Risk Factors on Cardiovascular Disease

Risk Factors that are Uncontrollable:

• · Increasing age - About four out of five people who die of coronary heart disease are age 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.
  
  
• · Male sex (gender) - Men have a greater risk of heart attack than women, 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 whites 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. It's even more important to treat and control any other risk factors you have.

Risk Factors You Can Control:

• · Smoking - Smokers' risk of heart attack is more than twice that of nonsmokers. Cigarette smoking is the biggest risk factor for sudden cardiac death; smokers have two to four times the risk of nonsmokers. Smokers who have a heart attack are more likely to die and die suddenly (within an hour) than are nonsmokers. 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'. Constant exposure to other people's smoke - called environmental tobacco smoke, secondhand smoke or passive smoking - increases the risk of heart disease even for nonsmokers.
  
  
• · High blood cholesterol - The risk of coronary heart disease rises as blood cholesterol levels increase. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. Age, sex, heredity and diet also affect a person's cholesterol level.
  
  
• · High blood pressure - High blood pressure increases the heart's workload, causing the heart to enlarge and weaken over time. It also increases the 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 several times.
  
  
• · Physical inactivity - An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous exercise is important in preventing heart and blood vessel disease. Even moderate-intensity physical activities are beneficial if done regularly and long term. More vigorous activities are associated with more benefits. Exercise 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 in the waist area - are more likely to develop heart disease and stroke even if they have no other risk factors. Excess weight increases the strain on the heart, 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 have difficulty losing weight. By losing 10 to 20 pounds, you can help lower your heart disease risk.
  
  
• · Diabetes mellitus - Diabetes seriously increases the risk of developing cardiovascular disease. Even when glucose levels are under control, diabetes greatly increases the risk of heart disease and stroke. About two-thirds of people with diabetes die of some form of heart or blood vessel disease. If you have diabetes, it's critically important to work with your healthcare provider to manage your diabetes and control any other risk factors you can.
  
  
• · 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.
  
  
• · Sex hormones seem to play a role in heart disease. It's well known that men have more heart attacks than women do before the age of menopause. Several population studies show that the loss of natural estrogen as women age may contribute to a higher risk of heart disease after menopause. If menopause is caused by surgery to remove the uterus and ovaries, the risk of heart attack rises sharply. If menopause occurs naturally, the risk rises more slowly. Hormones also affect blood cholesterol. Female hormones tend to raise HDL ("good") cholesterol and lower total blood cholesterol. Male hormones do the opposite. If you've had a natural or surgical menopause, you may be considering estrogen replacement therapy (ERT) or hormone replacement therapy (HRT). ERT and HRT may increase a woman's risk of some diseases and health conditions. Your healthcare provider can give you more information and help you make the best choice.
  
  
• · The early forms of birth control pills, with higher doses of estrogen and progestin , increased a woman's risk of heart disease and stroke, especially in older women who smoked heavily. Newer, lower-dose oral contraceptives carry a much lower risk of cardiovascular disease, except for women who smoke or have high blood pressure. If a woman taking oral contraceptives has other risk factors (and especially if she smokes), her risk of developing blood clots and having a heart attack goes up. It rises even more after age 35. If you take birth control pills, get yearly medical check-ups of your blood pressure, triglyceride and glucose levels.
  
  
• · 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. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. One drink is defined as 1½ fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.), 1 fl oz of 100-proof spirits, 4 fl oz of wine, or 12 fl oz of beer. It's not recommended that nondrinkers start using alcohol or that drinkers increase their intake.