Risk Factors for Heart Attack & Heart Disease
Q: What are the major risk factors for heart
attack and heart disease?
Dr. Donnica: The good news is that according
to American Heart Association (AHA) estimates, half of all heart attacks are
linked to known risk factors that can be reduced or eliminated. The bad news
is that most Americans don't implement these steps. The risk factors listed
are called "major risk factors"; and all but age and family history are modifiable.
Major risk factors for heart attack:
- Age itself, for men; age and menopausal/HRT status
for women. The risk of heart attacks and heart disease increases directly
with age. In general, women begin having heart disease 10 years later than
men, due to the protective effects of estrogen before menopause. While
you can't change your menopausal age, you can change the estrogen deficiency
responsible for menopause. Data show that HRT can cut the risk of heart disease
in half and can reduce the risk of heart attack by 40%! In menopausal women,
estrogen lowers LDL by 15% and raises HDL by 20-25%. It may increase triglyceride
levels, however. Estrogen also keeps the arterial walls flexible and elastic,
which improves blood pressure and blood flow.
- Family history of CAD or previous personal history
of heart attack. You are at increased risk if you have a first degree family
member who has had a "cardiac event": a heart attack, open-heart surgery, angioplasty,
etc. You are at greatly increased risk for a second heart attack once you have
already had your first.
- Smoking. Just stop. If you need data, consider
this. Among pre and post-menopausal women, smoking triples the risk of
heart attack. Even women who smoke only 5 cigarettes per day or less have more
than a doubled risk of heart attack compared to non-smokers! Cigarette smoking
also lowers the age for initial heart attack more for women than for men. Birth
control pills further increase the risk for heart attack in smokers, but not
in non-smokers. The good news is that women who quit smoking can decrease their
risk of cardiovascular causes of death by 24% within 2 years. Former smokers
may approach the coronary risk level of a nonsmoker within 3-5 years of quitting.
- *Elevated cholesterol, especially LDL and
triglycerides. The goal is to get your "good cholesterol" (HDL) as high as possible
and to reduce your triglycerides and "bad cholesterol" (LDL) to as low as possible.
- *Control your blood pressure.
- *Exercise. Studies show that regular exercise
can reduce your risk of heart attack by 40%! Physical inactivity is associated
with a doubled risk for cardiovascular events. Aerobic exercise increases
your circulation, strengthens your heart, inhibits blood clotting, helps with
weight control, lowers blood pressure, helps control blood-sugar levels, and
increases your "good cholesterol" (HDL).
- *Control blood sugar. Diabetes is a major
risk factor for heart disease, especially in women. The build-up of blood sugar
can damage the walls of blood vessels. Having diabetes also greatly increases
one's risk of a "silent" heart attack.
- *Being overweight. The more overweight you
are, the more demand you put on your heart. In addition, obesity increases
the risks of developing or worsening high blood pressure, diabetes, and cholesterol
problems. Central adiposity (having the "apple shape" rather than the "pear
shape") further increases your risk of heart disease significantly.
- *Stress. Stress and repressed anger have
been shown to increase blood pressure and heart rate, which can trigger a heart
attack. Exercise, relaxation, meditation, yoga, religious activities, and massage
can help alleviate stress; psychotherapy may be indicated for those with hostility,
repressed anger, and unhealthy or dangerous behaviors such as road rage.
Created: 9/28/2000  - Donnica Moore, M.D.
Half of all heart attacks are linked to known risk factors that can be reduced or eliminated.