Before getting into the risk factors that you can work to reduce, let’s cover the few that you can’t do anything about.
- AgeThis one’s pretty simple. The older you get, the likelier you are to develop heart disease. In fact, more than 80% people who die from heart disease are older than 65, because the heart tends to grow weaker as you move into your golden years.
- GenderWhile heart disease may be the number cause of death for both men and women, it tends to develop later in women. Why? Experts believe that hormones such as estrogen, which women have in much greater abundance than men, may provide some protection against heart disease. However, those hormones decline during menopause. By age 65, a woman’s odds of heart disease match those of a man of similar age.
- Genetics and Family HistoryIt’s true: Heart disease tends to run in the family. Did your dad develop heart disease before the age of 55 or your mom before she turned 65? If so, your own risk is higher than normal because one or both of your parents may have passed along a genetic ingredient in the recipe for heart disease.
- Early MenopauseAccording to a 2019 study in The Lancet Public Health, going through “The Change” before age 40 increases risk of heart diseases like CAD, heart failure, arrhythmia, and heart valve disease among the approximately 10% of women who experience early menopause. It remains unclear why, though a decline in estrogen may be a factor.
These four factors make up only part of the complex swirl of possible causes of heart disease. You can’t change your genes or age, but don’t despair. Instead, use that knowledge as motivation to address the risks you can change. These include:
- High Blood Pressure (HBP)Having hypertension, a.k.a. high blood pressure, is a red flag for other forms of heart disease, increasing your risk for CAD, heart attack, heart failure, and stroke. HBP results from plaque buildups in your arteries, thickening them and reducing blood flow.
- High Cholesterol Unhealthy cholesterol levels contribute to blockages in your blood vessels that can eventually lead to heart attack. Your body produces cholesterol naturally—we all need it to make important hormones and absorb Vitamin D—but it’s easy to get more than you need by eating foods that are high in saturated and trans fats (like red meat, eggs, and dairy). There are two types of cholesterol: low-density lipoprotein (LDL, or “bad” cholesterol) and high-density lipoprotein (HDL, or “good” cholesterol). LDL contributes to plaque buildups in your arteries. HDL protects against heart disease by transporting excess LDL to the liver to be processed as waste.
- Obesity Being obese forces your heart to work harder because your body requires more of the oxygen and nutrients that your blood supplies. This leads to high blood pressure. Excess weight also increases risk for heart disease, or makes them worse if you already have them, including high cholesterol and type 2 diabetes. Obesity has been linked to heart failure and CAD.
- Diabetes Type 1 and Type 2 diabetes, both limit your body’s ability to maintain a healthy level of glucose, a form of sugar that your body produces and uses for energy. Uncontrolled blood glucose damages your blood vessels and the nerves that control your heart, eventually leading to heart disease. In fact, as many as three out of four people with diabetes die from some form of heart disease.
- Physical Inactivity The couch potato life not only directly puts you at higher risk of heart disease, it opens the door to other risk factors like HBP, high cholesterol, and type 2 diabetes.
- Smoking or Vaping Lighting up does more than damage your lungs. It accelerates your heartbeat while narrowing your blood vessels and contributes to the formation of blood clots that can lead to heart attack or stroke. Less is known about the risks of vaping, but many of the chemicals involved have been linked to heart disease.
- Stress Pressure and tension can elevate your heart rate and blood pressure—and too much eventually damages your blood vessels. Stress also can lead some people to abuse alcohol and eat too much, as well as smoke. (And, remember, any amount of smoking or vaping is too much.)
- Drinking Alcohol Too much alcohol also can harm your heart. Excessive drinking ups your blood pressure and heart rate as well as your triglycerides, a type of fat linked to heart disease, because they may contribute to hardening and thickening of your arteries.
- Sleep Apnea This sleep disorder causes breathing trouble as you sleep, reducing the amount of oxygen to your blood and raising your blood pressure. Together, these can weaken your heart and put you at heightened risk chronic HBP, atherosclerosis, arrhythmia, and heart failure.
Lifestyle Changes for Heart Disease
You know the drill: Eat better, exercise, lose weight, and quit smoking. We know—easier said than done, but so worth it. That’s because the everyday choices you make today can halt the progression of heart disease tomorrow—leading to a healthier and likely longer life.
Let’s walk through the basic lifestyle choices you can implement to help make happen:
Lower your cholesterol. Cut back and avoid plaque buildup by swapping red meats for lean poultry and fish, consuming fibrous veggies and whole grains, and limiting (or even avoiding altogether) the saturated and trans fats found in fried and processed foods. Additional ways to get your cholesterol in check? Lose a few pounds, exercise more, and if that still isn’t enough, talk to your doctor about medication.
