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How healthy is my heart?

Risk Factors

Knowing your risk for cardiovascular disease is an important part of staying healthy. Risk Factors are characteristics that increase the likelihood of developing disease. Some risk factors can be changed or treated, such as diet and exercise. But others, such as age, gender, and ethnicity, cannot be changed.

The risk factors that you can change are very important. You can prevent heart disease or slow its progression.

Click on the links below to learn more about improving your cardiovascular risk factors.

Major risk factors of cardiovascular disease that you can change:

Major risk factors of cardiovascular disease that you can't change:

Other risk indicators (emerging risk factors):

Don't be discouraged if you have several risk factors. Work with your health care provider to decide what you need to change first. Some of these risk factors took years to develop, so don't expect change too quickly. Set reasonable goals. Be persistent and don't give up! You may encourage others to become heart healthy!

Discuss your cardiovascular risk with your health care provider. If you don't have a primary care provider, we can help you find one.
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Tobacco Use
Tobacco use significantly raises your risk for cardiovascular disease. If you smoke, your risk of heart attack is more than twice the risk of a nonsmoker. Cigarette smokers who have a heart attack are more likely to experience sudden death from a heart attack than nonsmokers. Smoking, chewing tobacco, snuff, cigars and pipe tobacco have all been shown to increase the risk of heart disease.

Why is it bad for me?
Tobacco use has many negative effects on the heart and vascular system. When nicotine enters the circulation it causes arteries to constrict and causes blood pressure and heart rate to increase. The toxic byproducts have also been linked to increased fatty acids in the blood.

Cigarette smoke contains high levels of carbon monoxide. Carbon monoxide adheres to the red blood cells that normally carry oxygen, decreasing the amount of oxygen that is delivered to the heart and other parts of the body. The heart muscle may not get enough oxygen. The heart then has to work harder to try to deliver adequate levels of oxygen.

What can I do to quit?
After only one year of not using tobacco, your risk of cardiovascular disease is reduced by one-half! After 15
years of quitting, your cardiovascular risk returns to levels of someone who never smoked.

Tobacco is an addictive drug, and many people struggle to stop on their own. Many resources are available. Talk to your health care provider about tobacco cessation methods, medications and programs. Make a plan to quit and stick to it!


TTY 1-800-332-8615

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Secondhand Smoke
Secondhand smoke can be a serious health hazard for nonsmokers. Secondhand smoke has been shown to contain over 40 known carcinogens. Secondhand exposure for as little as five minutes causes changes in blood vessels and blood flow.

Exposure to tobacco smoke increases the risk for blood to clot and can damage the lining of the arteries that supply the heart and other organs. Nonsmokers who have other factors such as high blood pressure and high cholesterol increase their risk of heart disease when exposed to secondhand smoke.

Limit your exposure and encourage loved ones to quit smoking.


TTY 1-800-332-8615
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High Lipid Levels

Cholesterol is a fat found in the bloodstream and in the cells of your body. Cholesterol is an important part of your healthy body, but increased levels can be a major risk for coronary heart disease, which can lead to a heart attack.

Lipoproteins are the carriers that transport cholesterol and other fats to the body's cells. Low density lipoproteins (LDL) are generally referred to as "bad" cholesterol. A high level of LDL cholesterol can predispose you to heart disease. When you have too much LDL, it can slowly build up on the walls of the arteries, forming plaques. Plaques are deposits that can block arteries, leading to heart attack or stroke. High density lipoprotein (HDL) is generally referred to as the "good" cholesterol because high levels have been shown to protect against heart attack, while a low HDL level may put you at more risk for heart disease.

Some cholesterol is produced naturally by your body. But it is also found in the foods we eat, such as animal meats, seafood and dairy products. Foods such as fruits, vegetables, grains, nuts and seeds do not have cholesterol.

The American Heart Association recommends that you limit the amount of cholesterol consumed to less than 300 milligrams. People with high cholesterol may need to further limit cholesterol intake.

Triglycerides are another form of fat in your blood, and high levels may increase your risk of heart disease. Triglycerides are produced from excess calories, excess sugar and alcohol.

To lower triglycerides maintain a healthy body weight, increase physical activity, decrease or avoid alcohol intake, and decrease the amount of carbohydrates and high sugar foods that you eat.

Know your levels! Discuss your levels with you primary health provider.
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High Blood Pressure
High blood pressure is a persistent increased blood pressure in your arteries. Over time, high blood pressure can cause your arteries to become thick, scarred, and less elastic, causing your heart to work harder to pump blood through your body.

You are considered to have high blood pressure when you have a persistent systolic pressure (top number) of 140 mmHg or higher or a diastolic pressure (bottom number) of 90 mmHg or higher.

High blood pressure can occur in anyone, but it is more prevalent in African Americans, middle-aged and elderly people, obese people, heavy drinkers, women taking birth control pills, diabetics, and people with gout or kidney disease.

How can I reduce my blood pressure?

Being overweight puts you at increased risk for high blood pressure. Even small weight loss can help reduce blood pressure.

Regular activity helps control weight, lower blood pressure and reduces your risk of a heart attack.

Heavy salt (sodium) intake can increase your blood pressure. If you are diagnosed with high blood pressure, reducing your salt intake may help to lower your blood pressure. Be wary of frozen or processed foods, which can contain large amounts of sodium. Be sure to read your food labels!
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Physical Inactivity
A sedentary lifestyle can greatly raise your risk for heart disease. Physical inactivity can also contribute to obesity, high blood pressure and low LDL cholesterol.

