Every 30 seconds, someone in the U.S. has a heart attack. The 2004 INTERHEART study, a landmark 52 country study that examined the probability of first heart attack in relationship to modifiable risk factors, stated that five factors--smoking, blood lipids (fats), hypertension, diabetes and obesity--accounted for roughly 80 percent of heart attack risk. Based on these study results, the top three modifiable risk factors for heart attack are abnormal blood lipids, current smoking and diabetes.
Abnormal Blood Fat Levels
Blood contains different kinds of fats including cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides. The total amount of fats (lipids) in the blood and the relative amounts of the various types affect the risk for heart attack . The INTERHEART study found 50 percent of heart attack risk is attributable to blood lipid abnormalities--the single greatest risk factor in the study. HDL-cholesterol is a major factor in our relative risk of coronary artery disease, the condition that leads to a heart attack. People often talk about HDL-cholesterol as "the good cholesterol" because low levels of HDL-cholesterol increase heart attack risk, while normal levels are protective.
It is vital to get blood fats in a healthy state and keep the heart strong First, you need to know what your blood lipid levels are. This requires a blood test, often called a lipid panel or profile. It typically includes measurements of your total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides. Once you've been tested, you and your doctor can discuss your numbers and decide how best to make sure your blood fats are in a healthy range.
Current Smoking
Smoking is bad for your lungs. It also damages the heart. The INTERHEART study found 36 percent of heart attack risk is caused by current smoking. A person smoking a pack of cigarettes per day has double the risk of a heart attack or stroke compared to a nonsmoker of the same age.
You have the power to change your heart attack risk by quitting smoking. Within the first 18 months of stopping smoking, most of the increased cardiovascular risk from past smoking is gone. By your third to fifth year of being smoke-free, your risk will return to that of a nonsmoker. If you're a current smoker, one of the best things you can do for your heart (and your lungs) is to stop smoking.
Diabetes
Diabetes significantly increases the risk for cardiovascular disease. With diabetes, the inner and outer walls of medium and large blood vessels are damaged. This damage predisposes the blood vessels to the formation of atherosclerotic plaques, thereby diminishing blood supply to the heart.The American Heart Association states cardiovascular disease accounts for at least 65 percent of deaths among people with diabetes. Furthermore, the risk of dying from a heart attack is significantly higher in people with diabetes compared to nondiabetics. Therefore, in the presence of diabetes, optimizing all other modifiable heart attack risk factors becomes that much more important.
Notably, 90 percent to 95 percent of American with diabetes have type 2 disease, which is caused by insulin resistance. This means insulin is being made, but the cells of the body are not responding normally, which leads to high blood sugar levels. Several factors known to decrease insulin resistance are also likely to improve heart health--doubling your health benefits. For example, obesity and an inactive lifestyle both contribute to insulin resistance. Losing weight and getting active not only help reduce insulin resistance, but also contribute to good heart health.
References
- American Heart Association: Heart disease and strokes statistics 2010 update at-a-glance
- Lancet"; Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study; Salim Yusuf, D.Phil., S. Hawken, S. Ounpuu; September 2004
- "American Heart Journal; Cardiovascular disease and multifactorial risk: challenge of the 1980s; W.P. Castelli, M.D.; November 1983
- Journal of the American College of Cardiology: Shedding light on high-density lipoprotein cholesterol
- Mayo Clinic Proceedings: Primary and secondary prevention of cardiovascular diseases: a practical evidence-based approach
