Wednesday, October 5, 2011

Risk Factors of Heart Disease

Who is at risk of getting heart disease?
Risk factors are conditions or habits that make you more likely to develop heart disease. The more risk factors you have, the greater your chances of getting heart disease. Some risk factors, such as your age or family history, cannot be changed. But many risk factors can be changed by making simple changes in the way you live.

Risk factors that you can change :
1. Abnormal Blood Cholesterol and Triglyceride Levels
Cholesterol and triglycerides  are types of fat found in your blood and other parts of the body. They are carried in the blood by lipoproteins. Your body needs small amounts of these substances to work well. But too much can lead to plaque buildup on your artery walls. In fact, plaque is made up mostly of unused cholesterol. A blood test will help measure your levels of:
• Low-density lipoprotein (LDL) or “bad” cholesterol—High levels lead to buildup of cholesterol in arteries.
• High-density lipoprotein (HDL) or “good” cholesterol—High levels are good. HDL cholesterol travels from other parts of your body to your liver, where it is processed to be removed from the body. This lowers the total cholesterol level in the body.
• Total cholesterol—LDL cholesterol plus HDL cholesteroll
• Triglycerides.
Ask your doctor for the results of your blood test and find out your risk in the table below. These numbers  help measure your chances of getting heart disease. Nearly half of U.S. women are at border- line high or high risk of heart disease. Some people have a tendency toward high cholesterol. But most cases of high cholesterol and triglyceride levels are from eating unhealthy foods, not exercising, and other lifestyle choices. In many cases, adopting a heart-healthy lifestyle can lower total cholesterol, LDL cholesterol, and triglyceride levels. In addition, moderate physical activity for at least 30 minutes on 5 or more days of the week can raise your HDL cholesterol levels. This can help reduce your heart disease risk. If lifestyle changes do not bring your cholesterol and triglyceride levels back to normal, your doctor may prescribe one or more of these types of medicines:
• Statins
• Bile acid resins
• Fibrates
• Cholesterol absorption inhibitors
2. High Blood Pressure (Hypertension)
Blood pressure is the force your blood makes against the walls of your arteries. Your blood pressure is highest when your heart pumps blood into your arteries. This is called systolic pressure. It is lowest between beats, when the heart relaxes. This is called diastolic pressure. Your blood pressure varies throughout the day. But if your blood pressure stays above normal most of the time, then you have high blood pressure, or hypertension. If your blood pressure is borderline high, then you have prehypertension. This means that you don’t have high blood pressure now but are likely to develop it in the future. High blood pressure is called the “silent killer” because you can have no symptoms. But years of high blood pressure can damage artery walls, causing atherosclerosis and heart disease. High blood pressure is a common problem among women, especially African American women. If you have hypertension or prehypertension, you may be able to lower your blood pressure by:
• Losing weight if you are overweight or obese
• Getting 30 minutes of moderate intensity physical activity on most days of the week
• Limiting alcohol to one drink per day
• Quitting smoking if you smokel eating foods that are good for your heart
• Reducing stress
If  lifestyle changes do not lower your blood pressure back to normal, your doctor may prescribe medicine. Some types commonly used to treat hypertension include:
• Diuretics
• Beta blockers
• Ccalcium channel blockers
• Angiotensin converting enzyme (ACE) inhibitors
• Sngiotensin II receptor blockers (ARBs)
If you have hypertension or prehypertension, you should also know that you may be at increased risk of developing type 2 diabetes. You should get tested for type 2 diabetes if your blood pressure readings:
• Are too high
• Are borderline high
• Have been steadily increasing for the last several years but are still in the normal range
3. Cigarette Smoking
The more you smoke, the higher your risk of heart disease. In fact, about half of all heart attacks in women are due to smoking. What’s more, if you smoke and also take birth control pills, you are at high risk of heart disease. If you are among the nearly 1 in 5 women in the United States who smokes, now is the time to quit. Talk to your doctor if you need help. There are medicines that can help you quit. Counseling and support groups can also be helpful.
4. Diabetes
Diabetes is a disease in which blood glucose (sugar) levels are too high. Type 2 diabetes the most common type usually begins after the age of 40, often in people who are overweight or obese. Uncontrolled diabetes can damage artery walls, leading to atherosclerosis and heart disease. In fact, uncontrolled diabetes raises a woman’s risk of heart disease more than it does for a man. Also, women with diabetes do not recover as well from a heart attack as men with diabetes do. If you have type 2 diabetes and are overweight or obese, you might be able to lower your blood glucose levels back to normal by losing weight. If this doesn’t work, your doctor might give you medicines or insulin, a hormone that lowers blood glucose levels.
5. Being Overweight or Obese
The more overweight you are, the higher your risk of heart disease even if you have no other risk factors. Being overweight or obese also raises your chances of developing diabetes, high blood pressure, and high blood cholesterol. Being overweight or obese is common among women in the United States, especially among African American and Hispanic women. How do you know if you are overweight or obese? Use the chart below to find your height and weight. The point at which the two meet is your body mass index (BMI).
