Several factors raise the risk for heart attack and coronary artery disease. The more risk factors someone has, the greater the chance of developing coronary artery disease. Also, the risk increases as each risk factor increases (for instance, high blood pressure that's just a bit higher than normal is less of a risk than skyrocketing high blood pressure).
Heart attack risk factors that can be controlled or modified:
- High blood cholesterol. As cholesterol rises, so does the risk of coronary artery disease. The goal is to keep total blood cholesterol levels as low as possible, according to the American Heart Association (AMA). Although many physicians maintain that LDL is a more effective gauge of risk than total (HDL plus LDL) blood cholesterol, the AMA offers these guidelines for blood cholesterol levels:
- Total blood cholesterol. Everyone should try to keep their levels below 200 milligrams/deciliter (mg/dL).
- HDL ("good") blood cholesterol. Women should try to have levels of 50 mg/dL or higher. Men should aim for 40 mg/dL or higher.
- LDL ("bad") blood cholesterol. In general, the lower the LDL level, the lower the risk. (Have the person in your care speak with a physician about her individual risks and ideal levels.) Here’s how the AMA ranks the various levels of LDL:
Less than 100 mg/dL: Optimal
100 to 129 mg/dL: Near optimal/above optimal
130 to 159 mg/dL: Borderline high
160 to 189 mg/dL: High
190 mg/dL and above: Very high
- High blood pressure. High blood pressure makes the heart work harder, increasing the risk of heart attack and stroke. Ideally, blood pressure should be lower than 120/80 mm Hg (or millimeters of mercury).
- Diabetes. Just having diabetes increases the risk of heart disease and stroke, but the risks are much greater if blood sugar isn’t well controlled. Keeping blood sugar levels within a person's target range can make a huge difference.
- Smoking. Smokers have up to four times greater risk of developing coronary artery disease than nonsmokers. People who smoke cigars or pipes seem to have a higher risk, too, but it isn't as great as that of cigarette smokers. Exposure to secondhand smoke also increases the risk of heart disease.
- Physical inactivity. Regular physical activity helps prevent heart and blood vessel disease. Vigorous exercise offers greater benefits -- if a person has built up to it. However, even moderate-intensity activities help if done regularly. (Any heart patient should consult her physician before beginning an exercise program.)
- Obesity and overweight. People with excess body fat are more likely to develop heart disease, especially if the fat is distributed mostly around the waist. The recommended waist circumference is 35 inches or less for women, 40 inches or less for men. Shedding as few as ten pounds lowers heart disease risk.
- Drinking too much alcohol. Drinking too much can raise blood pressure and cholesterol levels and cause arrhythmias and heart failure. But a "moderate" amount of alcohol (an average of one drink daily for women, two for men) may actually lower the risk of heart disease. However, because drinking even moderate amounts of alcohol may increase cancer risk, it's not recommended that nondrinkers start drinking.
Heart attack risk factors that can't be changed
- Increasing age. More than 83 percent of people who die of coronary artery disease are 65 or older. As a person ages, the risk of having a heart attack increases.
- Being male. Men have a greater risk of heart attack than women, and they have attacks earlier in life. But women are more likely to have undiagnosed heart disease and are more likely to die from heart attacks than men.
- Family history. Children of parents with heart disease are more likely to develop it themselves.