Cardiac Risk Factors

Patient Education from Capital Cardiology Associates

Avoidable Risk Factors

Factors that increase your risk of coronary artery disease include some you can’t control and several that you can. You can’t control your age, gender, race, family medical history or heart conditions you may have had previously. But you can control, treat or prevent the following risk factors:

• Excess weight
• Cigarette smoking and tobacco smoke
• Excessive consumption of alcohol
• High blood cholesterol
• High blood pressure (hypertension)
• Diabetes
• High salt consumption

Have your blood pressure checked at least every year. If your doctor diagnoses high blood pressure, diet, exercise and medication may be prescribed to keep it under control.

Physical inactivity

Regular moderate-to-vigorous activity is an excellent way to reduce your risk of heart attack and heart disease. It can help control blood cholesterol, diabetes and obesity, and can also help lower blood pressure and reduce the risk of stroke. Simple exercise like walking, gardening, housework and dancing for a total of 30 minutes on most days can help your heart. If you’ve been inactive, start with 10 minutes and increase gradually to 30 minutes. The American Heart association recommends 30-60 minutes of vigorous physical activity, 3-4 times each week to condition the heart and lungs. Brisk walking, aerobic dancing, jogging, running, rowing, swimming and sports such as singles tennis, racquetball, soccer and basketball are appropriate activities. The important thing is to make the time for a regular program of physical activity. Check with your doctor before you begin a vigorous activity program, especially if you’re middle aged or older, have heart disease or another medical problem, and have been inactive for a long time.

Overweight and obesity

Excess body fat – especially in the waist area – presents a significant risk for high blood pressure, high blood cholesterol, high triglycerides, diabetes, heart disease and stroke. This is true even if no other risk factors are present. You can estimate your body fat by measuring your waistline and using the body mass index (BMI). A high-risk waist measurement is 35 inches or more for women and 40 inches or more for men.

The BMI formula relates a person’s body weight to height and correlates accurately with body fat in most people. BMI values less than 18.5 are considered underweight. Values from 18.5 to 24.9 are considered healthy and pose minimal health risk.

Overweight is defined by BMI values of 25.0 to less than 30.0, and represents moderate risk.

Obesity is defined by BMI values of 30.0 or more, and 40 or more defines extreme obesity. People who have BMI values of 30 or more are at high risk of cardiovascular disease.

A weight loss of 10 to 20 pounds can help reduce your risk for heart attack and stroke. To lose weight, women should eat 1,200 to 1,500 calories per day, but not less than 1,200. The daily range for men is 1,500 to 1,800 calories, but not less than 1,500. Losing one or two pounds per week is considered a healthy weight loss.

If you need help losing weight, consult your doctor, a registered dietitian (RD), or a nutritionist licensed by the state (LD OR CN).

Smoking

When you smoke cigarettes, you are at serious risk of heart attack and stroke. Here’s why:

• Tobacco smoke has been shown to enhance development of atherosclerosis by damaging artery walls and creating cholesterol deposits.
• It reduces levels of high-density lipoprotein cholesterol (HDL), the “good” cholesterol.
• It can cause formation of blood clots that can cause heart attack or stroke.

If you smoke cigars or a pipe, you also have a higher risk of coronary artery disease. And if you’ve already had a heart attack and you continue to smoke, you risk sudden cardiac arrest, emphysema and even death.

To eliminate the risk, DON’T SMOKE. If you’ve never smoked, don’t start. If you do smoke, get help to quit. When you stop smoking, you start reducing your risk immediately.

High Blood Cholesterol

A high level of cholesterol in your blood can cause coronary artery disease and heart attack. It is also a secondary risk factor for stroke. Cholesterol is a soft, fat-like material that’s present in your blood and all of the cells in your body. There are two types of cholesterol:

Low-density lipoprotein (LDL) is “bad” cholesterol. LDL clings to artery walls, increasing plaque build-up. High levels of LDL increase your risk of heart disease and heat attack.

High-density lipoprotein (HDL) is “good” cholesterol. It carries excess cholesterol to the liver where it is removed from the body. If you have a low level of HDL, you have a higher risk of heart attack. But you can correct the condition by controlling your weight, having a proper diet, engaging in exercise and, in some cases, taking medication.

Triglyceride is the most common of the body fats. Although high triglyceride levels are not a direct risk factor for heart disease, they are often seen in people who have heart disease. When high levels of triglycerides are combined with low HDL or high LDL, they may speed up atherosclerosis and increase the risk of diabetes.

High Blood Pressure

When you have high blood pressure (hypertension), your heart must work harder, risking damage to the heart and the arteries. Your risk of heart disease, stroke, congestive heart failure and kidney failure is increased.

Blood pressure measurements indicate the force exerted on the blood when the heart beats (the higher number, called systolic) and when it’s at rest (the lower number, called diastolic). You have high blood pressure when the reading is 140/90 or more for two or more measurements.

The cause of high blood pressure is unknown in 90 to 95 percent of cases. The following factors, however, increase the chance of having high blood pressure:

• Your age. Blood pressure tends to increase with age.
• Your family history (including race). If your parents have high blood pressure, your risk is greater than those whose parents don’t. African Americans are more likely to have high blood pressure than are whites.

Diabetes Mellitus

When a person has diabetes mellitus, their body doesn’t make or respond properly to insulin, the hormone needed to convert sugar, starches and other foods into energy. Diabetics have blood glucose (blood sugar) levels that are too high – a fasting plasma glucose reading of 126 mg/dL or more measured on two occasions.

Type 2 diabetes is the most common form. It typically appears in adults, often in middle age. It can go undetected for many years in a mild form. Untreated, it can lead to a variety of serious medical problems, including heart and blood vessel disease. Obesity and physical inactivity are risk factors for Type 2 diabetes.

Type 1 diabetes, also called juvenile diabetes, typically begins early in life. Type 1 diabetics are insulin-dependent.

Diabetes is a major risk factor for heart attack and stroke, even when glucose levels are under control. In fact, most diabetics die of some form of heart or blood vessel disease – due in part to the fact that the disease affects cholesterol and triglyceride levels and blood pressure.

If you have diabetes, it is critically important to have regular medical check-ups to help you keep it under control.

Personal Medical History

If you have a personal history of heart disease, artery disease or blood disorders, your risk of heart attack and stroke may be increased. In many cases, treatment can reduce the risk.

In heart and artery disease, medication can be prescribed to help prevent clots from forming.

In carotid artery disease, surgery can be performed to remove clots and plaque that might cause a stroke

Transient ischemic attacks (TIAs) are extremely important warning signs for stroke and should not be ignored. A TIA is a mini stroke that lasts from a few minutes up to 24 hours, producing stroke-like symptoms such as numbness in an arm or leg, sudden dizziness or difficult vision. Any evidence of TIA should be immediately reported to your doctor.

Additional Reading

Additional Reading

Read our brochure on High Blood Pressure

Read our brochure on Obesity