Once you have found your BMI, check it against the ranges below:
Normal weight: BMI = 18.5–24.9
Overweight: BMI = 25–29.9
Obese: BMI = 30 or higher
For women, a waist size of more than 35 inches also increases heart disease risk. This is because fat located in the abdomen increases atherosclerosis more than fat located in other areas, such as the hips. If you are overweight, obese, or your waist size is more than 35 inches, losing weight can help prevent health problems like heart disease and diabetes. Work with your doctor to create a weight loss plan that stresses heart healthy foods and regular physical activity.
6. Metabolic Syndrome
Having metabolic syndrome doubles your risk of getting heart disease or having a stroke. You have it if you have any 3 of these 5 risk factors:
• Waist measurement of more than 35 inches
• Triglyceride level more than 150 mg/dL
• HDL cholesterol level less than 50 mg/dL
• Systolic blood pressure greater than or equal to 130 mmHg or diastolic blood pressure greater than or equal to 85 mmHg
• Blood glucose level after fasting for at least 8 hours of greater than 110 mg/dL
Taking steps to eliminate these risk factors will improve your heart and, overall, health. Lack of physical activity
Lack of physical activity increases your heart disease risk, even if you have no other risk factors for heart disease. It also increases your chances of developing high blood pressure and diabetes and of being overweight or obese. If  finding time to be physically active seems like an impossible challenge, take heart. As little as 30 minutes of moderate intensity physical activity on most, if not all, days of the week helps protect your heart. You can even split this time into three segments of at least 10 minutes each.
7. Drinking Alcohol
Heavy drinking causes many heart related problems. More than 3 drinks per day can raise blood pressure and triglyceride levels. Too much alcohol also can damage the heart muscle, leading to heart failure. Overall, people who drink heavily on a regular basis have more heart problems than either moderate drinkers or nondrinkers. However, moderate drinkers are less likely to develop heart disease than people who don’t drink any alcohol or who drink too much. Red wine drinkers in particular seem to be protected to some degree against heart disease. Red wine contains flavonoids , which are thought to prevent plaque buildup. Red grapes, berries, apples, and broccoli also contain flavonoids. Drinking more than one drink per day increases the risks of certain cancers, including breast cancer. And if you are pregnant, planning to become pregnant, or have another health condition that could make alcohol use harmful, you should not drink. With the help of your doctor, decide whether moderate drinking to lower heart attack risk outweighs the possible increased risk of breast cancer or other medical problems. If you do decide to drink alcohol, remember that moderation is the key.
8. Sleep Apnea
Has anyone ever told you that you snore? Loud snoring can be a sign of sleep apnea , a sleep disorder that can raise your chances of having a heart attack. With obstructive sleep apnea the most common type the tissue in the back of the throat relaxes and blocks airflow to your lungs. This lowers the oxygen level in your blood, which makes your heart work harder and often leads to high blood pressure. Also, these repeated pauses in breathing cause fragmented sleep, which results in daytime sleepiness. Women are more likely to develop obstructive sleep apnea after menopause. Other things that may increase the risk of obstructive sleep apnea are:
• Being overweight or obese
• Smoking
• Using alcohol or sleeping pills
• A family history of sleep apnea
If you think that you have sleep apnea, talk with your doctor. Your doctor might suggest a sleep test to see how severe your sleep apnea is. Mild cases often can be helped by lifestyle changes, such as losing weight and not drinking alcohol before bed. If you have severe obstructive sleep apnea or another type, your doc-tor may suggest other treatments, such as using a machine that props open your airway during sleep or having surgery.
Risk factors that you cannot change :
1. Age
Women develop heart disease about 10 to 15 years later than men. This is because until you reach menopause, your ovaries make the hormone estrogen, which protects against plaque buildup. But once you reach menopause, your ovaries stop making estrogen and your risk of developing heart disease goes up. By age 70, women have about the same chances of developing heart disease as same aged men. Even apart from the increased risk brought on by menopause, getting older is a risk factor for heart disease in women. With age, arteries stiffen and thicken. Also, systolic blood pressure often goes up. These and other changes contribute to plaque buildup in artery walls.
2. Family History of Early Heart Disease
Women with a father or brother who developed heart disease before age 55 are more likely to develop heart disease. Women with a mother or sister who developed heart disease before age 65 are also more likely to develop the disease. These trends suggest that you can inherit genes that increase your risk of heart disease. Still, young women with a family history appear to be less aware of their risks and less careful about living a heart healthy lifestyle than men with a family history.
Other Possible Risk Factors :
1. Depression, Anxiety, and Stress
