You Can Reduce Your Risk
Certain traits, conditions, or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk factors. Risk factors also increase the chance that existing CHD will worsen.
Women generally have the same CHD risk factors as men. However, some risk factors may affect women differently from men. For example, diabetes raises the risk of CHD more in women. Also, some risk factors, such as birth control pills and menopause, only affect women.
Having just one risk factor doubles your risk for CHD. Having two risk factors increases your risk for CHD fourfold. Having three or more risk factors increases your risk for CHD more than tenfold. Also, some risk factors, such as smoking and diabetes, put you at greater risk for CHD and heart attack than others.
About 91 percent of women aged 40 to 60 have one or more modifiable risk factors for CHD. Many risk factors start during childhood; some even develop within the first 10 years of life. You can control most risk factors, but some you can't.
To find out whether you're at risk for CHD, talk with your doctor or healthcare provider.
Risk Factors You Can Control
- Smoking—Smoking is the most powerful risk factor that women can control.
- High Blood Cholesterol and High Triglyceride Levels—Cholesterol travels in the bloodstream in small packages called lipoproteins. The two major kinds of lipoproteins are low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL cholesterol is sometimes called "bad" cholesterol. This is because it carries cholesterol to tissues, including your heart arteries. HDL cholesterol is sometimes called "good" cholesterol. This is because it helps remove cholesterol from your arteries.
- Guidelines for those levels are currently changing, depending on your age and other factors unique to you.
- High Blood Pressure—Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways. Women who have blood pressure greater than 120/80 mmHg are at increased risk for CHD. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)
- Diabetes and Prediabetes—Diabetes is a disease in which the body's blood sugar level is too high. This is because the body doesn't make enough insulin or doesn't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells, where it's used for energy. Over time, a high blood sugar level can lead to increased plaque buildup in your arteries. Prediabetes is a condition in which your blood sugar level is higher than normal, but not as high as it is in diabetes. Diabetes and prediabetes raise the risk of CHD more in women than in men.
- Overweight and Obesity—The most useful measure of overweight and obesity is body mass index (BMI). BMI is calculated using your height and weight. In adults, a BMI of 18.5 to 24.9 is considered normal. A BMI of 25 to 29.9 is considered overweight. A BMI of 30 or more is considered obese.
- You can use the National Heart, Lung, and Blood Institute's (NHLBI's) online BMI calculator to figure out your BMI, or your healthcare provider can help you. (http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm)
- Metabolic Syndrome—This is the name for a group of risk factors that raises your risk for CHD and other health problems, such as diabetes and stroke. A diagnosis of metabolic syndrome is made if you have at least three of the following risk factors:
- A large waistline. Having extra fat in the waist area is a greater risk factor for CHD than having extra fat in other parts of the body, such as on the hips.
- A higher than normal triglyceride level (or you're on medicine to treat high triglycerides).
- A lower than normal HDL cholesterol level (or you're on medicine to treat low HDL cholesterol).
- Higher than normal blood pressure (or you're on medicine to treat high blood pressure).
- Higher than normal fasting blood sugar (or you're on medicine to treat diabetes).
- Birth Control Pills—Women who smoke and take birth control pills are at very high risk for CHD, especially if they're older than 35. For women who take birth control pills but don't smoke, the risk of CHD isn't fully known.
- Lack of Physical Activity—Inactive people are nearly twice as likely to develop CHD as those who are physically active.
- Unhealthy Diet—An unhealthy diet can raise your risk for CHD. For example, foods that are high in saturated and trans fats and cholesterol raise your LDL cholesterol level. A high-sodium (salt) diet can raise your risk for high blood pressure.
- Stress or Depression—Stress may play a role in causing CHD. Stress can trigger your arteries to narrow. This can raise your blood pressure and your risk for a heart attack. Getting upset or angry also can trigger a heart attack. Stress also may indirectly raise your risk for CHD if it makes you more likely to smoke or overeat foods high in fat and sugar. People who are depressed are two to three times more likely to develop CHD than people who are not. Depression is twice as common in women as in men.
Risk Factors You Can't Control
- Age and Menopause—As you get older, your risk for CHD and heart attack rises. This is due in part to the slow buildup of plaque inside your heart arteries, which can start during childhood.
- Family History—Family history plays a role in CHD risk. Your risk increases if your father or a brother was diagnosed with CHD before 55 years of age, or if your mother or a sister was diagnosed with CHD before 65 years of age. Also, a family history of stroke—especially a mother's stroke history—can help predict the risk of heart attack in women.
Making lifestyle changes and taking medicines to treat risk factors often can lessen genetic influences and prevent or delay heart problems.
Emerging Risk Factors
- Inflammation—Research suggests that inflammation plays a role in causing CHD. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow.
High blood levels of a protein called C-reactive protein (CRP) are a sign of inflammation in the body. Research suggests that women who have high blood levels of CRP are at increased risk for heart attack. Also, some inflammatory diseases, such as lupus and rheumatoid arthritis, may increase the risk for CHD.
- Migraines—Some studies suggest that women who have migraine headaches may be at greater risk for CHD. This is especially true for women who have migraines with auras (visual disturbances), such as flashes of light or zig-zag lines.
- Reduced Vitamin Levels—Low bone density and low intake of folate and vitamin B6 also may raise a woman's risk for CHD. More research is needed to find out whether calcium supplements with or without vitamin D affect CHD risk. You may want to talk with your doctor to find out whether these types of supplements are right for you.