Heart Disease Risk

Knowing the risks of heart disease can help you be your own heart health advocate. Some risk factors can be controlled, others can't. And the more risk factors you have, the more likely you are to suffer a heart attack or stroke. Read more about the risks below and be sure to talk to you doctor about the ones that apply to you, especially the risks that you can control or modify.

Gender

There are some similarities between men and women when it comes to heart disease. First, heart disease is the leading cause of death for both men and women in the United States and accounts for more deaths than the next four causes combined, including cancer, accidents, diabetes, and chronic lower respiratory disease. Second, heart disease is preventable for both genders.

However, it's important to know some key differences between men and women related to heart disease. One difference is that women tend to experience heart attacks about 10 years later in life than men. Because women have heart attacks at older ages than men, they are more likely to die from them. Heart attack symptoms can also be different for women than men. Chest pressure is common for both genders, but women may experience atypical symptoms such as shortness of breath, jaw pain, headaches, nausea, fatigue, and stomach upset. As a result, women often don't realize they're having a heart attack or may not be diagnosed properly at the hospital.

Regardless of gender, it's important to understand all heart attack symptoms and seek immediate medical attention if you suspect you are having a heart attack. Remember, the longer you wait to seek medical attention, the lower your chances for survival.

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Age

With each year, your risk of heart disease increases. That's because your arteries become thicker and stiffer as you age. In addition, the incidence of certain heart disease risk factors, such as high blood pressure, increases with age as well. However, people under 50 can be at an elevated risk of heart disease if they have one or more risk factors, including family history, smoking, obesity, or high blood pressure.

Heart Disease and Age Facts:

The average age of a man's first heart attack is 64.5, while a woman's is 70.3.
About 82% of people who die of coronary heart disease are age 65 or older.
12.9% of the U.S. population between the ages of 40 and 59 has coronary heart disease.

Race

Heart disease is the leading cause of death for African Americans, accounting for 33% of all deaths. Additionally, blacks are 1.5 times more likely to die from heart disease than whites. This is largely because African Americans are more likely to develop one or more heart disease risk factors in their lifetime, including high blood pressure and obesity. In fact, 40% of adult non-Hispanic blacks have high blood pressure and 63% of adult non-Hispanic black men are overweight or obese. Hispanics in general are 10% less likely to have coronary heart disease than non-Hispanic white adults and less likely to have high blood pressure than non-Hispanic blacks. Asian adults are less likely to be diagnosed with any type of heart disease than white adults and are less likely to have high blood pressure than blacks.

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Family History

If anyone in your immediate family, including siblings or parents, has had heart disease, you have a higher risk than if distant relatives such as grandparents or cousins had the disease. Depending on which family member has had heart disease and the type of disease they had, your risk could increase between two and nine times.

Since both lifestyle and genes could have played a role in your family member's development of heart disease, your current risk is not fully dependent on your family history. For example, if your family member had a heart attack due to controllable risk factors such as poor diet or smoking, your risk could be different if you live a healthy lifestyle.

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Previous Heart Attack or Ischemic Stroke

Stroke and heart disease share many of the same risk factors, including high cholesterol, smoking, high blood pressure, and physical inactivity. If you have had either a heart attack or ischemic stroke, the American Heart Association recommends the following steps to reduce your risk of a recurrent event:

Have your fasting lipid profile checked by your doctor.
Ask your doctor what physical activities you can do.
Know and maintain your ideal weight.
Have your blood pressure checked regularly.
See your doctor regularly and ask questions to get involved in your health.
Ask your doctor if you should take an aspirin regimen. Aspirin has been proven to reduce the risk of a second heart attack by 30% and reduce the risk of a second ischemic stroke by 22%.

High Blood Pressure

High blood pressure increases the heart's workload, causing it to enlarge and weaken over time. Because it has no symptoms and is a leading risk factor for heart attacks and stroke, it is often known as the "silent killer." About 69% of first-time heart attack victims have blood pressure higher than 140/90 mm Hg. Reducing your blood pressure by 12-13 points over four years can reduce your risk for coronary heart disease by 21%. Overall, it will reduce your risk of death from cardiovascular disease by 13%.

