You probably know someone who has had a heart attack. You have also probably heard that heart attacks are somehow linked to poor lifestyle. But what exactly is the link between your heart’s health and the way you live? Here is an insight into the factors that determine the risk of coronary artery disease (CAD) that manifests as a heart attack. Read on, because you can substantially decrease your risk of CAD by being aware of your risk level and making healthy lifestyle choices.

 

What is CAD?

Coronary arteries are arteries wrapped around your heart that supply it with blood and oxygen. Coronary artery disease occurs when fatty deposits called plaque build up inside the coronary arteries. Plaque narrows the arteries and reduces the amount of blood that reaches your heart.  Chest pain on exertion (angina) and shortness of breath are typical symptoms of CAD. Very often, the first symptom is a heart attack.

What Increases the risk of CAD?

Years of meticulous research has shown that some attributes increase your likelihood of developing CAD. These are called risk factors. The more the number of risk factors present, the greater are the chances of CAD. Some of the risk factors are beyond your control (non modifiable risk factors).  The other risk factors are the ones that you can modify, treat or control by changing your lifestyle or taking medication. 

Non Modifiable Risk Factors

The three non modifiable CAD risk factors are:

• Age: People over 65 are more likely to have CAD.
• Gender: Men have a greater risk of heart attack than women do, and they have attacks earlier in life.
• Family history: Children of parents with heart disease are more likely to develop it themselves.

Since you can't do anything about these risk factors, it's even more important for you to manage the risk factors that can be changed.

Major Modifiable Risk Factors

Here is a quick look at major risk factors for having a heart attack:

• Smoking
• High blood fats (hyperlipidemia)
• High blood pressure (hypertension)
• High blood sugar (diabetes)
• Being overweight or obese
• Lack of physical activity

 

Smoking: Tobacco smoke is full of substances that damage your arteries. It greatly hastens the build-up of fatty deposits in arteries called plaque, which eventually causes a heart attack. If you smoke you are 2 to 4 times more likely to develop CAD.

High blood cholesterol:  Blood fats, or lipids, include cholesterol and triglycerides. The body needs a certain amount of cholesterol to function normally, but when there is more fat in the blood (hyperlipidemia), fatty deposits build up in the arteries, increasing the risk of heart attacks and strokes.

High blood pressure: Blood pressure is the force with which the blood pushes against the walls of arteries. If blood pressure is high, the heart is working harder than it should; over time, this will cause it to weaken. High blood pressure is one of the major risk factors for heart attacks.

High blood sugar (Diabetes mellitus):  Diabetes seriously increases your risk of developing cardiovascular disease. At least 65% of people with diabetes die of some form of heart or blood vessel disease.

Obesity and overweight: Excess body fat — especially if a lot of it is at the waist — increases your risk of heart disease even if no other risk factors are present. Excess weight puts strain on your heart, raises blood pressure, blood cholesterol and triglyceride levels, and lowers HDL ("good") cholesterol levels. It can also make diabetes more likely to develop.

Physical inactivity: An inactive lifestyle is a risk factor for CAD. Regular, moderate-to-vigorous physical activity helps prevent heart and blood vessel disease. Physical activity can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people.

 

Contributing Risk Factors

The role of some other risk factors in CAD is not so clear, but they can increase the overall risk when present in combination with the above major risk factors. These are:

Chronic stress: Some studies show a link between CAD and chronic stress. Stress may also play an indirect role by leading to unhealthy eating habits or smoking.

Excess alcohol: Too much alcohol can contribute to CAD risk by raising blood pressure and triglycerides. Though the risk of heart disease in people who drink moderate amounts of alcohol is lower than in nondrinkers, it is not recommended that nondrinkers start using alcohol.

Certain medications:  Oral contraceptive use in women who smoke and are above 35 years of age has been linked to increased CAD risk.

How Can You Reduce your Risk

• Stop smoking: Quitting smoking is the single most important thing that you can do to lower your CAD risk. It is difficult to quit, but better than a premature death caused by a sudden heart attack.  Seek medical help if needed, ask your friends and family for support, but do quit.
• Catch the Silent Killers Early: The three big CAD risk factors — hypertension, diabetes, and hyperlipidemia are all silent killers. They can exist for years damaging you from within but without producing a single symptom. Once every year, get yourself tested to know your blood pressure, blood lipid, and blood sugar levels.
• Control the Silent Killers: You may have hypertension, hyperlipidemia or diabetes because it runs in your family. However, lifestyle modifications can control these diseases in the early stages. The keys to doing this are: maintaining a healthy body weight, staying active and improving your diet. If your blood pressure, blood lipids, or blood sugar do not stay within normal limits with these measures, you will need to take medicines to control them. One of the biggest mistakes that people make is delaying or discontinuing the treatment of these conditions, which greatly increases their risk of a heart attack.
• Watch your weight and waist: Assess if your body weight is healthy by calculating your Body Mass Index (BMI) — your weight in Kg divided by the square of your height in meters. BMI over 25 kg/m2 shows that you are overweight. BMI over 30 kg/m2 indicates obesity. Ideally, the BMI should be maintained between 18.5 and 24.9 kg/m2. Another important body measurement is your waist size. Waist size more than 35 inches in women or more than 40 inches in men indicates an increased risk for heart disease and diabetes.
• Stay Active: Get at least 30 minutes of physical activity on most days of the week. Start slowly and if you feel comfortable, build it up gradually. Once you start getting regular exercise, don’t stop. You will lose the fitness you gained and all the benefits it brings. Do not look at exercise as a short term measure. Aim to stay active for your whole life.
• Improve your diet:
  

Eat at least five servings of fresh fruit or vegetables every day. One average-size banana, apple, orange, or mango would be a serving of fruit. Two tablespoons of cooked vegetables is a serving of vegetables.

Limit salt. A good guideline is to use less than 1 teaspoon (5 grams) of salt each day.

Eat more fiber. Good sources of fiber include beans, lentils, peas, oats, fruits, and vegetables.

Limit fatty foods. Saturated fats and trans-fats lead to “bad” cholesterol in your blood. Try to restrict your use of these fats. Unsaturated fats are less risky, but they still make you gain weight. You should eat them in moderation.

Include sources of omega-3 fatty acids in your diet such as a few walnuts, pistachios, peanuts or almonds a day, or a portion of tuna or salmon twice a week.  

Limit alcohol to two alcoholic drinks a day for men and one drink a day for women. One drink is about one 250-ml bottle of beer, one 100-ml glass of wine, or 25-ml of whisky, vodka or rum.

• De-stress: If you often find yourself overwhelmed by the level of stress in your life, make a deliberate effort to relax for some time every day.