9 heart disease risk factors you can control

When it comes to heart disease, there are some risk factors outside of your control. Fortunately, you can manage 90% of them. Some changes are about lifestyle and others are about getting medical care for the health conditions that can increase your risk.

What you can’t control

If you have one or more of these uncontrollable risk factors, it’s even more important to tackle the ones you can control:

• Older age (over age 45 for men, over age 55 for women)
• Sex (men are at higher risk than women until women reach menopause)
• Family history of a parent or sibling with premature coronary disease (men younger than 55 years old, women younger than 65 years old)

What you can control

Risk factors can add up. The sooner you take action to reduce them, the better. But remember, it’s never too late to improve your overall health.

In order of importance, here are nine controllable heart attack risk factors and what you can do to help them:

1. Cholesterol levels: Get yours under control with diet, exercise and medication, if needed. Every 1% reduction in LDL (“bad” cholesterol) reduces risk by 1%. Every 1% increase in HDL (“good” cholesterol) reduces risk 2 to 4%. Check with your health care provider to see if you should have a cholesterol blood test.
2. Smoking: Stop. Smoking one to five cigarettes a day increases the risk of heart attack by 38%, and 40 cigarettes a day by a whopping 900%. If you stop smoking, the risk decreases over time, and after three to five years, your risk is the same as a nonsmoker’s. Here’s a place to help you stop smoking.
3. Stress: Identify and reduce sources of stress in your life, including depression, anger and anxiety.
4. Diabetes: Find out if you have the condition and take action. Twenty-nine million people in the U.S. have diabetes and many don’t know it. Risk of heart disease increases two to four times when you have diabetes. New screening recommendations are being developed for when to begin testing, but if you have any signs of diabetes, talk to your health care provider.
5. High blood pressure: If you have the condition, treat it. One in three adults in the U.S. has hypertension, and only one-third is adequately controlling it. Everyone over age 18 should be screened for high blood pressure, according to the U.S. Preventive Services Task Force.
6. Obesity: Check your waist measurement and get your weight under control with diet and exercise. Abdominal obesity is a risk factor for heart attack. Waist measurement is a better predictor of risk than overall weight. Fat around the belly can also lead to metabolic syndrome – a combination of hypertension, high blood sugar and cholesterol problems that can double your risk of heart disease. If you are a man and your waist measurement is between 37.1 and 39.9 inches, you fall in the intermediate risk category. Forty inches and above puts you in the high risk category. For women, 31.6 to 34.9 inches puts you in the intermediate risk category. 35 inches and above is considered high risk. If you fall into either of these categories, you should talk to your health care provider.
7. Diet: Eat more fruits and vegetables. Eating less than the recommended four to five servings a day increases your risk. Get tips for eating more fruits and vegetables.
8. Exercise: Do it moderately (such as brisk walking) or strenuously (such as jogging), because lack of exercise is a risk factor.
9. Alcohol intake: It’s important to keep in mind that drinking too much can increase the risk of heart disease. Alcohol intake is something you should discuss with your health care provider.

The nine risk factors listed in this article are from the landmark study INTER-HEART: A global study of risk factors for acute myocardial infarction, published in The Lancet.

Dr. Robert Panther is a board-certified cardiologist at Aurora Health Care.

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