When was the last time you considered your heart health? People don’t bother to think about heart health. But your heart pumps blood constantly without being put into it, at a rate of 100,000 beats a day. And it works so quietly, most people just think it’s healthy until it’s not.
Heart disease does not show signs in the early stages. It takes several years to develop and is caused by damage to the arteries, high blood pressure, buildup of plaque, and slowly deteriorating metabolic health. According to statistics, heart disease ranks as the top killer of both men and women in the United States. It kills more Americans every year than all cancers combined.
Research shows that up to 80 percent of heart attacks and strokes are preventable through lifestyle changes and managing heart disease risk factors.
What is Heart Disease?
Heart disease isn’t a single disease. It is a collective term used for a number of conditions that impact the structure and function of the heart and blood vessels.
The most common type is coronary artery disease. It is caused by cholesterol deposits in the coronary arteries, which bring blood to the heart. Over time, the arteries get narrower and firmer, and blood doesn’t flow freely to the heart muscle. A heart attack occurs when a plaque bursts and a clot develops.
There are other forms, such as heart failure, when the heart is unable to pump blood effectively. Arrhythmias are irregular heart rhythms. Valvular heart disease refers to a condition in which the heart valves are not functioning properly. Peripheral artery disease is atherosclerosis in the arteries of the legs and other areas outside the heart.
The heart disease risk factors outlined in this guide lead mainly to coronary artery disease and atherosclerosis, which are the leading causes of most heart attacks and strokes.
Uncontrollable Risk Factors for Heart Disease
Genetics and aging are among heart disease risk factors that you can’t change, but you need to be aware of how they affect you. Once you understand your fixed risks, you’ll be more proactive in managing what you can manage.
1. Your Age
As you age, your risk goes up. As time passes, your blood vessels become less elastic. The heart has to pump blood through tighter arteries, which causes it to have to work harder. Most of the time, a heart attack happens in individuals who are more than 65 years old, but the buildup of plaque begins many years before then.
Being old does not directly lead to heart disease. But it means that more time has elapsed for heart disease risk factors to build up and for changes in the arteries to occur.
2. Your Gender
Men are more likely to have a heart attack at a younger age. There is a significant jump in risk for women after their menopause. Estrogen helps to create a protective coating on blood vessels. Once estrogen levels drop, a woman’s cardiovascular disease risk factors rise rapidly to match or exceed those of men.
3. Your Family History
Your genetic risk is very high if your father or brother had a heart attack before age 55, or your mother or sister had one before age 65. You might have genes that cause your body to make more cholesterol and/or clot more easily.
A family history of heart disease does not guarantee that you will have heart disease. But it does mean that the modifiable risk factors are more important to you than to someone who does not have such a history.
4. Race and Ethnicity
Some racial and ethnic groups have much higher risk factors for cardiovascular disease. African Americans are more likely to have hypertension, high blood pressure, and worse cardiovascular outcomes than white Americans. Hispanic/Latino people, including a large percentage of the Texas population.
5. Pre-existing Conditions From Birth
Structural problems (congenital heart defects) of the cardiovascular system that are present at birth raise the risk of cardiovascular problems throughout life.
There are some genetic diseases that make people extremely vulnerable to heart disease, even when they don’t make any lifestyle changes, such as familial hypercholesterolemia, an inherited condition that leads to high LDL cholesterol levels from birth.
Heart Disease Risk Factors You Can Control
These are the cardiovascular disease risk factors you can change, the ones where your choices, habits, and medical management have direct and measurable impact on your cardiovascular health. This is where prevention of heart disease takes place.
1. High Blood Pressure
High blood pressure is when the blood pushes too hard against the walls of the arteries. This places a constant pressure on the smooth lining of the blood vessels which causes very small microscopic breaks. Cholesterol and plaque easily get stuck in these tears. Because you cannot feel high blood pressure, you must get it checked regularly.
Normal blood pressure is less than 120/80 mmHg. Elevated blood pressure is 120 to 129 systolic. Hypertension is a blood pressure of 130/80 mmHg and higher. A lot of people suffer from dangerously high blood pressure for years without realizing it. That’s why it’s important to monitor blood pressure at regular check-ups, including during annual physical exams.
2. Insulin Resistance and Blood Sugar
Most people believe that sugar is a diabetic issue but in reality it’s a big heart problem. Excessive refined carbohydrates cause your body to release insulin to help your body get rid of the sugar. As time goes on, your cells become unresponsive and develop insulin resistance.
A major study discovered that high insulin levels can directly affect the inner lining of the arteries and cause plaque buildup, even if blood sugar is technically normal.
3. Cholesterol Particle Size
Cholesterol isn’t a bad thing, and your body actually requires it. The issue is when certain cholesterol levels are imbalanced.
LDL cholesterol is also known as bad cholesterol because it accumulates in the lining of the arteries and directly causes plaque to build up. HDL is the good cholesterol; it eliminates LDL from the blood and delivers it to the liver for elimination. When triglyceride levels are high in the blood, it causes inflammation in your arteries.
Increased LDL, decreased HDL, and increased triglycerides are all important risk factors for cardiovascular disease. In high-risk people, the Mediterranean diet pattern has been found to reduce cardiovascular events by 30 percent.
