Understand Your Risks to Prevent a Heart Attack
Quick Facts
- It’s important to know your risk factors for a heart attack.
- You can control some risk factors, such as tobacco use, physical activity, blood pressure, blood cholesterol and blood glucose.
- Work with your health care team to manage your risk of heart disease.
Knowledge is power. If you understand the risks for heart attack, you can take steps to improve your health.
Risk factors are traits and lifestyle habits that can increase your chance of having a heart attack. So, it’s important to know them. You can change some risk factors, some you can’t.
The first step is to talk to your health care professional. They can help you reduce, control or prevent as many risk factors as you can. They may suggest healthy changes to your daily habits, prescribe medication or both.
If you don’t have a primary care physician, you may be able to see someone at a clinic in your community.
Know your risk
Your health care team will review your medical and family history. They will also want to know:
- Whether you’ve ever had a heart attack or stroke or blockages in the arteries of your heart, neck or legs
- Your risk factors, including:
- Increasing age
- Gender
- Diabetes
- High blood pressure
- High cholesterol
- Being overweight or obese
- Tobacco use
- About your lifestyle. They will ask about your diet and physical activity levels, alcohol intake and medications or supplements you’ve been taking.
Your health care professional may use a risk calculator to estimate your chance of a heart attack.
If you’re between 40 and 75 years old and have never had a heart attack, ask to have your risk of a cardiovascular event in the next 10 years assessed.
Risk factors for heart attack include:
- Smoking
- High blood pressure
- High cholesterol
- Diabetes
- Overweight or obesity
- Family history of early atherosclerotic cardiovascular disease
- Metabolic syndrome
- Chronic kidney disease
- Chronic inflammatory conditions such as rheumatoid arthritis, psoriasis and HIV/AIDS
- History of preeclampsia or early menopause
- High-risk ethnicity such as South Asian ancestry
- Higher than normal triglycerides, ankle-brachial index and other lab tests
Can risk factors be changed?
Some risk factors can be changed and some can’t. You may be born with certain risk factors that can’t be changed. Since you can’t do anything about these risk factors, it’s even more important to manage those risk factors that can be changed.
Risk factors that can't be changed
Even after women reach menopause, at which time women’s death rate from heart disease increases, it has been noted that women’s risk for heart attack is less than that of men.
Children of parents with heart disease are more likely to develop heart disease.
Black people have disproportionately high rates of more severe high blood pressure. It also develops earlier in life. Heart disease risk is also higher among Mexican American, Native American, Native Hawaiian and some Asian American people. This may be partly due to higher rates of obesity and diabetes.
Historical and systemic factors play a major role in these statistics. Among them are adverse social drivers of health, the conditions in which a person is born and lives. The drivers include lack of access to health care and healthy foods and other societal issues.
Risk factors you can change
Tobacco use is a major risk factor for heart attack and stroke. Nicotine, a chemical in cigarettes and e-cigarettes, causes your heart to beat faster and blood pressure to rise. Smoking makes clots more likely to form. It can also promote the buildup of plaque in arteries.
Exposure to other people’s smoke also increases the risk of heart disease even for nonsmokers.
If you smoke, get help to quit. Many effective tools are available. These include behavior change programs, nicotine replacement therapy and other medications.
Learn about smoking and cardiovascular disease
If you’re over age 20, you should have your cholesterol checked every four to six years as part of a cardiovascular risk assessment. You may need to check it more often if:
- Certain factors put you at higher risk
- You already have heart disease
Your health care professional will test your blood to measure your cholesterol levels. This may be a fasting or non-fasting lipoprotein profile. It assesses several types of fat in the blood. The test gives you four results:
- Total cholesterol
- LDL (bad) cholesterol
- HDL (good) cholesterol
- Triglycerides (blood fats)
Learn more about managing your cholesterol.
High blood pressure increases the heart’s workload, causing the heart muscle to thicken and become stiffer. This stiffening of the heart muscle is not normal and causes the heart to function abnormally. It also increases your risk of stroke, heart attack, kidney failure and congestive heart failure.
The risk of heart attack or stroke increases even more when high blood pressure is present alongside:
- Obesity
- Smoking
- High blood cholesterol
- Diabetes
Normal blood pressure is below 120/80 mm Hg.
Learn more about managing your blood pressure.
