 What Is
A Risk Factor?
A risk factor is a specific condition or behavior
associated with the development of heart and blood vessel disease.
The more risk factors, the greater chance you have of developing
heart disease. Therefore, reducing these risk factors is the key to
a healthier heart.
What
Are The Risk Factors?
There are risk factors that cannot be controlled or
changed, and there are risk factors that can be controlled or
changed.
- Major Risk Factors That Cannot Be
Changed
 Heredity
Gender
Age
- Major Risk Factors That Can Be Controlled or
Changed
Smoking
High Blood Pressure
Blood Cholesterol Levels
Stress
- Contributing Factors
Obesity
Lack of Exercise
Diabetes
Heredity
Family history plays an important part in our
fate. According to some studies, if two immediate family members
have had a heart attack (myocardial infarction) before age 55, the
risk of developing heart disease is 5-10 times greater than in a
family with no history. Heredity also influences several of the risk
factors.
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Age & Gender
Men and women can both develop heart and
blood vessel disease, although hormones play a complex role in the
picture. Estrogen delays the onset of disease in most women by about
ten years.
- One in nine women
between the ages of 45-64 has some form of heart disease or
stroke; this ratio soars to one in three at age 65 and beyond.
- One in six men aged
45-64 has some form of heart or blood vessel disease; in men 65
and older the ratio decreases to one in eight.
These statistics suggest
that the risk for men is higher in the earlier years, whereas women
have a higher prevalence for heart disease after menopause.
(Heart & Stroke Facts
Statistics, American Heart Association, 1993)
Smoking
Smoking is a major cause of heart and blood
vessel disease. Cigarette smoking is the most dangerous of the
modifiable risk factors. Overall, smokers experience a 70% greater
death rate from heart and blood vessel disease than nonsmokers; and
heavy smokers (two or more packs per day) have a death rate two to
three times greater than nonsmokers. Inhaling cigarette smoke
produces temporary effects on the heart and blood vessels. The
nicotine in the smoke increases blood pressure, heart rate, and the
amount of blood pumped by the heart and the blood flow in the
vessels in the heart. Other effects include narrowing of the vessels
in the arms and legs. Nicotine is not the only bad element in
cigarette smoke. Carbon monoxide gets in the blood which reduces the
amount of oxygen available to the heart and all other parts of the
body. Cigarette smoking also causes the platelets in the blood to
become sticky and cluster which can harm the heart and blood
vessels. No cigarettes are considered safe. Many smokers who have
switched to low tar and low nicotine cigarettes smoke more or inhale
more deeply to make up for the decreased nicotine. By inhaling more
deeply, smokers may increase their risk of disease.
Regardless of how much
or how long you have smoked, when you quit smoking your risk of
heart and blood vessel disease gradually decreases. Ten years after
quitting, for example, your risk of death from heart disease is
almost the same as if you had never smoked. It is important to stop
smoking before the signs of this disease appear. Don't wait until
you have heart and blood vessel disease to quit - stop smoking now.
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Hypertension
Hypertension is also known as high blood
pressure. To help understand high blood pressure, you must first
understand what blood pressure is.
As your heart beats, it
forces blood through large blood vessels in your body called
arteries. Arteries take the blood from your heart to all other parts
of your body. As the blood is pumped through your body, it pushes
against the arterial walls. Blood pressure is the force of your
blood against the walls of your arteries. Normally, arteries are
muscular and elastic. They stretch and contract as blood goes
through them.
Your blood pressure
consists of two numbers. The top reading is the systolic pressure
(when your heart is contracting), the bottom number is the diastolic
pressure (when the heart is relaxing). If your blood pressure
consistently runs 140/90 or more, you may have hypertension (high
blood pressure).
In many cases, the cause
of hypertension is unknown but may include: family history of
hypertension, gender, age, race, obesity, and a high salt/high
cholesterol diet.
When the blood pressure
is continually elevated, your heart has to work extra hard to pump.
When high blood pressure occurs over a long period of time, the
heart tends to enlarge as it has a hard time keeping up with the
demands made on it.
High blood pressure may
also contribute to hardening of the arteries of the heart and other
vessels. High blood pressure may increase the possibility of strokes
due to damage to the blood vessels that lead to the brain; may cause
kidney damage, congestive heart failure; and may increase your risk
for coronary artery disease.
Primary high blood
pressure may not be cured but it can be controlled. Some treatments
that your doctor may recommend to you include:
- Reducing the amount
of salt (sodium) intake
- Weight reduction
- Stress reduction
- Exercise
- Regular doctor visits
- Regular blood
pressure checks (via physician office, fire departments,
hospitals, community or public centers, or local church programs)
- Taking medications as
prescribed by your doctor
- Stopping smoking
Blood pressure needs to
be controlled long-term!
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Cholesterol Levels
Reducing saturated fat and
cholesterol in your diet will help to achieve lower levels of fat
and cholesterol in your blood.
Cholesterol is the main
lipid-like (fat) component of the fatty (atherosclerotic) deposits
in heart arteries. Any increase in the total blood cholesterol level
has been closely associated with coronary artery disease. Studies
show that elevated cholesterol levels may be a familial trait;
however, environmental factors such as diet, are most
influential.
