Factors that increase the risk for cardiovascular disease fall into two categories: those that can be controlled and those that cannot. As you read about each factor, ask yourself whether it applies to you, and note the steps you can take to reduce its influence.
As early as 1984, the Surgeon General of the United States asserted that smoking was the greatest risk factor for heart disease. Generally, the more a person smokes, the greater the risk for heart attack or stroke. The risk for cardiovascular disease is 70 percent greater for smokers than for nonsmokers. Smokers who have a heart attack are more likely to die suddenly (within one hour) than are nonsmokers. Available evidence also indicates that chronic exposure to environmental tobacco smoke (ETS or passive smoking) increases the risk of heart disease by as much as 30 percent.
Although we do not fully understand how cigarette smoking damages the heart, there are two plausible explanations. One theory states that nicotine increases heart rate, heart output, blood pressure, and oxygen use by heart muscles. Because the carbon monoxide in cigarette smoke displaces oxygen in heart tissue, the heart is forced to work harder to obtain sufficient oxygen. The other theory, states that chemicals in smoke damage the lining of the coronary arteries, allowing cholesterol and plaque to accumulate more easily. This additional buildup constricts the vessels, increasing blood pressure and causing the heart to work harder.
When people stop smoking, regardless of how long or how much they’ve smoked, their risk of heart disease declines rapidly. Three years after quitting, the risk of death from heart disease and stroke for people who smoked a pack a day or less is almost the same as for people who never smoked. Quitting today will also raise your HDL levels, reducing your risks even further.
Cut Down on Fats and Cholesterol
Researchers now realize that high-fat diets are even more dangerous than previously thought. Fatty diets not only raise cholesterol levels slowly over time, but also can send the body’s blood-clotting system into high gear and make the blood sludgy in just a few hours, increasing the risk for heart attack. Studies indicate that fatty foods apparently trigger production of factor VII, a blood-clotting substance. Switching to a low-fat diet promptly eliminates the risk of clotting.
A fatty diet also increases the amount of cholesterol in the blood, contributing to atherosclerosis. In past years, cholesterol levels of between 200 and 250 milligrams per 100 milliliters of blood (mg/dl) were considered normal. Recent research indicates that levels between 180 and 200 mg/dl are more desirable for reducing the risk for CVD. Cholesterol comes in two varieties: low-density lipoproteins (LDLs) and high-density lipoproteins (HDLs). Scientists used to think that the critical question was whether a person had more of the “good” HDLs than the “bad” LDLs. But now, according to scientists, what may really count is the HDL component Lp(a). The more of this protective protein a person has, it seems, the lower the risk for heart disease.