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Many factors determine whether one has, or risks getting, coronary artery disease. Most are controllable, but several are not.
Controllable factors include smoking, high blood cholesterol, high blood pressure, chronically over-weight or obese, physical inactivity, stress and behavior.
Factors that can't be controlled include heredity, gender and age.
Controllable Risk Factors
- Smoking
- High Blood Cholesterol
- High Blood Pressure
- Obesity or Over-weight
- Physical Inactivity
- Stress
- Behavior
Smoking
Smoking remains the leading cause of preventable illness and death in the United States, leading to poor health and decreased lifespan. It's estimated that 20% of all death is this country are directly attributable to smoking. Although smoking levels among adults have decreased with greater awareness of the dangers and risks, younger people continue to start the habit. Why should people quit or better yet, never start the nicotine routine?
Consider the following facts:
Diseases and Increased Risks to Smokers
Lung Cancer 700 - 1500%
Emphysema 100 - 3000%
Larygeal Cancer 500 - 1300%
Esophageal Cancer 400 - 500%
Bladder Cancer 100 - 300%
Coronary Disease 100 - 300%
Peptic Ulcer 100%
Here are just a few links to help you
get started quitting smoking:
quitnet.com
quitsmoking.com
quitsmokingsupport.com
CDC - How to Quit
Surgeon General - Quitting Smoking
whyquit.com
High Blood Cholesterol
Heart disease continues to be the leading cause of death in the United States. This is due in large part to high blood cholesterol levels that often lead to heart disease.
Recent large studies indicate that a 1% increase in cholesterol leads to a 2% increase in the risk of heart disease. Repeated large studies have proven that reducing cholesterol to target levels (LDL rate less than 100 in people with known heart disease and less than 130 in people with high risk for heart disease) leads to nearly one-third fewer deaths, heart attacks, angioplasty (also called balloon) procedures (see Interventional treatments), and heart bypass surgery (see Heart Surgery).
Changes in diet and lifestyle often control cholesterol levels. However, some patients may also benefit from prescription treatments
The following "Heart Smart" hints from the Willis-Knighton Heart Institute may help:
- Eat plenty of fresh fruits and vegetable
- Choose whole grain breads and cereals
- Opt for low-fat milk, low-fat yogurt and low-fat cheese
- Eat starchy carbohydrate-high foods like potatoes, rice and pasta
- Skip toppings like butter, margarine, gravy, and sour cream that add extra fat and calories. If you do eat them, choose commonly available no-fat varieties or those that specify "no trans-fats." Trans fats can increase cholesterol. Also, try using grated Parmesan cheese (watch the added sodium), herbed cottage cheeses or low-fat yogurt toppings instead.
- Select leaner meats like chicken, turkey, fish and lean beef cuts like top round, eye of round, top loin & sirloin, lean hamburger (90% is best). Choose lean pork cuts such as tenderloin, loin chops, and ham (but again, watch the sodium levels). Trim off all visible fat and remove skin from poultry.
- Choose vegetable oils like canola, corn, sunflower, soybean and especially olive oils.
- Try angel food cake, frozen fruit, yogurt or sorbet bars, or low-fat frozen yogurt in place of rich creamy desserts.
- Use non-stick vegetable sprays to reduce added fat when cooking.
- Use fat-free cooking methods like baking, broiling, grilling, poaching, or steaming when preparing meat, poultry and fish, without dousing the food in butter or high-fat ingredients.
- Serve vegetable- and broth-based soups. Or, use low-fat milk when making cream soups.
Numerous medications can help decrease blood cholesterol levels for people who can't reduce it enough through lifestyle changes. Some bodies just make too much cholesterol internally and may improperly store it. This can't be controlled without prescription therapy such as HMG Co-A Reductase Inhibitors, Cholestyramine, Niacin, and Lopid. Only your physician can determine whether cholesterol-reducing drugs are right for you.
