What is Heart Disease?

High Blood Pressure (Hypertension)

High Blood Pressure increases your risk of heart disease, heart attack, and stroke. Although other risk factors can lead to high blood pressure, you can have high blood pressure without having other risk factors. If you are obese, smoke, or have high cholesterol levels along with high blood pressure, your risk of heart disease or stroke increases greatly.

Blood pressure can vary with activity and age, but a healthy adult who is resting should have a systolic pressure of 120 or less, and a diastolic pressure of 80 or less.

High Cholesterol (Hypercholesterolemia)

Cholesterol, a fat-like substance carried in the blood, is found in all of your body’s cells. Your liver produces cholesterol to form cell membranes, some hormones, as well as some vitamins from the food (meat, eggs, and dairy products) that you eat.

Although we often blame the cholesterol found in foods we eat for raising our cholesterol, the main culprit is the saturated fat in food (it’s important to read nutrition labels carefully because even though a food does not contain cholesterol it may still have large amounts of saturated fat). Foods rich in saturated fat include: butterfat in milk products, fat from red meat, and tropical oils such as coconut oil.

Too much low-density lipoprotein (LDL, or “bad cholesterol”) in the blood causes plaques to form on artery walls – causing a disease called atherosclerosis. When plaque builds up in the coronary arteries (coronary arteries supply blood to the heart), you have a greater risk of having a heart attack – as these plaques rupture, clots form, and these clots cause a total blockage of the artery.

Diabetes

Adult-onset – or Type 2 – diabetes (also known as non-insulin dependent diabetes) is a major risk factor in heart disease, and heart problems are the leading cause of death in people with diabetes. Certain racial and ethnic groups (African-Americans, Hispanics, Asian and Pacific Islanders, and Native Americans) are at greater risk of developing diabetes. The American Heart Association estimates that 65% of patients with diabetes die from some form of cardiovascular disease. If you know that you have diabetes, you should already be under a doctor’s care, because maintaining normal blood sugar levels can reduce your risk. If you think you may have diabetes but are not sure, see your doctor.

Obesity

Obesity is thought to lead to increased total cholesterol levels, high blood pressure, and an increased risk of coronary artery disease (CAD). Obesity increases your chances of developing other risk factors for heart disease – especially high blood pressure, high cholesterol, and diabetes.

Many doctors now measure obesity in terms of body mass index (BMI), which is a formula of weight (W) in kilograms divided by height (H) in meters squared:

According to the National Heart, Lung, and Blood Institute (NHLBI), being overweight is defined as having a BMI over 25. Those with a BMI over 30 are considered obese.

Smoking

Smoking is known to increase your risk of lung cancer, but few realize that it also greatly increases the risk of heart disease and peripheral vascular disease (disease in the vessels that supply blood to the arms, legs, kidneys, and the other organs). According to the American Heart Association, more than 400,000 Americans die each year of smoking-related illnesses. Many of these deaths are because of the effects of smoking on the heart and blood vessels.

Research has shown that smoking increases heart rate, tightens major arteries, and can create irregularities in the timing of heartbeats, all of which make your heart work harder. Smoking also increases blood pressure, which increases the risk of stroke in people who already have high blood pressure. Although nicotine is the main active agent in cigarette smoke, other chemicals and compounds (like tar and carbon monoxide) are harmful to your heart in many ways. These chemicals lead to the buildup of fatty plaques in the arteries, possibly injuring the vessel walls. They also affect cholesterol and levels of fibrinogen (a blood-clotting material). This increases the risk of a blood clot that can lead to a heart attack.

Physical Inactivity

Physical inactivity increases a person’s risk of heart attack more so than in people who exercise regularly. Exercise burns calories, helps control cholesterol levels and diabetes, and may help lower blood pressure. Exercise also strengthens the heart muscle and makes the arteries more flexible. Those who actively burn 500 to 3500 calories per week, either at work or through exercise, can expect to live longer than people who do not exercise. Even moderate-intensity exercise is helpful if done regularly.