Cholesterol is a
substance manufactured by the body, but may also be found in certain
foods. Egg yolks, organ meats, shrimps, oysters, fatty red meats,
lard, butter, and whole milk dairy products are high in saturated
fats which may raise cholesterol blood levels in most people. Some
vegetable oils, such as palm kernel oil, coconut oil and cocoa
butter, are high in saturated fat.
Polyunsaturated fats,
however, tend to lower the level of cholesterol in the blood. By
partially substituting polyunsaturated fats for saturated fats and
by increasing the amount of complex carbohydrates in the diet, it is
possible to lower the levels of cholesterol and fat in the
blood.
- Eat fish or poultry
more than red meat, consuming not more than 6 ounces a day
- When red meat (beef,
pork, lamb) is prepared, trim all visible fat before cooking,
serve small portions, and use select cuts
- Remove the skin from
poultry before cooking
- Serve more "white"
meat from poultry than "dark" meat
- Use skim milk and
skim milk products instead of whole milk or 2% milk and milk
products
- Consume no more than
3 egg yolks per week
- Cook with liquid
vegetable oils and use more polyunsaturated margarines (such as
safflower, cottonseed, corn, and soybean)
Diet changes should
never be drastic. You may harm your health by cutting essential
foods from your diet. Keep changes in your diet moderate with
careful use of saturated fats and cholesterol. Learn to read labels
for hidden saturated fats.
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Diabetes
High blood sugar is associated with an
increased risk of developing coronary artery disease, whether it
necessitates diet control, oral hypoglycemics or insulin control.
Hyperglycemia (carbohydrate intolerance) may be defined as a fasting
blood glucose greater than 130 mg/dl. As blood sugar increases,
there is an acceleration in the thickening of the coronary artery
basement membrane which predisposes the patient to early development
of coronary artery disease.
Diabetes is associated
with other risk factors including obesity, increased blood
cholesterol level and high blood pressure. Regular checkups,
adherence to a management regimen, and weight control are
essential.
Obesity
Weighing more than 30 percent over your ideal
weight can double your risk for developing heart disease. Other risk
factors such as high blood pressure, high cholesterol and adult
onset of diabetes may also be linked to obesity.
It is very important to
control your weight. The following are some tips for weight
control:
- Check with your
doctor or dietitian regarding how many calories you need a day
- Have the dietitian
instruct you on a proper diet
- Avoid crash or fad
diets as the weight loss is usually only temporary
- Exercise regularly
- Set realistic goals
- Once you have
achieved your goals, continue the new eating habits
- Learn how to eat -
not how to diet!
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Lack of Exercise
Your heart is a muscle and benefits
from regular exercise like all the other muscles in your
body.
Regular exercise of an
aerobic type (exercise that increases your heart rate and breathing)
can reduce the risk for heart disease by increasing the hearts
functional capacity, lowering the oxygen requirements of the heart,
increasing the tone of other muscles, and stimulating
circulation.
Improvements in fitness
result from exercise of moderate intensity (50-75% of capacity) when
done 15-30 minutes at least three times per week.
Good aerobic activities
include brisk walking, jogging, running, bicycling, and swimming.
Ask your doctor which activity is best suited to your age and
physical condition.
You may begin with
simple exercises (Progressive Cardiac Exercises also known as PCEs)
while you are in the hospital and may advance to a Cardiac
Rehabilitation Phase II program after you are home and have seen
your doctor for a referral.
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Stress
Stress, is "the nonspecific response of the
body to any demand made upon it." More specifically, stress is
defined by perception. If a person finds a job situation, or another
personality particularly stressful, the feeling often will trigger a
physiological response. On the other hand, studies have shown that
when a job situation or another personality stimulate feelings of
challenge or a positive reaction, these same physiological reactions
do not occur. Therefore, when we talk about stress in relation to
disease, we are looking at the more negative stress.
Physiological responses
to stress include an increase in heart rate, an increase in blood
pressure, and an increased rate of breathing. These symptoms are
caused by the release of adrenaline, which also narrows your
arteries, and results in a greater workload on the heart. If you are
unable to control your stress, you may be at risk for high blood
pressure and possibly injury to your artery walls which sets the
stage for plaque deposits. Negative stress is a risk factor for the
development of coronary artery disease.
Stress management is a
learning process. First, you need to identify the particular cause
of your stress. Second, you need to take steps to change those
circumstances that are stressful whenever possible. Third, you need
to relearn ways to cope with stress in your everyday life. The
following are a few suggestions for coping with
stress:
- Do not waste energy
being upset over little things. Remember that stress is our
reaction to situations, not the situation itself. Often it helps
to talk it out and get a different perspective of the situation
while at the same time venting your concerns.
- Escape from the
stress for a period of time. Exercise, taking a walk before lunch
to get rid of the morning's frustrations or taking a walk after
work to help unwind, can be very helpful to reduce your stress.
- Beware of the
super-person urges. Set priorities, establish realistic goals and
stop trying to do too much.
- Take time to relax
daily whether you learn relaxation techniques or just take time
out for a favorite hobby.
- Take it easy with
criticism or arguments. Stand your ground on what you believe is
right, but make allowances for the other party. Search for the
"positives" of an argument, of a critical person, as well as your
own positive qualities.
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