An inactive lifestyle is a risk factor for coronary heart disease. Regular moderate to vigorous physical activities can reduce your risk. Physical activity can help control blood cholesterol, diabetes and obesity. It can also help lower blood pressure in some people.
Adults should aim for at least:
- 150 minutes a week of moderate-intensity physical activity such as brisk walking
or
- 75 minutes of vigorous-intensity physical activity such as jogging
or
- A combination of the two
Learn more about getting active.
People who have too much body fat, especially at the waist, are more likely to develop heart disease and stroke, even if they have no other risk factors.
Overweight and obese adults with risk factors for cardiovascular disease such as high blood pressure, high cholesterol or high blood sugar should make lifestyle changes to lose weight.
Many people may have trouble losing weight. But for those above a healthy weight, a sustained weight loss of 3% to 5% may lead to significant reductions in some risk factors. Greater sustained weight losses can improve blood pressure, cholesterol and blood glucose.
Learn more about managing your weight.
Diabetes greatly increases your risk of developing cardiovascular disease.
Even when blood sugar levels are under control, diabetes increases the risk of heart disease and stroke. The risks are even greater if blood sugar is not controlled.
If you have diabetes, regular checkups are critical to help keep your blood sugar under control. Work with your health care team to develop healthy eating habits, control your weight and get regular physical activity. You also may need mediciations to help control your blood sugar or insulin levels.
Learn more about managing your diabetes.
Other factors to consider
Everyone feels stress, but people react differently. Individual response to stress may be a contributing factor for heart attacks.
Some research has found a relationship between coronary heart disease risk and stress in a person’s life, along with their health behaviors and socioeconomic status. These factors may affect existing risk factors.
Over time, unhealthy responses to stress may create health problems. For example, people under stress may overeat, start smoking or smoke more than they otherwise would.
Find healthy ways to deal with your stress and make time for things you enjoy.
Getting a good night’s sleep regularly is vital to cardiovascular health. Good sleep benefits your whole body, including your heart and brain. It can improve mood, memory and reasoning.
Your amount and quality of sleep can influence your eating habits, mood, memory, internal organs and more. Too much or too little can be harmful.
Adults should aim for an average 7-9 hours a night. Babies and kids need more depending on their age.
Drinking too much alcohol can raise blood pressure and increase your risk for cardiomyopathy, stroke, cancer and other diseases. It can also contribute to high triglycerides and cause irregular heartbeats. Excess alcohol consumption also contributes to obesity, alcoholism, suicide and accidents.
If you don’t drink, don’t start. If you drink alcohol, limit yourself to no more than two drinks per day for men or one drink per day for women. The following count as one alcoholic drink equivalent:
- 12 fluid ounces of regular beer (5% alcohol)
- 5 fluid ounces of wine (12% alcohol)
- 1.5 fluid ounces of 80-proof distilled spirits (40% alcohol)
A healthy diet is one of the best ways to fight cardiovascular disease. What you eat can affect other controllable risk factors, such as cholesterol, blood pressure, diabetes and weight.
Choose nutrient-rich foods, which have vitamins, minerals, fiber and other nutrients, but are lower in calories than nutrient-poor foods.
- Eat more vegetables, fruits and whole grains.
- Also include low-fat dairy products, plant-based proteins, fish, poultry, legumes, nuts and nontropical vegetable oils.
- Limit your intake of saturated and trans fats, sodium, sweets, sugar-sweetened beverages and red meats.
To maintain a healthy weight, you need to use up as many calories as you consume through normal metabolism and physical activity.
Learn more about healthy eating.
Be a team player and ask for support
A heart attack can happen at any age. You’re never too young to start living healthier. If you’re over 40, or if you have multiple risk factors, work closely with your health care team to address your risk of developing cardiovascular disease. A team-based approach is the best way to prevent heart disease and stroke. You and your health care team can build a prevention plan that works for you.
If you’re prescribed medications to manage blood sugar, cholesterol, blood pressure or other conditions, take them as directed.
Talk about challenges in your life that may affect your health and ask for support. If you have concerns about accessing care, affording your medications or finding transportation to and from medical appointments, ask your health care team for help finding resources.
You’re the most important member of your health care team. And they depend on you to tell them how you feel and what help you need. So ask questions and make decisions together.
Together, you can reduce your risk of heart attack.
