The 10 Biggest Risk Factors for Heart Disease

The world can be a scary place. Killer storms, terrorist attacks, and disease are front page news practically every day. It can make you scared to step foot outside. But shocking truth is that despite all the terrible things happening around the world, the biggest risk to your life is right there in the room with you. Heart disease remains the leading cause of death in the United States—for men and women—killing about 600,000 people each year. That’s roughly 1 in 4 total deaths (or more than all cancer deaths combined).

Men have a higher risk of heart disease than women until the age of 75

The good news is that many of the factors that lead to heart disease are avoidable, and other factors are treatable with easy to get, inexpensive medications and a few simple lifestyle changes. Heart attacks are a scary thing to think about, but there’s a heck of a lot more you can do for your heart than the next superstorm. Get to know the 10 biggest risk factors that contribute to heart disease and cardiovascular disease so you can prevent falling victim to the real biggest killer in the US.

Table of Contents

• Heart Disease: Non-modifiable Risk Factors
• Heart Disease: Modifiable Risk Factors
• Treating Cardiovascular Disease: Lifestyle & Medication
• Heart Attacks: Understanding Your Unique Risk Factors
• More Heart Disease Information and Resources

Heart Disease: Non-modifiable Risk Factors

Let’s start with the bad news first: There’s nothing you can do about three of the biggest risk factors for heart disease. Your age, family history, and even your gender are all strong risk factors for cardiovascular disease. That’s the bad news. The good news is that knowing how these risk factors affect you can help you and your doctor reduce their impact. In fact, it might even be more important to address existing conditions like high cholesterol and blood pressure as you age and if you have a strong family history of heart disease. Good heart health starts with awareness.

Here are the three most important non-modifiable risk factors for heart disease:

1. Age: The older you get, the more likely you are to suffer from heart disease. Medical professionals always factor age into risk calculators to estimate your risk of heart disease. And while “age is just a number,” it’s still important to take into account when making treatment decisions.
2. Family history/genetics: Sorry guys, if you have a family member who developed heart disease at a young age (before 55 for men and 65 for women) you’re at greater risk. While you can’t change your genes, you can change your environment, which is partially responsible for how your genes are expressed (aka “epigenetics”).
3. Gender: Men have a higher risk of heart disease than women until the age of 75. It’s just one of those things. Studies previously thought that women’s lower risk of heart disease was due to the protective effects of estrogen on the cardiovascular system. However, more research has shown that may not be true after all, and even though the reasons for this gender gap aren’t totally clear, the results remain the same.

Heart Disease: Modifiable Risk Factors

Now for the good news (finally). You can modify the rest of the heart disease risk factors on this list with a few simple lifestyle changes.

1. Smoking: The CDC estimates that smoking can double or even quadruple your risk of heart disease and stroke. Smoking damages blood vessels and increases blood pressure and plaque buildup in the arteries. These factors increase the likelihood of developing arterial blood clots (aka heart attacks and strokes).
2. Sedentary lifestyle: A sedentary lifestyle increases the risk of cardiovascular disease in men. Increasing your physical activity has been shown to protect against cardiovascular disease in a dose-response relationship—meaning that a larger dose of exercise is more protective than a smaller one. When it comes to being physically active, more is more.
3. Poor Diet: Nutrition science is confusing. Every day you hear about another superfood or life-changing diet that will revolutionize your health. Most of this advice is hype. However, there are a few dietary patterns that have been shown to be beneficial for health, including cardiovascular health. The Mediterranean Diet is one such diet. It’s relatively high in fat from olive oil and nuts and suggests eating more fruits, vegetables, fish, fermented dairy products, and poultry. It’s also low in sweets, refined carbohydrates, sugar-sweetened beverages, added sugar, and red meat.
4. Obesity: Obesity is an independent risk factor for heart disease. Basically, that means, all things being equal, obesity alone increases your risk for heart disease. If that’s not bad enough, type 2 diabetes, high cholesterol, hypertension, inflammation, blood clots and dysfunctional blood vessel linings (endothelial dysfunction) are all connected to both obesity and heart disease. There’s also some research that shows that weight loss intervention can prolong life in adults with obesity.

According to the CDC,smoking increases the risk of heart disease and stroke by 2-4 times.

Treating Heart Disease: Lifestyle & Medication

The best approach to the prevention and treatment of heart disease is a combination of education, medical intervention, and positive lifestyle changes—especially for these high-risk factors:

1. Diabetes: Both Type 1 and Type 2 diabetes are risk factors for cardiovascular disease. Type 2 diabetes makes up about 90-95% of diabetes in the US, and over 86 million people in the US are prediabetic (meaning they’re at risk for developing type 2 diabetes). People with diabetes can lower their risks for heart disease by quitting smoking, staying physically active, eating a healthy diet, and monitoring and controlling their blood pressure and cholesterol levels. Basically everything from the list above. Diabetes medication, like metformin, can also help treat type 2 diabetes.
2. Hypertension: Hypertension is often called “the silent killer” for a reason. High blood pressure is associated with a 20-45% increased risk of various types of heart disease. If you’re diagnosed with hypertension you can lower your blood pressure and risk for cardiovascular disease with weight loss, increased physical activity, the DASH Diet, drinking less alcohol, and drug therapy when necessary.
3. High Cholesterol: Elevated levels of LDL and non-HDL cholesterol are major risk factors for cardiovascular disease. Many of the same recommendations for people with hypertension apply to those with high cholesterol levels. However, your doctor might also prescribe different medications like Lipitor (atorvastatin), Crestor (rosuvastatin), Zocor (simvastatin).

Heart Attacks: Understanding Your Unique Risk Factors

Obviously, there are other cardiovascular disease risks besides these 10 factors. However, these existing conditions and lifestyle risks account for the vast majority of all cardiovascular disease.

Heart disease doesn’t have to be inevitable—even if you’re at risk. Most of these factors are modifiable with lifestyle changes and medication. Work with your doctor or healthcare provider to assess your risk factors and create a treatment plan to lower your risk for heart disease.

Geek Out: More Heart Disease Resources

Not enough info for you? Geek out on heart disease with these studies and stats from the most trusted health sources on the interwebs. And if you have any questions or you think we missed something important, leave a comment or book a consultation with me or one of these trained medical professionals and we’ll answer your questions and concerns in no time.

• Deaths and Mortality Statistics (CDC)
• Family History and Other Characteristics That Increase Risk for Heart Disease (CDC)
• Family History and Heart Disease and Stroke (AHA)
• Sex/Gender Differences in Cardiovascular Disease Prevention (AHA)
• Health Effects of Cigarette Smoking (CDC)
• Sedentary Behaviors Increase Risk of Cardiovascular Disease Mortality in Men (Med Sci Sports Exerc)
• Physical Activity and Cardiovascular Disease: How Much is Enough? (Am J Lifestyle Med)
• Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity (AHA)
• Mediterranean Diet and Cardiovascular Health (Adv Nutr)
• Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss (AHA)
• Mechanisms linking obesity with cardiovascular disease
• Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer (BMJ)
• Type 2 diabetes and cardiovascular disease (World J Diabetes)
• Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people (Lancet)
• 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

Dr. Tzvi Doron

Dr. Tzvi Doron is board certified family doctor and the Clinical Director of Roman. He’s a member of the American Osteopathic Association (AOA) and the American Academy of Family Physicians (AAFP).