Gender

Gender is another determining factor in heart disease – men are at higher risk of heart attack than women. But that difference narrows after women reach menopause. After the age of 65, the risk of heart disease is about the same between men and women when other risk factors are similar.

Heredity

Heredity is one of the most important risk determinants in developing heart disease. For example, if your parents or siblings had a heart or circulatory problem before age 55, then you are at greater risk for heart disease than someone who does not have that family history. Risk factors (including high blood pressure, cholesterol, diabetes, and obesity) are passed from one generation to another.

Researchers have found that some forms of cardiovascular disease are more common among certain racial and ethnic groups. For example, studies have shown that African-Americans are at greater risk for developing high blood pressure, heart, and kidney disease than whites. The bulk of cardiovascular research for minorities has focused on African-Americans and Hispanics – with Caucasians used as a comparison. Risk factors for cardiovascular disease in other minority groups are still being studied.

Age

Age is a prime risk factor for heart disease. In fact, about 4 of every 5 deaths due to heart disease occur in people above the age of 65.

As we age, our hearts tend to not work as well. The heart’s wall may thicken and arteries may stiffen and harden – making the heart less able to pump blood to the body. Because of these changes, the risk of developing cardiovascular disease increases with age. Women are generally at lower risk of developing heart disease – due to normal levels of sex hormones – and with the onset of menopause (and lower levels of those hormones), their risk starts to increase. Women 65 and older have about the same risk of cardiovascular disease as men of the same age.

Stress

Stress is considered a contributing risk factor for heart disease because its effects on the heart are not completely understood. Emotional stress, behavior, habits, and socio-economic status are suspected of contributing to the increase in the risk of developing heart disease and heart attack. This is because we all deal with stress differently – how much, and in what way stress affects us – varies from person to person.

Researchers have identified several reasons why stress may affect the heart:

• Stressful situations raise your heart rate and blood pressure, increasing your heart’s need for oxygen. This need for oxygen can bring on angina pectoris, or chest pain, in people who already have heart disease.
• During times of stress, the nervous system releases extra hormones (most often adrenaline). These hormones raise blood pressure, which can injure the lining of the arteries. When the arteries heal, the walls may harden or thicken, making it easier for plaques to build up.
• Stress also increases the amount of blood clotting factors that circulate in your blood, making it more likely that a clot will form. Clots may then block an artery narrowed by plaque and cause a heart attack.

Sex hormones

Sex hormones appear to play a role in heart disease. Among women younger than 40, heart disease is rare. But between the ages of 40 and 65, around the time when most women go through menopause, the chances that a woman will have a heart attack greatly increase. From age 65 and up, women make up about half of all heart attack victims.

Birth control pills

When these were first sold, they contained high levels of estrogen and progestin, and taking these pills increased the risk of heart disease and stroke – especially in women age 35 or older who smoked. Birth control pills that are currently on the market contain lower doses of estrogen and progestin and are considered safe for women age 35 and younger and who do smoke or have high blood pressure. According to the American Heart Association, women who take birth control pills should have yearly check-ups that test blood pressure, triglyceride, and glucose levels.

Alcohol

Alcohol has been found to lower the risk of heart disease in those who drink moderate amounts of alcohol in comparison to non-drinkers. Experts say that moderate intake is an average of 1 – 2 drinks per day for men and 1 drink per day for women. One drink is defined as 1½ fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.) or 1 fl oz of 100-proof spirits or 4 fl oz of wine or 12 fl oz of beer. Drinking more than a moderate amount of alcohol can cause heart-related problems such as high blood pressure, stroke, irregular heartbeats, and cardiomyopathy (disease of the heart muscle). The average drink has between 100 and 200 calories. Calories from alcohol often add fat to the body, which may increase the risk of heart disease; for this reason, it is not recommended that non-drinkers start using alcohol or that drinkers increase the amount that they drink.

It is never too late – or too early – to begin improving your heart’s health. Some risk factors can be controlled, while others cannot. But by eliminating risk factors that you can change and properly managing those you cannot control, you may greatly reduce your risk of heart disease.