The American Heart Association has identified three different categories of risk factors for heart disease and/or heart attack:
- Hereditary risk factors that cannot be changed
- Major risk factors that can you can reduce or control by taking medicine or changing your lifestyle
- Other risk factors that can contribute to heart disease
Hereditary Risk Factors
- Increasing Age: According to the AHA, 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.
- Gender: Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, it's not as great as men's. However, it is important to note that heart disease is the number one killer of women as well.
- Race: 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. This is partly due to higher rates of obesity and diabetes.
- Family History: Children of parents with heart disease are more likely to develop it themselves. Most people with a strong family history of heart disease have one or more other risk factors, increasing the importance of treating and controlling any other risk factors.
Major Risk Factors that Can Be Changed by Changing Your Lifestyle and/or Taking Medicine
- Tobacco Smoke: Smokers' risk of developing coronary heart disease is two to four 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 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.
- High Cholesterol: 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.
- High Blood Pressure: High blood pressure increases the heart's workload, causing the heart 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 is combined with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times.
- Physical Inactivity: An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous physical activity helps prevent heart and blood vessel disease. Benefits increase with vigorous activity. However, even moderate-intensity activities help if done regularly. Physical activity can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people.
- Obese/Overweight: 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. 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 as few as 10 pounds, you can lower your heart disease risk.
- Diabetes Mellitus: Diabetes seriously increases your risk of developing heart 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 percent 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 doctor 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 Risk Factors
- Stress: Individual response to stress may be a contributing factor. Some scientists have noted a relationship between 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.
- Alcohol: 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. 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.
- Diet and 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.