4. Chronic Inflammation
Heart disease is an inflammatory disease. Plaque is an active, inflamed lump in your artery. When you have systemic inflammation, your body is fighting the plaque in your arteries. This means that the plaque is unstable and is likely to tear, causing a sudden heart attack to occur. A blood test called hs-CRP can be used to measure systemic inflammation.
5. Smoking and Alcohol
Smoking is the most preventable risk factor of heart disease. It has a direct effect on the wall of your blood vessels and increases clotting and stickiness of the blood.
Additionally, drinking too much alcohol can also cause high blood pressure and extra calories, which eventually lead to belly fat and insulin resistance.
6. Physical Inactivity
A sedentary lifestyle is an independent heart disease risk factor. This indicates that it increases your risk of cardiovascular disease even when the individual is not overweight, does not smoke, and has no other apparent risk factors.
Exercise helps to lower blood pressure, increase HDL cholesterol, increase insulin sensitivity, decrease inflammation, help maintain a healthy weight, and strengthen the heart muscle itself. Compared to sedentary lifestyles, regular aerobic exercise lowers your risk of heart disease by 35%.
7. Excess Body Weight/Obesity
Excess fat, especially around the belly, raises your risk of heart disease in several ways. Obesity leads to raised blood pressure, raised LDL, reduced HDL, insulin resistance and pre-diabetes, chronic low-grade inflammation, and causes direct strain on your heart muscle.
A waist circumference of more than 40 inches in men and more than 35 inches in women is associated with increased heart disease risk factors regardless of body weight or BMI.
8. Poor Diet and Nutrition
Diet is one of the most modifiable cardiovascular disease risk factors. One of the strongest weapons in heart disease prevention. Typically, the Standard American Diet includes processed foods, refined carbohydrates, added sugars, and industrial seed oils, promoting all the major cardiovascular risk factors.
The Mediterranean diet pattern is best known for protecting your heart health. Research in high-risk individuals indicated that the Mediterranean diet combined with olive oil or nuts reduces cardiovascular events by about 30 percent, compared to a low-fat diet.
9. Poor Sleep
Poor sleep (less than 7 hours per night) is linked with increased levels of hypertension, obesity, diabetes, and inflammatory markers. Having poor sleep quality, whether due to untreated Obstructive sleep apnea, contributes to high blood pressure and increased cardiovascular risk.
Obstructive sleep apnea is where breathing repeatedly stops during sleep. It occurs in many people who already have heart disease and is a leading cause of high blood pressure that cannot be controlled.
Heart Disease Prevention
Preventing heart disease is an ongoing, lifelong process that involves taking charge of the risk factors you can control and managing those you cannot.
The following are the top heart disease prevention actions, based on the evidence:
Ask to get an advanced cholesterol test: Don’t settle for a basic lipid panel. Request from your doctor an NMR LipoProfile, or advanced lipid panel to assess the size and quantity of your LDL particles.
Control blood pressure. It is the single most important modifiable cardiovascular disease risk factor. Your target should be below 130/80 mmHg.
Control blood sugar and insulin resistance. It is better to be at a target blood sugar level when you are in the pre-diabetes stage, where the damage is already being done.
Get seven to nine hours of regular sleep. If you experience any symptoms, screen for sleep apnea.
Eliminate refined carbohydrates: Avoid white bread, pasta, sugary drinks, and processed snacks. Instead, use healthy proteins, healthy fats, and fiber-rich vegetables to maintain a steady blood sugar.
30 minutes of exercise every day: Blood vessels require exercise for flexibility. Brisk walking, biking, or swimming helps to reduce blood pressure and inflammation and improves the way your cells respond to insulin.
Stick to an omega-3 diet: Wild-caught salmon, sardines, and anchovies help reduce systemic inflammation and chances of plaque rupture. If you do not consume fish, consider a good Omega-3 supplement.
Quit smoking entirely: Your risk of heart disease becomes half as likely within a year of quitting smoking. Your blood vessels will start to heal within minutes.
Take prescribed medications. Medications such as statins, antihypertensives, and drugs for blood sugar do work if they are used regularly.
Control stress: High levels of cortisol due to chronic stress can increase blood pressure and inflammation. Do deep breathing, yoga, or simply get away from the screens to relax the nervous system.
Bottom Line
Risk factors for heart disease don’t work in isolation. They influence and reinforce one another.
Someone who has high blood pressure, diabetes, and smokes has a very high cardiovascular risk compared to those with individual factors. Risk factors do not add but multiply. That’s why it’s more useful to have a thorough cardiovascular risk assessment rather than a single number.
At Kairos Integrative Care, Lola, one of our integrative nurse practitioners, will review your full cardiac risk profile, which includes blood markers such as high-sensitivity CRP, homocysteine, lipoprotein(a) (for eligible patients) and determine a plan that will help to safeguard your heart for the long-term.
We proudly serve patients in Houston, Sugar Land, and nearby areas (77046 & 77478) and accept most major insurance plans, including Aetna, Cigna, BCBS, UnitedHealthcare, Tricare, and more.
