Risk Factors for Heart Disease
by Cecilia Mullen, R.N.C., N.P.
January 24, 2001
So the holidays are over and it's time to get back on track with diet and exercise. Perhaps you've gained some weight or maybe you're tired of being overweight. Did you know that obesity, lack of exercise, and high cholesterol are three big risk factors for heart disease and stroke?
There are measures you can take to reduce your risk of heart disease and what better month to get started than February, which is Heart Health Month sponsored by the American Heart Association.
Cardiovascular disease is the number one killer of both women and men in the United States. Two of the most prevalent types of cardiovascular disease are high blood pressure and coronary artery disease, which can lead to heart attacks, angina, and strokes.
Fifty million people in the United States have high blood pressure. Unfortunately, most people don't make the necessary lifestyle changes to help control their hypertension. What you eat, how much you exercise, whether you smoke or drink, all play a role in your risk of developing hypertension and heart disease.
A normal blood pressure is considered less than 140/90. If either number is equal to or greater than these and goes untreated, your chances of having a heart attack are increased considerably.
High blood pressure has no symptoms, so unless you see your doctor regularly, you may not know you have it. It is important to have regular check-ups, which include a blood pressure check.
Risk factors for heart disease are divided into two categories: non-modifiable factors, which are factors you have no control over such as age, sex, race, or genetics; and modifiable factors, which are factors you can change and include excessive weight, too much alcohol, lack of activity, cigarette smoking and poor diet.
Cholesterol levels have a direct relationship to risk of heart disease. The higher the LDL (bad cholesterol), the higher your risk of heart disease becomes. The lower the HDL (good cholesterol), the higher your risk of heart disease.
Your cholesterol values, although perhaps related to heredity, are considered modifiable with diet, exercise, and medications. LDL levels should generally be less than 130 for individuals who have minimal risk factors for heart disease. People who have two or more risk factors such as diabetes, high blood pressure, cigarette smokers, older individuals, those with a family history of early heart disease, overweight or sedentary individuals should have LDL levels less than 100.
The first step in reducing high cholesterol and high blood pressure is to develop healthier habits. A diet rich in fruits and vegetables and low in fat is recommended. Animal fats such as those found in meat, cheese, dairy and processed foods should be avoided. Fewer than 30% of total daily intake of calories should be from fat, which means about 60 grams of fat and of those 60 grams, fewer than 20 grams from saturated or animal fats.
Regular physical activity helps control weight, lowers LDL and increases HDL and has a beneficial effect on risk factors. Exercise such as walking 30 minutes each day can lower blood pressure and improve cholesterol values. Losing as little as 10 pounds can make a difference.
Cigarette smoking is the most important preventable cause of premature death in the U.S. Cigarette smokers and those who inhale other people's cigarette smoke, called "passive smoking" have a much greater risk of developing heart disease and stroke. Studies indicate smoking increases your risk of heart disease by seven times.
Drinking too much alcohol raises blood pressure and can interfere with medications. The most anyone should drink per day is two drinks for men and one drink for women. This includes beer and wine.
If lifestyle changes do not lower your blood pressure or cholesterol levels to an acceptable level, your doctor or nurse practitioner may decide to place you on medication.
Lowering your cholesterol levels will lower your risk of heart disease and stroke. Combining lifestyle modifications and medications is an effective way to reduce your risk and allows you the opportunity to take the smallest amount of medication possible with the greatest beneficial effect.
If for any reason you do not tolerate the medications or want to reduce or stop your medications, always check with your doctor first. Stopping some medications abruptly can have harmful effects. Your doctor can prescribe a different medication that may work better for you. Medication is prescribed depending on an individual's needs, so what works for one individual may not be right for someone else.
Find out if you have high blood pressure or high cholesterol. Preventing heart disease and stroke is something you can do for yourself and your family.
Cecilia Mullen is a nurse practitioner at Granite Medical Group. The information in this column is not intended to diagnose individual conditions. Readers should see their own doctors about specific problems.