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What
are the risk factors?
After extensive research in coronary heart disease, it
has been determined that risk factors fall into two
categories: major and contributing. Major
risk factors are those that significantly increase your
chances of having coronary heart disease. Some of
these major risk factors can be modified, treated or
controlled and some can't. Contributing
risk factors are associated with increasing your risk
for coronary heart disease and can be controlled to
lessen your risk.
What
are the major risk factors?
-
Heredity
-- Heart
disease often runs in families. The
genes that carry the blueprints for our
bodies may carry heart disease from
parents to children. Habits and customs
practiced by a family also may increase
a person’s risk.
Although you cannot control this
factor, you can be aware of your family’s
history of heart disease.
If your family has a history of
heart disease, you may be more likely to
develop it as well.
-
Gender
--Men are more likely than women
to develop heart disease and are more
predisposed to getting into trouble at
an earlier age. This is probably related
to the protective effect of female
hormones. This is supported by the fact
that heart disease in women increases
dramatically after menopause when women’s
bodies stop producing the hormone
estrogen. However, this does not mean
that women are immune to heart disease.
-
Race
-- The risk of heart attacks in
African-Americans is higher than in any
other race. The reason may be that
African-Americans are twice as likely to
have high blood pressure as others.
-
Age
-- Recent studies suggest that
men 45 years of age or older are at a
higher risk of heart disease. Women age
55 or older (post-menopausal) are at a
higher risk for coronary artery disease,
unless they are taking estrogen
supplements.
These major factors can't
be controlled or changed; that is why it is important to
treat and control contributing risk factors so they
don't add to your already high risk for coronary heart
disease.
What
are the contributing risk factors?
- Cigarette
smoking-- Nicotine
from
cigarette
smoking
makes
the heart
work
harder
by temporarily
increasing
blood
pressure
and heart
rate.
Furthermore,
the carbon
monoxide
from
cigarette
smoke
gets
in the
blood
stream
and reduces
the amount
of oxygen
delivered
to the
heart
and other
parts
of the
body. Cigarette
smoking
also
causes
platelets
(clotting
agents)
in the
blood
to become
sticky
and
cluster,
shortens
their
survival,
reduces
the
clotting
time
and
makes
blood
thicker.
All
of these
factors
are
harmful
to the
cardiovascular
system
and
put you
at higher
risk
for
a heart
attack.
Giving up smoking is the only
way to decrease this risk
factor. For those that have
given up the habit, the risk of
heart attack eventually declines
almost to the same level as that
of people who have never smoked.
There are many over-the-counter
medications to help a person
quit smoking. However, you
should always check with your
physician before starting these,
since many can contain nicotine
and have some of the same
effects on the heart as smoking
can. Your physician, nurse and
exercise physiologist can help
you develop an individual plan
to help kick the habit.
- Cocaine
abuse-- Cocaine
causes
constriction
of
the
coronary
arteries,
which
decreases
the
flow
of
blood,
and
hence
oxygen,
to
the
heart
muscle.
At
the
same
time,
it
increases
the
heart
rate,
which
increases
the
heart’s
need
for
oxygen.
These
combined
reactions
can
result
in
angina,
heart
attacks
and
sudden
death.
These
effects
can
happen
in
individuals
who
use
cocaine
for
the
first
time
or
repeatedly.
- Diabetes--
People
with
diabetes
have
a higher
risk
of heart
disease
than
those
who are
not diabetic.
Diabetes
is a
condition
that
occurs
when
the pancreas
is
unable
to make
enough
insulin
or when
the body
is unable
to use
its own
insulin.
It
is often
associated
with
a
fatty
buildup
in the
arteries.
If you
are diabetic
and also
suffer
from
heart
disease,
it is
doubly
important
that
you
follow
your
doctor’s
advice
in managing
your
controllable
risk
factors.
Regular
checkups,
a balanced
diet
and
exercise
are important
in treating
diabetes
as well
as in
treating
heart
disease. back
to top
- High
blood pressure--
High
blood pressure
(hypertension)
places
a
greater-than-normal
demand
on
the
heart
muscle.
It
is
generally
agreed
that
blood
pressures
consistently
greater
than
140/90
should
be
treated.
In
most
cases,
the
cause
of
hypertension
is
unknown.
A
person
with
mild
elevation
of
blood
pressure
often
begins
treatment
with
a
program
of:
- weight
reduction, if
needed
- salt
reduction
- exercise
- elimination
of cigarette
smoking
- modification
of stressful
habits
- medication
The
left ventricle is the chamber of
the heart that is responsible
for pumping blood to every part
of the body, from your toes to
your head. Untreated high blood
pressure can cause this part of
the heart to enlarge
(hypertrophy), resulting in
increased risk of heart failure
and heart rhythm disturbances.
Fortunately, treating high blood
pressure treats this problem as
well.
-
Behavioral
characteristics--
Having
a “Type A”
personality is thought
by some experts to be a
risk factor for heart
disease. This
personality type is
characterized by an
intense time pressure,
chronic impatience and
hostility or anger. Hard
work and long hours are
not necessarily features
of this type of
behavior. All human
beings feel stress; life
without it would be
dull, indeed. Each of us
reacts to stress
differently. Excessive
stress over a long
period may create health
problems in some people.