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Smoking

Smoking increases blood pressure, hardens the arteries, and increases the tendency for blood to clot, all of which increase your risk of a heart attack or stroke. In fact, smokers are two to four times more likely to develop heart disease and two to three times more likely to die from it than non-smokers.

Smoking is the single greatest preventable cause of premature death in the United States. So, if you currently smoke, quit! Within two years of quitting, the risk of coronary heart disease is substantially reduced. And over time, the risk returns to that of a non-smoker.

If you don't smoke now, don't start and limit your exposure to secondhand smoke as much as possible. Non-smokers exposed to secondhand smoke increase their risk of heart disease by 25-30%.

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Physical Inactivity

People who don't exercise regularly are 1.5 times more likely to develop heart disease. That's why exercise is such an important part of a heart healthy lifestyle. It can help lower your blood pressure, manage diabetes, control your weight, and increase your HDL (good) cholesterol levels. For maximum health benefit, you should perform moderate to vigorous intensity aerobic activity for 30 minutes on most days of the week. Some activities that are especially beneficial include brisk walking, jogging, running, swimming, and bicycling. But, you can also benefit by participating in lower intensity activities like walking for pleasure, gardening, and even playing recreational sports.

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Diabetes

Diabetes can cause the blood vessels to narrow or clog and seriously increase your risk of suffering a heart attack. Even when glucose levels are under control, diabetes increases the risk of heart attack or stroke by at least double. In fact, about 68% of deaths among people with diabetes are attributed to heart disease or stroke. If you have diabetes, it's important for you to monitor and control your other risk factors for heart disease. Improving your diet, losing weight, quitting smoking, exercising, and taking medications can make a big difference.

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High Cholesterol

When there's too much cholesterol in your blood, it builds up inside the walls of your arteries, causing them to harden. This restricts the flow of blood and oxygen to the heart. If not enough blood and oxygen can reach your heart, you may suffer chest pain. If blood is completely blocked from flowing to a portion of the heart, the result is a heart attack. If part of the buildup ruptures, it can cause a clot, leading to a heart attack or stroke.

If you have cholesterol over 200 mg/dL, you are at increased risk for heart disease. Unfortunately, 45% of all adults in the U.S. are at or above this level. If you are at 240 mg/dL, your risk of a heart attack doubles. That's why it's so important to get your cholesterol checked regularly and to incorporate a healthy diet and exercise plan to help keep your cholesterol within a healthy range.

Total Cholesterol	Measure
Less than 200	Desirable
200-239	Borderline high
240 and above	High

Low HDL Cholesterol

HDL cholesterol is known as "good" cholesterol. That's because it helps prevent the cholesterol from accumulating in your arteries and helps your body carry cholesterol into the liver where it is passed out of the body. So the higher your HDL levels, the better. If your HDL is less than 40 mg/dL, you are at high risk for developing heart disease. Conversely, HDL levels higher than 60 mg/dL are generally associated with a decreased risk of heart disease. You can increase your HDL levels by managing your weight, getting exercise, and eating a healthy diet.

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BMI & Waist Circumference

BMI stands for body mass index, which is a commonly used measure of your relative height and weight to help determine your risk of obesity-related diseases. Being overweight or obese is a strong independent risk factor for heart disease. However, the BMI measurement is not as reliable in determining risk for athletes and older adults.

Your waist circumference is a good indicator of your abdominal fat, which is another predictor for developing risk factors for heart disease. Incidences of risk factors are more likely for waist measurements of over 40 inches for men and over 35 inches for women.

To fully understand your risk, you should evaluate your BMI and waist circumference together. The chart below shows which combinations are associated with increased risk for obesity-related diseases like heart disease.

Disease Risk* Relative to Normal Weight and Waist Circumference

	BMI (kg/m²)	Men (40in or less) Women (35in or less)	Men (> 40in) Women (> 35 in)
Underweight	< 18.5
Normal	18.5 - 24.9
Overweight	25.9 - 29.9	Increased	High
Obesity	30.0 - 34.9	High	Very High
Obesity	35.5 - 39.9	Very High	Very High
Extreme Obesity	40.0+	Extremely High	Extremely High

* Disease risk for Type 2 diabetes, hypertension, and CVD

You can reduce your risk for heart disease with even a modest decrease in weight. But be sure to talk to your doctor before starting any diet or exercise program.

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