The American Heart Association recommends beginning heart disease prevention early in life, starting by assessing your risk factors and working to keep them low. The sooner you know and manage your risk factors, the better your chances of leading a heart-healthy life.
Major risk factors that can't be changed
The risk factors on this list are ones you're born with and cannot be changed. The more of these risk factors you have, the greater your chance of developing coronary heart disease. Since you can't do anything about these risk factors, it's even more important for you to manage the risk factors that can be changed.
Increasing Age: Most people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men to die from them within a few weeks.
Male Sex: 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.
Heredity (Including Race): Children of parents with heart disease are more likely to develop it themselves. 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.
Most people with a strong family history of heart disease have one or more other risk factors. Just as you can't control your age, sex and race, you can't control your family history. Therefore, it's even more important to treat and control any other risk factors you have.
Major risk factors you can modify, treat or control
Tobacco smoke: Smokers' risk of developing coronary heart disease is much higher than that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease. Cigarette smoking also acts with other risk factors to greatly increase the risk for coronary heart disease. Exposure to other people's smoke increases the risk of heart disease even for nonsmokers.
High blood 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. A person's cholesterol level is also affected by age, sex, heredity and diet.
High blood pressure: High blood pressure increases the heart's workload, causing the heart muscle 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 exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases even more.
Physical inactivity: An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous physical activity helps reduce the risk of heart and blood vessel disease. Even moderate-intensity activities help if done regularly and long term. Physical activity can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people.
Obesity and 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. Overweight and obese adults with risk factors for cardiovascular disease such as high blood pressure, high cholesterol, or high blood sugar can make lifestyle changes to lose weight and produce clinically meaningful reductions in triglycerides, blood glucose, HbA1c, and risk of developing Type 2 diabetes. Many people may have difficulty losing weight. But a sustained weight loss of 3 to 5% body weight may lead to clinically meaningful reductions in some risk factors, larger weight losses can benefit blood pressure, cholesterol, and blood glucose.
Diabetes: Diabetes seriously increases your risk of developing cardiovascular 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 68% of people >65 years of age with diabetes die of some form of heart disease and 16% die of stroke. If you have diabetes, it's extremely important to work with your healthcare provider to manage it and control any other risk factors you can. Persons with diabetes who are obese or overweight should make lifestyle changes (e.g., eat better, get regular physical activity, lose weight ) to help manage blood sugar.
Other risk factors you can modify, treat or control
Stress: Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary 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, increase risk of cardiomyopathy and stroke, cancer and other diseases. It can contribute to high triglycerides, and produce irregular heartbeats. Excessive alcohol consumption contributes to obesity, alcoholism, suicide and accidents. However, there is a cardioprotective effect of moderate alcohol consumption. 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. The National Institute on Alcohol Abuse and Alcoholism defines one drink as 1-1/2 fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.), 5 fl oz of wine or 12 fl oz of regular beer. It's not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.
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 weight. Choose nutrient-rich foods — which have vitamins, minerals, fiber and other nutrients but are lower in calories — over nutrient-poor foods. Choose a diet that emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meats. 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.
Preventing heart attacks
A heart attack can occur at any age. You’re never too young to start heart-healthy living. If you are over 40, or if you have multiple risk factors, work especially closely with your doctor to address your risk of developing cardiovascular disease.
Heart attack prevention should begin early in life. Start with an assessment of your risk factors and a plan you can follow to keep your heart attack risk low. Prevention is critical, because many first-ever heart attacks are fatal or disabling.
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