Regular exercise can significantly reduce your risk for cardiovascular disease. Even small increases in physical activity can be beneficial if done regularly over a long period of time.

Even people who start to exercise after a heart attack can benefit and have been shown to have better survival rates. A cardiac rehabilitation program is a monitored exercise program to improve cardiac health.

Some physical activity is recommended at least 30 minutes five times per week. Activity can be split up into three 10-minute sessions per day if necessary. Activity does not need to be vigorous to be beneficial. Evidence shows that even low to moderate intensity activities, such as walking, gardening, household chores, can benefit your cardiovascular health if done consistently.

Physical activity also has other health benefits, such as reducing depression, building healthy bones, improving muscle and joint mobility, and reducing the risk of colon cancer.

Start slow and don't overdo it. Check with your health care provider before starting any new exercise programs.
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Overweight/ Obesity
Obesity in itself can raise your risk for heart disease. But it also increases your risk for high cholesterol and triglycerides, lowers HDL "good" cholesterol, raises blood pressure and increases your risk for diabetes. It also causes gallstones and can worsen joint problems.

Overweight is defined as a Body Mass Index (BMI) between 25 and 30. A BMI over 30 is considered obese. The BMI is used as a general tool to identify ideal body weights, but it can vary between individuals based on muscle mass and other factors. Ask your health care provider to help calculate your BMI and to identify the ideal BMI for you.

Larger waist measurements have been shown to place you at higher risk for cardiovascular disease. Waist measurements of more than 35 inches for women and 40 inches for men increase your cardiac risk.

Even small amounts of weight loss can be beneficial in reducing your cardiovascular risk. If you are overweight, losing just 10 percent of your current weight can reduce your risk of cardiovascular disease and improve your overall health.

Check with your health care provider to set a target for your ideal weight.


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Metabolic Syndrome
Metabolic syndrome is a condition in which you have at least three of the following characteristics, which greatly increases your risk for cardiovascular disease:

  • High blood pressure
  • High blood sugar
  • High triglycerides
  • Low HDL cholesterol
  • Increased waist measurement
    • More than 35 inches for women
    • More than 40 inches for men

Any of these characteristics in itself can raise your risk of heart disease. But in combination, the risks to your cardiovascular health are multiplied.

Can it be treated?
The treatment for metabolic syndrome is aimed at treating the disorders that make up the metabolic syndrome. Discuss your risk with your health care provider. You may need to take medications along with making lifestyle changes.
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Although there is nothing you can do to change your age as a risk factor for cardiovascular disease, you should be aware that the risk increases as your age increases. Women over the age of 65 and men over the age of 55 are at the greatest risk.
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Cardiovascular disease is the single largest killer of adult Americans. The risk is increased for men at a younger age than women. It is thought that estrogen has a mild protective effect. However, after menopause, the levels decrease and the risk for women rises.
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Family History
Heart disease does indeed run in families. This could be partially genetic and partially because of like lifestyle factors.

If you have a family history of heart disease, discuss your risk and ways to reduce your risk with your health care provider.
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While heart disease can strike all races and socioeconomic levels, some groups have a higher risk. African Americans are at higher risk for uncontrolled blood pressure and heart disease than Caucasians. Heart disease risk is also greater for Mexican Americans, American Indians and native Hawaiians.
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Evidence supports stress as a risk factor for cardiovascular disease. While stress by itself may not lead to heart disease, it can lead to other unhealthy behaviors such as smoking, inactivity, and unhealthy eating habits.

Coping strategies can help you reduce stress, including physical activity, meditation, limiting caffeine, avoiding stressful situations and participating in enjoyable activities.
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Excess alcohol can lead to increased levels of triglycerides, increased blood pressure, and can cause heart failure. Constant excessive drinking and binge drinking can also increase your risk for stroke.

Alcohol intake should be limited to a moderate amount. A moderate amount is considered to be 1-2 drinks per day for men and 1 drink per day for women. One drink is equal to 1 ounce of liquor, 4-5 ounces of wine or 12 ounces of beer.

If you drink, moderation is the key to reducing your cardiovascular risk.

If you have questions regarding your alcohol use, discuss with your health care provider.
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Depression can increase your risk factors for heart disease. It has also been shown to delay your recovery after a heart attack.

Depression can increase your cardiovascular risk by changing your memory, attitude and well-being. It can affect your thinking, eating, sleeping and health behaviors.

Talk to your health care provider about symptoms and treatment options if you think you have depression.
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Social support
After a heart attack, people who have strong support systems recover quicker and have better overall outcomes than those without support.

Social support comes in many forms: supportive significant other, children, friends and pets. Other sources of support can include support groups and online social networks.

Involve your support person(s) in your journey to a healthier you. Everyone needs a little encouragement now and then.
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Homocystine is a substance found naturally in the blood. It is used by your body to build tissue. But high levels of homocystine have been shown to increase your risk of heart disease. Although the exact reason is not known, high homocystine levels can scar and thicken the lining of your arteries, which in turn leads to plaque formation.

Increased homocystine combined with tobacco use and high blood pressure can further raise your risk for heart attack or stroke.
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Lipoprotein (a)
Lipoprotein (a) is a substance found naturally in the blood that helps in the clotting process. High levels of lipoprotein (a) can increase your risk for forming clots, which increases your risk for heart attack or stroke.
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C-reactive protein (CRP)
C-reactive protein in your blood is an indicator of inflammation. Studies are showing that high CRP levels are related to a higher risk of heart attack or stroke. CRP may also be an indicator to help identify those people who have cardiovascular disease.

For more information on CRP or other emerging risk factors, discuss with your primary health care provider.
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