High Blood Pressure
High blood pressure affects almost every part of your body, especially your vital organs. Blood pressure increases can adversely affect the heart, brain and kidneys, making them work harder and often leading to increased risk of heart attack, stroke or kidney failure.
Ideally, depending on your age, weight and gender, it's best to keep your top number (systolic pressure) less than 140 and bottom number (diastolic pressure) less than 90. These parameters are not always feasible, especially with age. And results can be skewed by nervous stresses triggered in some people by physician visits. However, your physician can detect this and avoid such false readings by recording results in other places under different conditions.
Obese or Overweight
Being overweight (especially more than 30% above our ideal body weight) forces the heart to work harder, frequently leading to an increased incidence of heart disease, high blood pressure, diabetes and high blood cholesterol. Patients are often amazed to learn that losing weight can often "cure" high blood pressure, diabetes, and elevated cholesterol in some people.
Physical Inactivity
Studies have repeatedly proven that regular exercise is critical in preventing heart disease. Recent research alone shows a 30% reduction in coronary artery disease in those who exercise regularly compared to those people with a sedentary lifestyle.
Recommended exercise, or aerobic activity, includes walking, jogging, cycling, swimming, rowing, cross-country skiing, stair climbing, and dancing. People should strive to perform aerobic exercise for at least 20-30 minutes, three to five times a week. It's not necessary to run marathons to achieve results. Walking just 10-20 miles per week will accomplish that goal. Any activity is better than a complete lack of exercise, but time and long-term commitment are critical to reaching maximum health benefits.
Stress and Behavior
Research has proven that people who frequently respond with anger and impatience to life's daily trials and tribulations are at an increased risk of heart attack. These "hot reactors" respond with intense constriction of blood vessels and high blood pressure. Changing behavior remains the single most important way to avoid this. Many helpful resources in bookstores and libraries can assist with learning to permanently change behaviors and reactions. Ask your physician for further recommendations.
Uncontrollable Risk Factors
Heredity
Of course, no one can control what genes we bring with us into the world, but we also know that if one or both of our parents had heart disease at an early age, we are much more likely to develop coronary artery disease. We also have to realize that families pass on more than genes. A recent study indicated that people with a family history of coronary artery disease have two times the risk of having a significant elevation in cholesterol. The types of food, exercise habits, and exposure to smoking also run in families.
However, these are all controllable factors and do not mean that we accept it and do nothing. If we have heart disease in our family history, we must do everything possible to reduce other risk factors. Eating right, exercising regularly, never starting to smoke (or quitting if we do) controlling high blood pressure and decreasing stress levels all potentially can make great strides in counteracting any inherited predisposition to heart disease.
Gender
Overall, males tend to have a higher incidence of heart disease at an earlier age, which is why there are four times as many women over the age of 80 than men.
For years, women with heart disease were considered the exception, but they're not. Their symptoms were historically written off as nervous conditions or panic attacks. Studies are really supporting what physicians have been seeing for years. Although women experience pain and symptom patterns very differently than men, their conditions are just as serious. As a result, cardiology has refocused on women and their heart disease with specific treatment regimens and protocols that take these differences into account.
We now know that after the onset of menopause, the incidence of cardiovascular disease in women more closely approximates that of men. Generally, this means that women tend to develop problems with heart disease about ten years later than men.
As more women enter the work force and assume the lifestyle habits of their counterparts (smoking, poor eating habits, lack of exercise, increased stress) the incidence of heart disease in younger women has also increased.
The fact that menopause coincides with when women begin to catch up to men in the area of incidence of heart disease has led to a great deal of hormonal research. This has led to much research on the effect of estrogen replacement (hormonal) therapy and heart disease. For more specifics, discuss your concerns with your physician.
Age
Although the risk of heart disease increases with age, it does not become unavoidable. Lifestyle changes and reducing controllable risk factors have proven to be helpful at any age. Some research has shown that quitting smoking as late as age 60 could add five to seven years to one's life. Regardless, beginning and maintaining a healthy lifestyle as early as possible remains key to disease prevention and improving quality of life.
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