Ask your cardiac rehab
specialist for stress
management techniques
and programs
available. back
to top
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Blood
cholesterol levels--
Cholesterol is a blood
fat or lipid. Our bodies
make cholesterol, and it
is found in some foods.
Cholesterol is essential
to health. It enables
the body to build cells,
repair tissues and make
sex hormones and vitamin
D. Unfortunately, too
much cholesterol can
build up in the
arteries, reducing blood
flow and leading to
heart disease.
Cholesterol is carried
in the blood by
proteins. The blood fat
and protein together are
called lipoproteins.
High-density
lipoprotein (HDL),
the so-called “good”
cholesterol, is the part
of cholesterol that
leaves the body and does
not build up deposits.
- HDLs
help
transport
cholesterol
from
the
body’s
cells
to
the
liver
where
it
is
broken
down.
HDLs
also
may
keep
LDLs
from
entering
cells.
Low-density
lipoprotein
(LDL),
the
so-called
“bad”
cholesterol,
is
the
type
of
cholesterol
that
can
damage
your
health.
-
LDLs
are
mostly
fat
and
tend
to
break
down
as
they
move
through
the
blood.
They
leave
behind
deposits
of
cholesterol,
which
builds
up
in
the
arteries.
-
Both
HDL
and
LDL
components
are
considered
in
the
evaluation
of
a
person’s
risk
for
heart
disease.
If
LDL
elevation
is
the
only
risk
factor
present,
a
person
should
try
to
keep
the
LDL
level
under
160.
If
additional
risk
factors
are
present,
the
target
LDL
level
should
be
less
than
130.
If
a
person
has
already
developed
symptoms
of
heart
disease,
the
target
LDL
level
should
be
100.
-
Attempts
should
be
made
to
bring
the
HDL
and
triglyceride
levels
into
the
desirable
range.
Triglycerides
are
the
chemical
form
in
which
most
fat
exists.
HDL
levels
in
men
should
be
greater
than
35,
and
in
women,
greater
than
45.
Triglyceride
levels
should
be
less
than
200.
Smoking
cessation,
exercise,
diet
and
weight
loss
can
help
increase
the
number
of
HDLs
and
decrease
the
LDLs
in
your
blood.
Sometimes,
though,
medication
may
be
needed
to
help
you
achieve
your
target
cholesterol
level.
-
In
addition
to
HDLs,
LDLs
and
triglycerides,
Lipoprotein(a)
or
“Lp
little
a,”
a
specific
form
of
LDL
cholesterol,
has
begun
getting
more
attention
from
physicians.
Many
studies
have
shown
that
higher
levels
of
Lp(a)
are
associated
with
an
increased
frequency
of
coronary
heart
disease.
Doctors
are
increasingly
looking
at
Lp(a)
levels
when
evaluating
a
person’s
risk
for
heart
disease.
back
to
top
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Obesity
--
Extra weight
puts extra
strain on your
heart. In most
cases, being
overweight
simply results
from eating too
much and
exercising too
little. Excess
body fat (20
percent
overweight)
makes the heart
work harder and
increases the
risk of
hypertension,
diabetes and
elevated
cholesterol
levels. In
addition to
weight itself,
it appears that
weight
distribution is
associated with
cardiac risk.
When weight is
mostly in the
abdominal area,
the so-called
“apple
distribution,”
the risk for
heart disease is
increased. When
the weight is
mostly in the
hips and buttock
area, the “pear
distribution,”
the risk does
not appear to be
as great.
The
Jewish Hospital Weight
Management Center
can help you control
this risk factor by
helping you create your
own balance of smart
eating, attitude and
activity that can last a
lifetime.
The
St. Luke Hospitals also
offer a weight
management program.
For more
information, call 859-
572-3382.
-
Lack
of exercise
-- Exercise and
diet are the
best ways to
lose body fat
and weight. For
every 3,500
calories you
either don’t
eat or you burn
up with
increased
activity, you
lose one pound.
If you cut 425
calories out of
your daily diet
and use up an
extra 450
calories in
exercise, it
would take four
days to lose one
pound. A
balanced diet
containing the
number of
calories needed
to maintain an
ideal weight
will help reduce
the risk of
heart attack.
Weigh yourself
weekly and
follow your
physician’s
advice for
weight
reduction. A
hospital
dietitian can
help you.
The
American Heart
Association now
recognizes lack
of exercise as a
major risk
factor for heart
disease. For
sedentary people
just adding a
little exercise
to a daily
routine can help
fight heart
disease, as well
as reduce the
risk of high
blood pressure,
osteoporosis,
breast and colon
cancer,
depression,
anxiety and
stress. For more
information
about the
benefits of
exercise or for
help in starting
an exercise
program, refer
to the Home
Exercise Program
in Your
Recovery from
Heart Surgery.
Also,
please consult
with your doctor
and the hospital’s
exercise
physiologists
for guidelines.
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