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Risk factors for heart disease

Coronary heart disease, or CHD, is the biggest killer in the UK causing around 82,000 deaths a year.

It is responsible for around one in five deaths in men and one in eight deaths in women. There is considerable variation in mortality from CHD across the UK. Death rates are higher in Scotland than the South of England, in manual workers than in non-manual workers and in certain ethnic groups.

Because heart disease is so common and often silent until it strikes, it is important to recognise the risk factors.

What are the risk factors for heart disease?

There are several risk factors for heart disease; those that are beyond our control include:

  • Male
  • Older age
  • Family history of heart disease
  • Being post-menopausal
  • Ethnicity.

Those within our control include:

  • Smoking
  • High LDL, or ‘bad’ cholesterol and low HDL, or ‘good’ cholesterol
  • High blood pressure
  • Physical inactivity
  • Overweight/obese
  • Diabetes
  • Excess alcohol consumption
  • Stress and anger.

What can I do to lower my risk of heart disease?

  • Stop smoking. This is the single most beneficial thing you can to do to reduce your risk of heart disease as smokers have more than twice the risk of suffering a heart attack as non-smokers and are much more likely to die if they do. Smoking is also the most preventable risk factor. Non-smokers who are exposed to constant smoke also have an increased risk.
  • Improve cholesterol levels. The NHS advises that total cholesterol levels should be less than 5mmol/L and the bad cholesterol, LDL, should be less than 3mmol/L. Interpretation and treatment of cholesterol values must, however, be individual, taking into account all risk factors for heart disease. A diet low in cholesterol and saturated and trans fat will help lower cholesterol levels, as will regular exercise. Often, medication is needed to reach cholesterol goals.
  • Control high blood pressure. Hypertension, or high blood pressure, is the most common heart disease risk factor. The NHS recommends systolic blood pressure (the upper number) be below 140, and diastolic blood pressure (the lower number) be below 90. Like cholesterol, blood pressure interpretation and treatment should be individual, taking into account your entire risk profile. Control blood pressure through diet, exercise, weight management, and if needed, medication.
  • Control diabetes. If not properly controlled, diabetes can lead to significant heart damage including heart attacks and death. You can control diabetes through a healthy diet, exercise, maintaining a healthy weight and taking medication as prescribed by your doctor.
  • Get active. People who exercise have lower rates of heart disease and death. Even leisurely activities such as gardening or walking can lower your risk of heart disease. Most people should exercise for 30 minutes, at moderate intensity, on most days. More vigorous activities are often associated with more benefits. Exercise should be aerobic, involving the large muscle groups. Such activities include brisk walking, cycling, swimming, skipping and jogging. Seek medical advice before starting any exercise programme.
  • Eat well. Eat a heart-healthy diet low in salt, saturated fat, trans fat, cholesterol and refined sugars. Try to increase your intake of foods rich in vitamins and other nutrients, especially fibre. Also eat plant-based foods such as fruits and vegetables, nuts and wholegrains.
  • Achieve and maintain a healthy weight. Excess weight puts significant strain on the heart and worsens several other risk factors such as diabetes, high blood pressure and high cholesterol. By eating well and exercising, you can lose weight and reduce your risk of heart disease.
  • Manage stress. Poorly controlled stress and anger can lead to an increased risk of heart attacks and strokes. Learn to manage stress by practising relaxation techniques, learning how to manage time and setting realistic goals.
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