Heart Disease Risk Factors: What You Can and Cannot Change

Anyone can develop heart disease, but some people are more likely to than others. Knowing your risk factors helps you and your doctor decide what to check and what to change. This article draws on the CDC, WHO and NHS. A risk factor raises the chance of a problem. It does not mean you will definitely get it.

The three key risk factors

The CDC says high blood pressure, high blood cholesterol and smoking are the key risk factors for heart disease, and that 47% of people in the United States have at least one of the three. High blood pressure and high cholesterol usually cause no symptoms, so they are often found only through checks.

Risk factors you can change

The CDC lists these controllable factors:

• High blood pressure, high cholesterol, diabetes and obesity
• Diets high in saturated fat, trans fat, cholesterol or salt
• Not getting enough physical activity
• Drinking too much alcohol
• Tobacco use, including exposure to second-hand smoke

The WHO groups behavioural risks as an unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. It also names air pollution as an environmental risk, and says high blood pressure, high blood glucose, high blood fats and overweight are intermediate risks. The CDC notes a link between heart disease and mental health conditions.

Risk factors you cannot change

The NHS lists several factors that can increase the chance of cardiovascular disease:

• Age: it mainly affects people over 50.
• Sex: men are more likely to develop it than women.
• Ethnicity: the likelihood is higher for people from South Asian, Black African or African Caribbean backgrounds.
• Family history: having a close relative with cardiovascular disease.

The CDC adds that genes likely play a role in high blood pressure and heart disease, and that family habits may also contribute. It says family history combined with unhealthy choices, such as smoking or a poor diet, can raise risk further. The WHO also lists poverty, stress and heredity among the wider determinants.

Why knowing your risk helps

Even if some factors cannot be changed, many others can. The CDC says the main message is to know your risk so you can prevent heart disease. The NHS says a health check for people aged 40 to 74 in the UK can show whether someone is at higher risk, and that statins may be advised for people at high risk. Ask your doctor what checks are available where you live.

Steps to take

No one can change their age or family history, but the list of things you can do is long. A good first step is simply to find out your numbers. Start with a few of these, and add more over time:

• Have your blood pressure, cholesterol and blood sugar checked
• Do not smoke, and avoid second-hand smoke
• Eat a balanced diet that is lower in salt and saturated fat
• Be active in ways your doctor says are safe for you
• Keep to a healthy weight
• Take prescribed medicines as directed

When to see a doctor

See a doctor if you have several risk factors, a close relative who had heart disease at a young age, or you have never had a heart check. Tell them about your family history and ethnicity, as these affect how your risk is assessed.

Call emergency services at once for chest pain that is tight or squeezing, pain spreading to the arms, neck or jaw, severe breathlessness, or sudden weakness or numbness on one side of the face or body. The NHS advises not to drive yourself to hospital.

In an emergency, call your local emergency number (112 in India, 911 in the United States).