Negative emotions such as depression, anxiety, and anger have all been shown to increase your chances of developing or dying of heart disease. We don’t know why this is so. Perhaps being depressed, anxious, or angry leads to behaviors that put your heart health at risk, such as smoking, drinking, and eating high fat foods. It is also possible that negative emotions affect the body in ways that trigger atherosclerosis or blood clot formation within arteries. Stress also appears to be linked to heart health in some way. Here are some examples:
• Work stress. Feelings that you have little control over what happens to you at work or that you are not being rewarded enough for the work that you do have been linked to getting heart disease.
• Stress at home. If you are caring for a disabled or ill spouse, the stress of this role may raise your risk of heart attack.
• Combined stress. Being stressed both at work and at home has been shown to increase your chances of having a heart attack or severe angina more than either type of stress by itself.
• Low social support. People with few friends or family to help them deal with stress are more likely to develop heart disease.
If you’re unhappy with your life or feel distressed in some way, talk to your doctor. Although we don’t know if treating emotional problems or reducing stress can lower your chances of getting heart disease, doing so can boost your emotional health and overall well being.
2. Lower Income
Research shows that lower income adults have an increased risk of heart disease. Also, children born into lower income families are more likely to have heart disease in adulthood. There are many possible reasons for this link. For instance, low income adults are less likely to be physically active and eat a heart healthy diet, and they are more likely to smoke.
It can be difficult to eat a heart healthy diet in lower income neighborhoods. Many of these neighborhoods lack a grocery store that sells fresh fruits and vegetables. Or if they do, these items may be too costly. People in some of these neighborhoods have dealt with these problems by forming food coops that buy fresh fruits and vegetables in bulk and then sell them at low prices.
Also, it can be difficult to be physically active in neighborhoods that are unsafe. Some communities have dealt with this problem by creating physical activity programs at local recreation centers or churches. Contact your local parks department and churches to see if any such programs exist in your community.
3. Not enough sleep
Most adults need 7 to 9 hours of sleep to feel well rested during the day. Your heart needs a good night’s sleep too. Sleeping 5 hours or less each night doubles the risk of high blood pressure for people between the ages of 32 and 59. One reason for this may be that feeling cranky, tired, and stressed due to lack of sleep makes it harder to follow a heart healthy lifestyle. Try these tips to get the good quality sleep your heart needs:
• Go to bed and wake up at the same time each day (even weekends).
• Engage in a relaxing activity before bed, such as reading or taking a bath.
• Make sure your bedroom is dark, quiet, and cool.
• Use your bed for sleep and sex only.
• Don’t eat or become physically active for several hours before sleep.
• Avoid alcohol, caffeine, and nicotine close to bedtime.
Can menopausal hormone therapy prevent heart disease?
Some research has shown that women who start estrogen or certain types of hormone therapy around the time of menopause are less likely to get heart disease. But a very large study by the U.S. National Institutes of Health (NIH) had different results. The NIH research found that:l Estrogen alone didn’t affect the risk of a heart attack. Estrogen did increase the risk of stroke. Estrogen also increased the risk of blood clots in the legs.l Estrogen plus progestin may have slightly increased the risk of a heart attack. Progestin is a man made form of the female hormone progesterone. Estrogen plus progestin raised the risk of stroke and blood clots in the legs and lungs. Researchers continue to study this issue. The age at which menopausal hormone therapy is started may be the key to whether this therapy reduces your chances of getting heart disease. Most of the women in the NIH study did not start menopausal hormone therapy until after the age of 60, yet menopause happens for most women after the age of 45. Some experts think that many of the women in the NIH study may have already developed atherosclerosis because of many years in which their estrogen levels were low. This would explain why estrogen did not protect against heart disease in the study. More research on younger women may support the use of some kind of menopausal hormone therapy to prevent heart disease. And more research will be needed to ensure that the benefits of such a therapy outweigh its risks.

Can antioxidant or folic acid supplements prevent heart disease?
Antioxidants, such as beta carotene and vitamins A, C, and E, and folate are substances found naturally in many foods. They can also be taken as dietary supplements, either in pill form or added to food. Some early research suggested that taking antioxidant supplements might prevent atherosclerosis. But more recent research has not found this to be the case. The best way to get your antioxidants is by eating fruits, vegetables, whole grain products, and nuts. As with antioxidants, some early research suggested that taking folic acid supplements might reduce the risk of heart disease. But more recent research has not found this to be the case. Currently, the American Heart Association does not recommend that women use folic acid supplements to prevent heart disease. Even so, you need some folic acid in your diet to help your body make blood cells. Folic acid also is very important for women who are or plan to become pregnant.

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