Having a heart attack increases the probability of having another because coronary artery disease can progress over time. Certain interventions or treatments such as angioplasty, artherectomy and bypass surgery decrease the probability by improving the blood supply but do not cure the disease. In order to attempt to slow down this process, it is very important to reduce risk factors associated with the development and progression of coronary artery disease.
Extensive studies have identified certain characteristics or risk factors, which have been demonstrated to increase the risk of developing heart disease. These risk factors can be grouped into two classifications: 1) major risk factors and 2) contributing risk factors. The more risk factors a person has, the greater the chance of developing heart disease.
MAJOR RISK FACTORS Major risk factors are those factors that medical research has shown to be definitely associated with an increased risk of heart disease.
Can be changed or modified:
- Smoking cigarettes, pipes, cigars
- High blood pressure
- Elevated blood cholesterol (greater than 200mg/dl), high LDL and low HDL
- Lack of regular exercise
CONTRIBUTING RISK FACTORS
Contributing risk factors are those associated with increased risk of heart disease, but their significance and prevalence have not been directly determined.
Cannot be changed or modified:
- Male gender
- Heredity (inherited traits)
- Increasing age (greater than 65 years old)
Can be changed or modified:
- Obesity (greater than 25 -30% of ideal body weight)
SMOKING (Cigarettes, chewing tobacco, pipes, cigars and second-hand smoke)
Why is Smoking Dangerous?
- A smoker’s risk of having a heart attack is more than twice that of a nonsmoker.
- Nicotine increases oxygen demand by increasing heart rate and blood pressure.
- Carbon monoxide from the smoke decreases the oxygen supply by taking the place of oxygen in the blood. One cigarette increases the carbon monoxide level for about 4 hours making it difficult for the heart muscle to get enough oxygen.
- The heart has to beat faster and harder to pump more blood to deliver the same amount of oxygen.
- Smoke damages the inner lining of the artery walls, causing small abrasions or rough spots to develop on the artery wall. This rough surface attracts cholesterol resulting in a buildup called plaque. This leads to a narrowing of the artery which decreases blood flow.
- Smoke may trigger coronary artery spasms, which can cause the vessel to constrict and decrease blood supply to the heart muscle.
- HDL levels, the good cholesterol, can decrease.
- The possibility of having irregular heart beats increases.
What Can be Expected After Quitting?
The beneficial effects are apparent almost at once, regardless of the number of years or packs/day smoked.
- Heart rate and blood pressure will be lower.
- The heart muscle receives more oxygen.
- The risk of having another heart attack is reduced to almost that of a non-smoker within six months!
HYPERTENSION (HIGH BLOOD PRESSURE)
What is Blood Pressure?
- Blood pressure is the amount of pressure the circulating blood puts on the artery walls.
- Each time the heart contracts or beats, blood is pumped out and creates pressure in the arteries. This surge of pressure is known as systolic pressure and is the top number of the blood pressure reading.
- Each time the heart relaxes between beats, the blood pressure will go down. This is known as the diastolic pressure and is the bottom number of the blood pressure reading.
What is High Blood Pressure?
- High blood pressure is a reading higher than 130/85 mmHg.
- It is called the “Silent Killer,” as there are no warning symptoms.
Why is High Blood Pressure Dangerous?
- It increases the workload of the heart, causing the heart muscle to become enlarged over time.
- It increases the heart’s need for oxygen.
- The constant increased pressure damages the inside lining of the arteries and causes small rough spots that attracts cholesterol resulting in a build up of plaque. This leads to a narrowing of the artery which decreases blood flow.
- It is a contributing factor in:
- Coronary artery disease
- Heart attack
- Congestive heart failure
- Kidney failure
How is High Blood Pressure Treated?
- Low sodium (salt) diet
- Weight loss
HIGH CHOLESTEROL LEVELS
What is Cholesterol?
- Cholesterol is the fat that is found in atherosclerotic plaque. It narrows the artery, reducing blood flow.
- Age, gender, heredity, and diet affect cholesterol levels.
- Refer to section on Cholesterol.
LACK OF REGULAR EXERCISE
- Lack of regular exercise decreases the efficiency of the heart’s vascular system (blood vessels) blood vessels.
- Exercise can help decrease other risk factors such as high blood pressure, stress, obesity, and high cholesterol levels.
- Chronic stress of an intense and negative nature can have a detrimental effect on the heart.
- See section on Stress
OBESITY (25 – 30% over recommended weight for age, sex and height)
- Makes the heart work harder to pump blood throughout a larger body
- Increases the heart’s need for oxygen
- Increases blood pressure
- Increases cholesterol levels
- Can lead to diabetes
If there is a family history of coronary artery disease, it is more likely that future generations will develop coronary artery disease.
- Genetic makeup determines the way the body handles cholesterol and other fats.
- Family habits and traits such as eating high-fat meals, smoking, sedentary lifestyle, overweight, and hypertension can contribute to the development of heart disease.
- People with diabetes are at greater risk for developing heart disease at an earlier age and it is also likely to progress at a faster rate.
- It negatively affects cholesterol and triglyceride levels.
- The risk is lessened when diabetes is controlled by observing dietary restrictions and/or taking prescribed medications.
- About 5% of all heart attacks occur in people under age 40, and 45% occur in people under age 65. Of those who die, almost four out of five are over 65. Atherosclerosis is part of the aging process, but its progression and severity depend on family history and lifestyle factors.
- Men are at greater risk for heart attacks, and they occur at an earlier age in men than women. Female hormones protect women in their younger years. After menopause, women’s death rate from heart disease increases because of decreasing estrogen levels. Yet, in today’s society, women are also exposed to additional stressors e.g. careers, and they are more likely to smoke, thus increasing their risk of heart disease.