6.6.2: Risk Factors for Heart Disease
- Page ID
- 80531
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Risk Factors for Heart Disease
Because heart disease is the leading causes of death in the United States, it is critical to address lifestyle choices that will ultimately decrease risk factors. The 2023 Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines state the following as risk factors that can be modified with lifestyle.1 The following list is provided here in alphabetical order.
- Alcohol Use: Although light to moderate alcohol use (5 to 25 grams alcohol daily) may have favorable impact on lipids, endothelial function, insulin resistance, and platelet clumping, drinking alcohol for protection from heart disease is no longer recommended. One standard drink containing 14 grams of alcohol is equivalent to one 12-ounce beer, 5 ounces of wine, or 1.5 ounces of distilled spirits, so small amounts of alcohol add up quickly. Heavy alcohol use and binge drinking increase heart disease risk. Patients with known heart disease are at risk with alcohol intake because of interactions with many prescription medications and an increase in blood pressure. There is also a genetic component to how alcohol increases heart disease risk, which cancels out some of the proposed favorable impact.2
- Diabetes: Manage your blood sugar levels, as heart disease risk doubles when you have diabetes.3
- Family history of premature heart disease. If possible, learn about your family's history and share that with your healthcare provider.
- Food Choices: Studies are consistent that a food pattern with a higher intake of whole grains and fiber, along with lower intake of saturated fat, sodium, refined carbohydrates, and sweetened beverages, supports heart health. These food choices are consistent with the Mediterranean diet food pattern, which helps reduce cardiovascular risk factors, including insulin resistance, diabetes, elevated lipid levels, high blood pressure, and obesity.1
- Hyperlipidemia (high blood lipids, including LDL-C and Lp(a)): Know your numbers and work with your healthcare provider to treat as necessary.
- Hypertension: Know your numbers. Shift your food choices to align with the DASH Diet food pattern introduced in Chapter 2, maintain a healthy weight, and keep physically active.
- Obesity: Balance food choices and physical activity to maintain a healthy weight.
- Recreational substance use (marijuana): The American Heart Association states that there are no well-documents benefits of marijuana use to prevent or treat heart disease. In fact, studies indicated the risk of heart attack, stroke, heart failure, and abnormal heart rhythms increase with marijuana use.4
- Physical inactivity: Increasing your energy expenditure by just twenty minutes of physical activity at least three times weekly will improve your overall health. Physical exercise can help you manage or prevent high blood pressure and blood cholesterol levels. Regular activity raises HDL while at the same time decreasing triacylglycerols and plaque buildup in the arteries. Calories are burned consistently, making it easier to lose and manage weight. Circulation improves, the body is better oxygenated, and the heart and blood vessels function more efficiently.
- Social determinants of health: Mental health, psychosocial stressors, health literacy, sociocultural influences, financial strain, transportation, insurance status, food security, neighborhood or environmental exposures, options for regular physical activity, and social support are all factors that can impact heart health at all levels (from prevention to testing to treatment). This reflects our prior learning of the Dimensions of Wellness (Chapter 1). Seeking resources to handle these potential barriers is recommended.
- Tobacco use: Exposure to tobacco smoke increases heart disease risk. Cigarette smoke has a negative effect on endothelial function, increases atherosclerosis, and increases blood clot risk. Smokeless tobacco also increases the risk of heart disease. Assistance is available to help you stop using tobacco, including 1-800-QUIT-NOW, Texting QUITNOW to 333888 for free help in English and Spanish, The National Cancer Institute’s quitSTART app, and the National Cancer Institute’s Smokefree.gov website.5
Additional risk factors can influence your risk of heart disease, such as age, genetic factors, and other health conditions. You may not be able to change these risk factors, but knowing they exist can help you make lifestyle decisions that work in your favor. In addition, many prescription medications are effective in the treatment of heart disease, but that topic is beyond the scope of this book.
Interested in doing a self-assessment of your heart health, or just want to learn more about these risks? Visit the Life's Essential 8 checklist.
Attributions:
- Zimmerman, "An Introduction to Nutrition (Zimmerman)," CC BY-NC-SA 3.0. Text and references added.
References
- Virani S, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023;82(9):833-955. doi:10.1016/j.jacc.2023.04.003.
- Biddinger KJ, Emdin CA, Haas ME, et al. Association of habitual alcohol intake with risk of cardiovascular disease. JAMA Netw Open. 2022;5(3):e223849. doi:10.1001/jamanetworkopen.2022.3849.
- Your Heart and Diabetes. Centers for Disease Control and Prevention. Updated May 15, 2024. Accessed August 3, 2023. https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-heart.html?CDC_AAref_Val=https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html.
- The 411 on marijuana use and cardiovascular health ahead of 4/20 Day. American Heart Association. Published April 17, 2023. Accessed August 4, 2023. https://newsroom.heart.org/news/the-411-on-marijuana-use-and-cardiovascular-health-ahead-of-420-day#:~:text=Smoking%20and%20inhaling%20marijuana%2C%20regardless,and%20other%20serious%20cardiovascular%20conditions.
- Quitlines and Other Cessation Support Resources. Centers for Disease Control and Prevention.cdc.gov. Updated May 15, 2024. Accessed August 3, 2023. https://www.cdc.gov/tobacco/hcp/patient-care/quitlines-and-other-resources.html?CDC_AAref_Val=https://www.cdc.gov/tobacco/patient-care/quitlines-other/index.html.