Lower your blood pressure. The same lifestyle changes that help bring down unhealthy cholesterol levels can also help manage your blood pressure, often in tandem with one of the various blood-pressure lowering medications available.
Do everything you can do to quit smoking. We know—it’s really hard. But we also know that smoking causes lung cancer and seriously hurts your heart. Plus, a nicotine or vaping habit damages your arteries, ups your risk of dangerous blood clots, raises your heart rate, and contributes to HBP and high cholesterol. So make quitting smoking your top priority. Going cold turkey works for some, while others have to slowly wean themselves from lighting up with the help of nicotine patches and other aids, including medications and support groups. Your doctor can walk you through your options, so have that conversation as soon as possible. Visit the American Heart Association to learn more about how to quit.
Get moving. Physical activity of just about any kind beats the couch potato life. That’s because exercise strengthens your heart muscle so that it can do its job more efficiently. It helps lower your cholesterol, blood pressure, and, if you have diabetes, blood sugar levels, too. An added benefit? Breaking a sweat leads to a slimmer, fitter you. Exactly how much exercise you can do depends on your current state of health. Talk to your doctor, who might advise you to start slow and gradually build up endurance. If a walk around the block is your limit, that’s OK—lace up your shoes and get going. Tomorrow, you’ll likely go even further. If you’re recovering from a serious heart issue, cardiac rehabilitation programs can get you started safely.
Eat less, and eat better. Changing how you stock your fridge and pantry is often connected to lowering your cholesterol levels—so follow the same advice: Try high-fiber foods, lean proteins, vegetables, and whole grains, and skip overly processed junk food and fried fare. If you need guidance, consider enlisting a registered dietitian/nutritionist to outline a healthy eating plan for you—and provide strategies to stick with your plan to reach your goals.
Lose weight. It can’t be overstated: Being overweight or obese is hard on your heart. Your body mass index (BMI) measures body fat based on your weight in relation to your height. A BMI of 25 to 29 is considered overweight. You are considered obese if your BMI is 30 or higher. While use of BMI has been questioned by researchers as of late, partly because even the super-fit and muscle-bound may technically have “unhealthy” BMI numbers, some doctors still use it as a guide. More and more, however, physicians are concerned when excess body fat is concentrated around your waist, likely because a lot of belly fat can cause chronic inflammation, a risk factor for heart disease. The result? Your blood pressure and cholesterol go up and stay up—and you want neither to happen.
If your heart health is at risk, and you find losing weight slowly and safely to be an impossible task, consider securing the services of a registered dietician, or ask your doctor if gastric bypass surgery is right for you.
Manage your diabetes. Diabetes and heart disease are a deadly combination. People with diabetes have as much as four times the risk of dying from heart disease than someone without this condition. This is in part due to the effect diabetes has on your blood vessels, and also because many other health conditions often accompany diabetes, including HBP, high cholesterol levels, and obesity. Controlling your diabetes through medication and lifestyle changes benefits your heart.
Consider medications for heart disease, if you need them. Many drugs treat coronary artery disease, or CAD. (Remember, CAD occurs when your arteries become clogged with plaque, restricting the flow of blood.) Here are the more commonly prescribed types of medication for CAD and other heart ailments:
- Cholesterol lowering drugs, like statins, lower the amount of plaque-forming materials in your bloodstream.
- Anti-coagulants (a.k.a. blood thinners) help prevent the formation of dangerous blood clots in your arteries, where they would block the flow of blood.
- Anti-platelets, including aspirin, also help prevent clots from forming.
- Beta blockers both lower your blood pressure and reduce your heart rate. That, in turn, causes your heart’s need for oxygen to drop.
- Calcium channel blockers are often used in tandem with beta blockers. They lower blood pressure and heart rate while relaxing arteries in order to boost blood flow to the heart.
- Nitroglycerin eases chest pain, or angina, caused by restricted blood flow to the heart. It works by allowing more oxygen-rich blood into your heart.
- ACE inhibitors lower blood pressure and ease the heart’s workload, which helps prevent further weakening of the heart.
Heart failure as well as heart valve disease are both treated with some of the same medications, such as diuretics, which help rid your body of excess fluids. In heart failure, for example, fluid can build up in your lungs and make it difficult to breathe. You may also be prescribed digitalis, a type of drug that strengthens the contractions of your heart and lowers your heart rate. Beta blockers and anti-clotting medications are also among the drugs that may be used to treat both conditions.
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Health and Wellness Associates
REVIEWED BY DR JEROME WAGNER