Causes and Risk Factors.
Coronary artery disease is caused by a buildup of plaque within the coronary arteries. The arteries often become progressively narrowed due to worsening plaques or from blood clots within the artery. This can cause the supply of blood to the heart muscle to decrease and you may experience chest pain or angina. A heart attack occurs when the blood flow is completely cut off and a portion of the heart muscle is damaged.
Research has uncovered several factors that contribute to cardiovascular disease. The more risk factors a person has, the greater their chance of developing cardiovascular disease. Although some risk factors cannot be changed, you can modify others with your doctor’s help, and still others can be eliminated altogether. The following checklist can help you determine your risk.
Major risk factors that cannot be changed:
- Heredity and Race – Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. Heart disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is partly due to higher rates of obesity and diabetes. Most people with a strong family history of heart disease have one or more other risk factors. Just as you can’t control your age, sex and race, you can’t control your family history. Therefore, it’s even more important to treat and control any other risk factors you have.
- Gender – Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause, when women’s death rate from heart disease increases, it’s not as great as men’s.
- Age – Over 83 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks.
Major risk factors that can be changed:
- Smoking – Smokers’ risk of developing coronary heart disease is 2–4 times that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease; smokers have about twice the risk of nonsmokers. Cigarette smoking also acts with other risk factors to greatly increase the risk for coronary heart disease. People who smoke cigars or pipes seem to have a higher risk of death from coronary heart disease (and possibly stroke) but their risk isn’t as great as cigarette smokers’. Exposure to other people’s smoke increases the risk of heart disease even for nonsmokers.
- High Blood Pressure – High blood pressure increases the heart’s workload, causing the heart to thicken and become stiffer. It also increases your risk of stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times.
- Blood Cholesterol Levels – The risk for heart disease increases as your total amount of cholesterol increases. A total cholesterol level over 200, a HDL, or “good” cholesterol level under 40, or a LDL, or “bad” cholesterol level over 160 indicates an increased risk for heart disease. Of course, interpretation of cholesterol values must be individualized, taking into account all of your risk factors for heart disease. A diet low in cholesterol and saturated fat will lower cholesterol levels and reduce your risk for heart disease.
- Physical inactivity – Many people lead sedentary lives, exercising infrequently or not at all. People who don’t exercise have higher rates of death and heart disease compared to people who perform even mild to moderate amounts of physical activity. Even leisure-time activities like gardening or walking can lower your risk of heart disease.
- Obesity – Excess weight puts significant strain on your heart and worsens several other heart disease risk factors such as diabetes. Researchers now know that obesity itself increases heart disease risk. By eating right and exercising, you can lose weight and reduce your risk of heart disease.
Other Risk Factors:
- Diabetes – Diabetes increases the risk of heart attack because it raises blood cholesterol levels. In addition, people who develop diabetes in midlife are often overweight, which is an additional risk factor.
- Stress – Excessive emotional stress over a prolonged period appears to increase the risk of heart disease. Stress can increase other existing risk factors, such as overeating, smoking, and high blood pressure.
- Alcohol – Drinking too much alcohol can raise blood pressure, cause heart failure and lead to stroke. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. It is not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.
Next: Heart disease risk calculator