Patient Education & Resources

Risk Factors

Many factors contributing to the development of heart disease have been identified and referred to as 'Risk Factors'. Some risk factors can be easily controlled or eliminated, while others are inherited and are beyond your control. If your are at risk because of one of these uncontrolled factors you need to pay special attention to those risk factors you can control.

Uncontrollable Risk Factors

1. Family History

You are at greater risk if one of your parents or a sibling suffers angina or has had a heart attack, has elevated blood cholesterol level, or has high blood pressure or diabetes. This is especially true if the heart attack or angina occured before the age of 65 in women or 55 in men.

2. Gender

Men are two to three times more vulnerable to heart disease than woman, especially in the earlier years. However, when a woman reaches menopause she becomes as susceptible to heart disease as a man.

3. Age

This risk of heart disease also increases with age for both men and women. Nearly 55% of all heart attack victims are 65 or older.

4. Diabetes

Good diabetes control is essential. If you have diabetes, in order to reduce your risk of heart disease:

• follow your doctor's and dietitian's advice
• eat a balanced diet
• keep your weight under control
• exercise regularly

Controllable Risk Factors

Smoking:

The most important thing you can do to reduce the risk of having a heart attack is to Quit Smoking.

• Smokers have a 70% greater chance of having a heart attack than non-smokers
• If you stop smoking, within two years your risk of a heart attack is the same as a non-smoker.
• Continuing to smoke after a heart attack will increase the chance of having a second attack and double your chances of death within one year
• When you quit smoking you reduce your risk of a heart attack regardless of how long and how much you have smoked.

What does smoking do?

1. Increases rate of plaque build up in arteries
2. Narrows blood vessels in your heart and body therefore increases heart rate, blood pressure and workload on the heart as it has to pump harder
3. Adds carbon monoxide to the lungs and oxygen becomes less available to the heart and body
4. Irritates the lungs causing breathing difficulties and increased work for the heart

High cholesterol & fat levels:

The amount of cholesterol (a fat-like substance) and other fats in the blood stream are affected mainly by three factors

• An inherited tendency toward having high levels of cholesterol/fat in the blood
• Certain diseases
• Eating of foods which contain high amounts of cholesterol/fats

The body itself is always producing cholesterol/fats (necessary components for survival) but in some cases it produces too much, which in turn, is a causative factor in blocking arteries leading to a heart attack

Changes needed to lower your cholesterol and fat levels in the blood:

• Follow a low cholesterol low saturated fat diet
• Exercise regularly
• Stop smoking
• Reduce alcohol and simple sugar consumption
• Certain types of medications may be needed

Hypertension: "High Blood Pressure"

Blood pressure is the force of blood pushing against the walls of your arteries as it flows through them.

High blood pressure is caused when the blood exerts too much pressure on the inner walls of the arteries as it passes through. Arteries which are subjected to these higher pressures eventually become damaged over the years and accumulate cholesterol and fat deposits more easily.

Suggestions to control high blood pressure:

1. Have your blood pressure checked regularly by your doctor. You should be aware of what your usual blood pressure is. You may have high blood pressure without knowing it because there are no symptoms of high blood pressure
2. Stop smoking
3. Lose weight as the heart pumps harder to supply the excess weight
4. Reduce your salt intake. It tends to cause your body to retain fluid, making your heart work harder (no adding salt to food, avoid canned soups, sauces, processed packaged foods)
5. If you are taking medication for high blood pressure, it must be taken regularly as prescribed and continued even if you feel well. DO NOT stop it unless your doctor instructs you to. If you feel unwell on any medication please inform your doctor.

Lack of Exercise: Sedentary lifestyle

A flabby, inactive body is like a poorly tuned car. Exercise has a beneficial effect to the body. Carefully planned regular exercise should:

1. Improve your circulation as the muscles will help return the blood to your heart
2. Tone all your muscles
3. Help you manage stress better
4. Help control your weight if combined with a proper diet
5. Help lower your blood pressure and heart rate in some people
6. Help lower your blood cholesterol levels
7. Give you a feeling of well being & confidence

Note: Diabetics frequently require less insulin when on a regular exercise program.

Overweight: "Obesity"

When you are overweight your heart pumps harder to supply the overweight body with blood. Since it works harder it too needs more oxygen and nutrients

Obesity often coexists with high blood pressure, high levels of fat and cholesterol in the blood, diabetes, and a sedentary lifestyle which all contribute to increasing heart disease risk factors.

Recommendations:

1. Determine your ideal body weight (ask the health care worker to assist you)
2. Set realistic goals for weight reduction
3. Do not go on extreme fat reducing diets
4. Start with a low cholesterol, low saturated fat diet. It will help you lose fat in a healthy way
5. Reward yourself for weight loss: new clothes, a movie, a trip (but not with food)

Notice how much better you feel and look as you reach your goals!

Abdominal Obesity:

Extra weight, when it is carried in the abdominal region, is of particular importance. The fat cells that make up this type of fat has been linked to cardiovascular disease. Women with a waist circumference of more than 88 cm (35") and men with a waist circumference of more than 102 cm (40") are considered to be at increased risk.

To Properly Measure Your Waist:

• Locate the top of you hip bone
• Place a tape measure evenly around the bare abdomen at this level

Abdominal obesity is also linked to Metabolic Syndrome. Metabolic Syndrome is a clustering of interrelated risk factors that predisposes a person to developing Cardiovascular Disease.

The Criteria for Metabolic Syndrome is:

• Elevated waist circumference
• Elevated triglycerides
• Reduced HDL (good cholesterol)
• Elevated blood pressure
• Elevated fasting glucose

A person with abnormal levels of 3 of the above criteria is considered to have metabolic syndrome.

Stress:

Stress is a part of our daily living as we respond to positive and negative situations. Constant high levels of stress & tensions cause the body to produce more adrenaline & can increase your blood pressure, heart rate and blood cholesterol levels.

Suggestions for Reducing Stress:

1. Handle one thing at a time. Divide your workload into smaller tasks and enjoy a feeling of accomplishment when each one is completed
2. Learn to say "no"
3. Save some private time for yourself
4. Working "with" others is easier than "competing" with others in everyday activity
5. Learn to talk about problems & concerns
6. Learn relaxation techniques & exercise techniques

In general, you should try to be more aware of the main source(s) of stress in your life, and attempt to lessen their impact.