Heart Disease: Factors You Can Control

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You can control the following risk factors by making lifestyle changes. Your doctor might also suggest medicine to help control some risk factors, such as high blood pressure or high cholesterol.

Poor blood cholesterol (koh-LESS-tur-ol) and triglyceride (treye-GLIH-suh-ryd) levels — These are types of fat found in your blood and other parts of your body. The body needs small amounts of them to work, but too much can cause a problem. The extra amounts can cling to, and clog, your arteries. A blood test can measure your levels of:

• Low-density lipoprotein (LDL) or “bad” cholesterol — High levels lead to buildup of cholesterol in arteries. To lower your heart disease risk, your LDL level should be less that 100 mg/dL.
• High-density lipoprotein (HDL) or “good” cholesterol — High levels of this type are actually good. HDL cholesterol helps lower the total cholesterol level in your body. To lower your heart disease risk, your HDL levels should be above 60 mg/dL.
• Total cholesterol — This is your LDL cholesterol plus HDL cholesterol. To lower your heart disease risk, your total cholesterol should be less than 200 mg/dL.
• Triglycerides — Another artery clogger. To lower your heart disease risk, your triglyceride level should be less than 150 mg/dL.

High blood pressure — Blood pressure is the force your blood makes against your artery walls. If this pressure is too high, over time it can damage your artery walls. There are two kinds of pressure. Systolic (siss-TOL-ihk) is the pressure as your heart pumps blood into your arteries. Diastolic (deye-uh-STOL-ihk) is the pressure between beats, when your heart relaxes. To lower your risk of heart disease, your blood pressure should be less than 120 systolic/80 diastolic.

Cigarette smoking — Smoking hurts your heart. The more you smoke, the higher your risk. About half of all heart attacks in women are due to smoking! And, if you smoke and also take birth control pills, you are at even higher risk.

Diabetes — Diabetes is a disease in which blood glucose (sugar) levels are too high. Type 2 diabetes is the most common type. It usually begins after the age of 40, often in people who are overweight or obese. Uncontrolled diabetes can damage artery walls. This risk is even higher in women than men.

Being overweight or obese — The more overweight you are, the higher your risk of heart disease. This is true even if you have no other risk factors. Being overweight also raises your chances of developing diabetes, high blood pressure, and high cholesterol. To lower your risk, your body mass index (BMI) should be between 18.5 and 24.9. A BMI of 30 or higher is considered obese. Use this calculator to find your BMI.

Lack of physical activity — Like being overweight, lack of physical activity raises your heart disease risk even if you have no other risk factors. Being inactive also increases your chances of developing high blood pressure and diabetes. It also raises your risk of being overweight or obese.

You can improve your health by doing the following each week:

• 2 hours and 30 minutes of moderate-intensity aerobic physical activity
  or
  
• 1 hour and 15 minutes of vigorous-intensity aerobic physical activity
  or
• a combination of moderate and intense aerobic physical activity
  and
  muscle-strengthening activities on 2 or more days of the week

So pick an activity you like, and do it often.

Drinking alcohol — Depending on how much you drink, alcohol can greatly raise your risk of heart disease, or help lower it. Heavy drinking can cause many heart-related problems. More than three drinks a day can raise blood pressure and triglyceride levels. Too much alcohol can also damage your heart muscle. However, moderate drinkers are less likely to develop heart disease than people who drink heavily or don’t drink at all. For women, moderate means no more than one drink a day. Drinking more than one drink a day increases your risk of certain cancers. And if you’re pregnant or planning to become pregnant, you should not drink. Your doctor can help you decide if the heart benefits of moderate drinking outweigh the risks.

Sleep apnea — Has anyone ever told you that you snore? Loud snoring can be a sign of sleep apnea (AP-nee-uh). Sleep apnea is a sleep disorder that can raise your chances of having a heart attack. With obstructive sleep apnea — the most common type — the tissue in the back of the throat relaxes. This blocks airflow to your lungs. This lowers the oxygen level in your blood, which makes your heart work harder. Sleep apnea often leads to high blood pressure. If you think you might have sleep apnea, talk to your doctor.

Metabolic syndrome — Having metabolic (met-uh-BOL-ihk) syndrome doubles your risk of getting heart disease or having a stroke. You have it if you have any three of these five risk factors:

• Waist measurement of more than 35 inches
• Triglyceride level more than 150 mg/dL
• HDL cholesterol level less than 50 mg/dL
• Systolic blood pressure greater than or equal to 130 mmHg or diastolic blood pressure great than or equal to 85 mmHg.
• Blood glucose level after fasting for at least eight hours of greater than 110 mg/dL

Taking steps to eliminate these risk factors will improve your heart and overall health.

Additional Resources

Publications

1.     Heart Truth for Women: If You Have Heart Disease, The — This brochure is for women with heart disease. In addition to general information about screening, risk factors, and treatment of heart disease, it provides information on how to write a Heart Attack Survival Plan. This plan will inform emergency medical personnel and hospital staff of medications you are taking, how to contact your doctor and family, and other important information in the event you suffer a heart attack.

   http://www.nhlbi.nih.gov/health/hearttruth/material/factsheet_heartdisease.pdf

2.   Live Healthier, Live Longer: Cholesterol Counts for Everyone — Visit this interactive page to find a how-to guide for lowering cholesterol and tips to prevent heart disease. This page also gives people with heart disease information on reducing the risk of heart attack.

   http://www.nhlbi.nih.gov/chd/

3.   Smoking and Tobacco Use — The Centers for Disease Control and Prevention's Office on Smoking and Health provides this extensive resource on smoking and other types of tobacco use. It includes educational materials, reports, news, and information on how to quit. It has special sections for kids, teens, adults, community service workers, and more.

   http://www.cdc.gov/tobacco/

4.   Your Guide to Lowering High Blood Pressure — This Web site, sponsored by the National Heart, Lung, and Blood Institute, is an interactive guide that answers common questions about high blood pressure and offers tips and quizzes. It also provides information on medications and suggestions on how to talk to your doctor.

   http://www.nhlbi.nih.gov/hbp/index.html

5.     Your Guide to Physical Activity and Your Heart — You know you should be more physically active. But are you confused, concerned, or just can't get started? This guide uses science-based information to help adults develop a safe and effective program of physical activity that can be sustained. All research indicates that regular, moderate physical activity will improve your heart health and how you look and feel. Find out about the importance of physical activity in reducing heart disease risk and how to begin or maintain an activity program that's right for you!

   http://www.nhlbi.nih.gov/health/public/heart/obesity/phy_active.pdf

6. Alcohol, Wine and Cardiovascular Disease (Copyright © AHA) — The American Heart Association discusses the potential risks of developing heart and cardiovascular disease from drinking too much alcohol.

   http://www.americanheart.org/presenter.jhtml?identifier=4422

7. Risk Factors and Coronary Heart Disease (Copyright © AHA) — While some risk factors of coronary heart disease can be modified, other risk factors cannot. This publication discusses risk factors that you cannot control, as well as some risk factors that you can control.

   http://www.americanheart.org/presenter.jhtml?identifier=4726

Organizations

1.   Division of Nutrition, Physical Activity and Obesity, NCCDPHP, CDC
2.   Heart Truth
3.   National Heart, Lung, and Blood Institute, NIH, HHS
4.   Weight-Control Information Network, NIDDK, NIH, HHS
5. American Heart Association

= Indicates Federal Resources

Content last updated: February 1, 2009