your risk.
Lower your cholesterol. A diet low in cholesterol, saturated and trans fats, and simple sugars and high in complex carbohydrates and good fats (omega-3s) will help lower cholesterol levels and reduce your risk for heart disease. Regular exercise will also help lower “bad" cholesterol and raise “good" cholesterol. Often, medications are needed to reach cholesterol goals.
Control high blood pressure. About 67 million people in the U.S. have high blood pressure, making it the most common heart disease risk factor. Nearly 1 in 3 adults has systolic blood pressure (the upper number) over 130, and/or diastolic blood pressure (the lower number) over 80, which is the definition of high blood pressure. Like cholesterol, blood pressure interpretation and treatment should be individualized, taking into account your entire risk profile. Control blood pressure through diet, exercise, weight management, watching your salt, and if needed, medications.
Control diabetes. If not properly controlled, diabetes can lead to significant heart damage, including heart attacks and death. Control diabetes through a healthy diet, exercise, maintaining a healthy weight, and taking medications as prescribed by your doctor.
Get active . Many of us lead sedentary lives, exercising infrequently or not at all. People who don’t exercise have higher rates of death and heart disease compared to people who perform even mild to moderate amounts of physical activity. Even leisure-time activities like gardening or walking can lower your risk of heart disease. Most people should exercise 30 minutes a day, at moderate intensity, on most days. More vigorous activities are associated with more benefits.
Exercise should be aerobic, involving the large muscle groups. Make an exercise menu. Pick a couple of activities that sound like fun. That way, you always have some choices about what to do. Aerobic activities include brisk walking, cycling, swimming, jumping rope, and jogging.
If walking is your exercise of choice, use the pedometer goal of 10,000 steps a day. Make an exercise menu. Pick a couple of activities that sound like fun. That way, you always have some choices about what to do. Consult your doctor before starting any exercise program.
Eat right. Eat a heart-healthy diet low in sodium, saturated fat, trans fat, cholesterol, and refined sugars. Try to increase your intake of foods rich in vitamins and other nutrients, especially antioxidants, which have been proven to lower your risk for heart disease. Also eat plant-based foods such as fruits and vegetables, nuts, and whole grains.
Rethink your drink. Limit alcohol. Moderate drinking may be OK, but more than that isn’t good for your health. What’s moderate drinking? Up to one glass a day for women, and up to two glasses a day for men.
Achieve and maintain a healthy weight. Excess weight puts significant strain on your heart and worsens several other heart disease risk factors such as diabetes, high blood pressure, high cholesterol, and triglycerides. Research is showing that obesity itself increases heart disease risk. By eating right and exercising, you can lose weight and reduce your risk of heart disease.
Manage stress. Poorly controlled stress and anger can lead to heart attacks and strokes. Use stress and anger management techniques to lower your risk. Learn to manage stress by practicing relaxation techniques, learning how to manage your time, setting realistic goals, and trying some new techniques such as guided imagery, meditation, massage, tai chi, or yoga.
Talk to your doctor: Discuss your lifestyle as well as your family’s medical history so that you can learn more about what you can do to lower your risk.
Referenced on 16/05/2021
- American Heart Association: “Understand Your Risk of Heart Attack."
- CDC: “Prevention: What You Can Do."
- Myers, R. Heart Disease: Everything You Need to Know, Firefly Books, 2004.
- Tonkin, A. Atherosclerosis and Heart Disease, Taylor & Francis, 2003.