Risk Factors for
Coronary Artery Heart Disease
Smoking
Smoking is one of the most important risk factors for developing coronary artery
disease. Smokers have a significantly increased risk of early heart attack. There are a
number of factors that are important in promoting coronary artery disease. Many of these
factors cause an abnormal arterial wall lining to develop and lead to hardening of the
arteries (atherosclerosis). Once arteriosclerosis does develop smoking may cause a heart
attack to happen.
The positive effects of stopping smoking are seen within a matter of hours. It is never
too late to stop smoking. Those patients who stop smoking after a heart attack,
angioplasty or bypass surgery have a much better prognosis than those who continue to
smoke do.
High Blood Pressure
High blood pressure or hypertension is one of the most common risk factors for
heart disease and stroke. Hypertension can be a silent killer, for until the disease is
very advanced, there are no symptoms of high blood pressure. It is important to have your
blood pressure checked regularly and to follow-up with your doctor is high readings are
seen. Normal blood pressure is less than or equal to 120 over 80 (120/80). High blood
pressure is greater than 140/90. The top number is the systolic blood pressure and the
bottom number is the diastolic. Blood pressure can often be lowered, when it is high, by
exercise, weight reduction and a low salt diet. These measures should be undertaken only
under the supervision of your doctor. There are a number of excellent medications to treat
high blood pressure and when successful, lower the risk of heart attack and stroke.
Physical Activity
Those of us who lead a sedentary life style have a higher
risk of developing heart disease than those who lead an active life style. Walking briskly
for 20 minutes three times a week can have significant positive health benefits. Exercise
can help control weight and lower blood pressure. You should check with your doctor before
beginning an exercise program.
Age
Cardiovascular disease becomes more common with age. About 10,000 women and 18,000
men under age 45 die of cardiovascular disease each year in the United States. Between the
ages of 45 and 64, that figure climbs to about 40,000 women and 85,000 men. From ages 65
and 84, it soars to about 240,000 women and 260,000 men. That is why it becomes
increasingly important as you age to pay careful attention to diet, fitness and other
factors that can prevent or reduce the risk of heart disease. Years or decades of a poor
diet take their toll as you age and fatty plaques that have collected along artery walls
slow or impede blood flow. People who do not exercise regularly are more likely to develop
other cardiovascular risk factors such as high blood pressure and diabetes. The effects of
age also are felt directly by the blood vessels and the heart. As blood vessels age, they
become less flexible and thus make it harder for blood to move through them. Exercise, a
low fat diet and body weight control help to slow the process of hardening of the arteries
(atherosclerosis).
Diabetes
Diabetes is responsible for many health complications, including an increased risk of
blood vessel disease and coronary artery disease. Diabetes increases the risk of heart
disease 5-fold in a woman and 2-fold in a man. In fact, about 80 percent of people with
diabetes die of heart disease or stroke. Part of the reason is that diabetes raises
cholesterol and triglyceride levels. In Type 2 (also called
"non-insulin-dependent" or "adult-onset") diabetes, the body’s
cells become resistant to insulin and the pancreas cannot produce enough insulin to
overcome the resistance. Insulin is the hormone that permits blood glucose (sugar) to move
into the body’s cells where it is used for energy. Insulin also reduces the amount of
glucose released by the liver. When the body fails to respond to normal insulin levels,
insulin production increases. Elevated levels of insulin, however, can raise blood
pressure and encourage the deposition of fat in artery walls. The result is clogged
coronary arteries, plus a variety of other vascular problems, such as the leg pain of
peripheral artery disease. Weight loss can decrease the demand for insulin and exercise
can help you to use excess blood glucose, preventing or slowing the onset of diabetes.
Sex and Menopausal Status
Men are at increased risk for coronary artery disease. While the reasons for this
are not entirely known, lipid status (cholesterol and fats) seem to play a role.
Premenopausal women tend to have higher levels of HDL (‘good cholesterol’) and
this may have a protective effect. Premenopausal women may still develop coronary artery
disease, however the risk increases significantly in postmenopausal women. Many physicians
think that estrogen replacement in postmenopausal women may lower the risk of coronary
artery disease, however this is not certain and this decision must be made on an
individual basis.
Cholesterol and Lipids
The blood levels of cholesterol and triglycerides are also important risk factors
for coronary artery disease. The level of cholesterol is directly related to the risk of
coronary artery disease. Cholesterol is measured as LDL or ‘bad cholesterol’ and
as HDL or ‘good cholesterol’. The level of cholesterol that your doctor will
consider "good" for you will depend on many factors. Levels of total cholesterol
are often best kept below 220. We can lower the level of our cholesterol by eating a diet
low in fats and cholesterol. Avoiding fried and fatty foods can be an important part of
controlling blood cholesterol.
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