Risk Factors for Heart Disease
A risk factor is something that increases your chance of having heart disease. Heart disease (also called coronary artery disease) involves damage to the heart arteries. These blood vessels need to work well to provide the oxygen your heart needs to pump blood to the rest of your body. Things like smoking or high cholesterol levels can damage arteries. You can’t control some risk factors, such as age and a family history of heart disease. But there are many things you can control to reduce your risk for heart disease.
Unhealthy cholesterol levels
Cholesterol is a fat-like substance in your blood. It can build up along the artery walls. This is called plaque. Over time, plaque narrows the arteries and reduces blood flow to your heart or brain. If a blood clot forms or a piece of the plaque breaks off, it can completely block the artery and cause a heart attack or stroke. Your risk of heart disease goes up if you have high levels of LDL ("bad") cholesterol or triglycerides (another fatty substance that can build up). You’re also at risk if you have low HDL cholesterol ("good") cholesterol. HDL helps clear the bad cholesterol away. You're at risk if you have: HDL cholesterol 50 mg/dL or lower; LDL cholesterol 100 mg/dL; or triglycerides of 150 mg/dL or higher.
This is the most important risk factor you can change. Smoking causes inflammation and damages the smooth muscle that lines the arteries making them less flexible. It also raises your blood pressure, causing further damage to the artery lining. Smoking also increases your risk that your blood may clot, block an artery, and cause a heart attack or stroke. Smoking also damages your lungs, which affects the delivery of oxygen to the body. If you smoke, you are 2 to 4 times more likely to develop coronary artery disease. If you smoke, it's never too late to help your heart. Ask your doctor about nicotine replacement products and smoking cessation support.
High blood pressure
High blood pressure occurs when blood pushes too hard against artery walls. This causes damage to the artery walls and the formation of scar tissue as it heals. This makes the arteries stiff and weak. Plaque sticks to the scarred tissue narrowing and hardening the arteries. High blood pressure also causes your heart to work harder to get blood out to the body. High blood pressure raises your risk of heart attack, also known as acute myocardial infarction, or AMI, and especially stroke. The brain tissue is especially sensitive to high blood pressure damage. You're at risk if your blood pressure is 120/80 or higher.
Chronic stress, pent-up anger, and other negative emotions have been linked to heart disease. This occurs because stress increases the levels of a hormone that increase the demand on your heart. Over time, these emotions could raise your heart disease risk.
This is caused by a combination of certain risk factors. It puts you at extra high risk of heart disease, stroke, and diabetes. You have metabolic syndrome if you have 3 or more of the following: low HDL cholesterol; high triglycerides; high blood pressure; high blood sugar; extra weight around the waist.
Diabetes occurs when you have high levels of sugar (glucose) in your blood. This can damage arteries if not kept under control. Having diabetes also makes you more likely to have a silent heart attack—one without any symptoms.
Excess weight makes other risk factors, such as diabetes, more likely. Excess weight around the waist or stomach increases your heart disease risk the most.
Lack of physical activity
When you’re not active, you’re more likely to develop diabetes, high blood pressure, high cholesterol levels, and excess weight.
Most people with heart disease have more than one risk factor.
February 14, 2018
Estimation of cardiovascular risk in an individual patient without known cardiovascular disease, Up To Date, Greenland, P., Guidelines for Assessment of Cardiovascular Risk in Asymptomatic Adults, Journal of the American College of Cardiology (2010); 56(25); pp. s50-s103, Grundy, SM, Assessment of Cardiovascular Risk by Use of Multiple Risk Factor Assessment Equations, Circulation (1999); 100; pp. 1481-1492
Fetterman, Anne, RN, BSN,Gandelman, Glenn, MD, MPH,Image reviewed by StayWell art team.