Could you be at risk for heart disease?
Many risk factors play a part in heart disease. Some of those risk factors are out of our control. Those risk factors are:
- Family history of heart disease
- Previous stroke or heart attack
But the good news is that a whopping 80% of heart disease and stroke events can be prevented by making changes in the risk factors we can control.
Those risk factors are:
- High blood pressure
- High blood cholesterol
- Lack of regular activity
- Obesity or overweight
Additional lifestyle factors that can contribute to heart disease, high blood pressure, and stroke include stress and lack of sleep.
Let's talk about each of these areas individually.
High Blood Pressure
In 2017, the American College of Cardiology and the American Heart Association released new blood pressure guidelines.
Blood pressure categories in the new guideline are:
- Normal: Less than 120/80 mm Hg;
- Elevated: Systolic between 120-129 and diastolic less than 80;
- Stage 1: Systolic between 130-139 or diastolic between 80-89;
- Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
- Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage. (Source: American College of Cardiology)
If you are in the elevated or Stage 1 category, your goal should be to make lifestyle changes now to control your blood pressure. If you are in stage 2, you should discuss with your physician if you need medication to help manage your blood pressure, or if you can control your blood pressure through lifestyle changes alone. In either category, lifestyle changes will be necessary to successfully manage your blood pressure.
Cigarette smoking is one of the major risk factors for heart disease - in fact, smoking increases your risk of cardiovascular disease by 2 to 4 times. Women who smoke have a 25% higher risk of heart disease than men who smoke (Source: American Heart Association).
The chemicals in tobacco smoke damage the cells in the body, including the heart and the blood vessels. Smoking increases the "bad" LDL cholesterol and decreases the "good" HDL cholesterol, and increases triglycerides, leading to more plaque formation in the artery walls. Smoking raises blood pressure and heart rate. Smoking also makes blood "sticky" and more likely to clot, blocking blood flow to the heart and brain. And the carbon monoxide in smoke decreases the amount of oxygen in your blood that can reach your heart, brain, and body.
No wonder smoking can make you feel so out of breath and tired!
Second-hand smoke is also dangerous - even breathing second-hand smoke for a few minutes can damage the lining of your blood vessels and cause your blood to become stickier.
If you smoke and have other risk factors for heart disease such as high cholesterol, obesity, or diabetes, your risk significantly increases.
The good news is that smoking is the most controllable risk factor of all, and quitting smoking can cut your risk of heart disease in half in just one year!
We can all make small changes in these areas that can really pay off in terms of decreasing our risk for heart disease, high blood pressure, peripheral arterial disease, and stroke.
High Blood Cholesterol and triglycerides
Cholesterol is a waxy substance that is used to help build cells. We actually need cholesterol in our bodies. Cholesterol is made in the liver, and the liver makes all the cholesterol our bodies need.
There are two types of cholesterol. We talk about these two types of cholesterol as being the "good" cholesterol and the "bad" cholesterol.
Low Density Lipoprotein, or LDL for short, is the bad type of cholesterol. This type of cholesterol builds up in the artery walls as part of plaque, contributing to hardening and thickening of the arteries, and increased risk of cardiovascular disease. The higher the level of LDL in your bloodstream, the higher your risk of heart disease is.
High Density Lipoprotein, or HDL for short, is the good type of cholesterol. Think of HDL cholesterol as the cleaner in your blood. It travels through the bloodstream scooping up LDL cholesterol and carrying it back to the liver to be broken down and eliminated from the body. Higher levels of HDL in the body protects against cardiovascular disease. Low levels of HDL in your bloodstream increase your risk of heart disease.
Triglycerides are another type of fat found in your blood. When you take in more calories than your body can use, your body converts those calories into triglycerides and stores them in your fat cells. When your body needs energy, your body releases the triglycerides into the bloodstream.
Some foods that we eat are associated with higher levels of bad LDL cholesterol and triglycerides in our blood, especially diets high in refined carbohydrates, saturated fats, and trans fats.
Women with high cholesterol or high triglycerides do not necessarily experience symptoms so it is important to be tested for your levels. The American Heart Association recommends that all adults over the age of 20 be tested for cholesterol and triglyceride levels every 4 to 6 years. This test is called a "lipid profile" or a "lipoprotein profile" and is a simple blood test.
lack of regular activity
It's no secret that our society as a whole has become less active over the past fifty years. With an increase in jobs that are sedentary and increased usage of computers for daily work, people are more likely to sit. In fact, we sit on average 12 hours a day, but are bodies evolved to move. When we sit for long hours, our bodies burn fewer calories, our blood glucose and triglycerides rise, and we are at increased risk for high blood pressure and heart disease, as well as other chronic conditions such as weight gain, stress, and type 2 diabetes.
Reducing the amount of time you spend sitting and regular physical exercise such as daily walking for 30 minutes is linked to a lower risk of cardiovascular disease and heart attack.
obesity or overweight
According to the American Heart Association, nearly 70% of Americans are either overweight or obese. Obesity and overweight relate to the amount of body fat you have based on your body mass index (BMI) measurement. Your BMI is your weight in kilograms divided by the square of your height in meters, and the CDC provides a calculator online if you want to find out your BMI. The BMI is not without its detractors, but it is a useful screening tool in most cases to determine if you are carrying around more body fat than you should.
If you have over 30 percent body fat, you are considered to be obese, and if your body fat percentage is higher than between 25 and 30 percent, then you are considered to be overweight.
Obesity and overweight increases the risks for heart disease and stroke because of their association with higher cholesterol, higher blood pressure, and higher risk for type 2 diabetes. According to the World Health Organization, obesity and overweight are associated with more deaths worldwide than underweight. Visceral fat, deep in the abdomen, has been associated with inflammation leading to insulin resistance and diabetes. And obesity and overweight have been linked to an enlarged left ventricle in the heart which can lead to heart failure.
Diabetes is one of the major risk factors for cardiovascular disease. Adults with diabetes are two to four times more likely to die of heart disease than adults who do not have diabetes. Diabetes is associated with high blood pressure, high cholesterol, and high triglycerides. Diabetes can contribute to earlier and more severe heart disease, less successful outcomes, and higher risk of death and disability. For people who have diabetes, the higher their blood sugar is, the higher risk they have of developing heart disease.
As you may have gathered as you read through these controllable risk factors, they are all interlinked. Each risk factor by itself increases your risk of cardiovascular disease; however, they rarely come by themselves. Most often, people have two or more risk factors, greatly increasing the chance they may be affected by heart disease, stroke, and/or peripheral vascular disease.
Overweight and obesity, diabetes, high blood pressure, high cholesterol, lack of physical activity, and smoking are all controllable risk factors, meaning we can take action to improve our odds. In the next series of articles, we will explore what we can do to improve each risk factor. When you improve one risk factor, you will improve all of them, and give yourself the best chance to increase your heart health.