VIDEO
These 4 Things Happen Right Before A Heart Attack
Risk Factors, Symptoms, and Diagnosis
Why is high blood pressure the major coronary risk factor?
What is cholesterol? What is “bad” (LDL) versus “good” (HDL) cholesterol?
How is diabetes harmful?
RISK FACTORS
What are the most common known coronary risk factors?
Patient comment:
When you have one or more coronary risk factors, you should try very hard to control or even eliminate these factors because their cumulative effects speed up the atherosclerotic process, leading to a heart attack even among young people.
Smoking is a typical example of a major risk factor that can be eliminated entirely when you have the strong will to stop.
Remember that smoking is also a very strong risk factor for lung cancer, and your family members also are hurt by your second-hand smoke.
Certain medical conditions (e.g., diabetes), disorders, personal habits (e.g., smoking), and drugs or chemicals are known to increase the risk of coronary artery disease, particularly a heart attack. Such factors that lay the groundwork for heart problems are called coronary risk factors. To prevent heart attack, you should be fully aware of various coronary risk factors. They include high BP, abnormal blood cholesterol levels, and smoking; these factors must be modified or even eliminated.
Some risk factors, such as age and male gender, are beyond our control, but we can modify many other factors and even eliminate them altogether. Family history of a heart attack (the genetic or hereditary factor) is a very strong risk factor, but it can be limited to a certain degree. For instance, obesity (overweight), high BP, hyperlipidemia (elevated cholesterol or triglyceride, or both, in the blood), and cigarette smoking frequently run in the same family, but certain life styles and eating habits often influence these factors and can influence a family history of heart attack. Many individuals have been shown to have multiple risk factors. Typically, obese people have a tendency to have high BP, elevated cholesterol, and diabetes, and all that may be worsened by a sedentary life style.
Coronary risk factors can be summarized as major and minor.
Major risk factors include:
• Genetic (hereditary) factors (e.g., a family history of premature coronary artery disease);
• Age and gender (e.g., men who are 45 years old and older, and women who are 55 years old and older); or women in premature menopause.
Risk factors also include:
• High BP (140/90 mm Hg or higher);
• Elevated blood lipids (e.g., cholesterol or triglyceride or both);
• Diabetes mellitus;
• Cigarette smoking;
• Obesity
• A sedentary lifestyle (being physically inactive); and
• Emotional stress.
Emotional stress is a major risk factor that you might consider less important because it is not evident as a physical process. However, such stress often raises BP, and it may cause overeating or smoking from nervous tension. Anger also does not always exhibit physical signs or effects. Yet angry young men are prone to premature coronary artery disease, particularly a heart attack.
One type of minor risk factor is the excessive use of alcohol. Excessive alcohol drinking can raise BP and triglyceride blood levels, and overuse of alcohol often triggers the onset of various abnormal heart rhythms. Nevertheless, some medical reports state that consumption of a moderate amount of alcohol (e.g., one to two glasses of wine) is said to be a protection against heart attack. Another well-known fact is that drinking large amounts of alcohol often produces heart muscle damage.
Another minor risk factor is the type-A personality. The term type-A personality describes a person who has an aggressive, ambitious, and competitive character. Such people seem to have heart attacks more often, but this theory is somewhat controversial. Homocysteine is a further minor risk factor. Abnormally high blood levels of amino acid homocysteine (a special chemical) are considered to create an increased risk for coronary artery disease and stroke. Homocysteine may harm the lining of the arteries and contribute to blood clotting. Excessive homocysteine levels are reported to occur with the deficiency of vitamins B6, B12, and folic acid, so it may be beneficial to ensure that you get sufficient amounts of these vitamins to prevent high homocysteine levels.
Other vitamins may also be beneficial in prevention of heart attacks. Vitamin E seems to reduce the risk of coronary artery disease, but its role is still controversial. Vitamin C may improve the function of the inner layer of the blood vessel (called the endothelium), which can affect blood flow. High intake of beta carotene and other carotenoids from dark-colored fruits and vegetables may also help reduce the risk of heart attack. Depression has adverse biological effects on the immune system, on blood clotting, on BP, on the blood vessels, and on heart rhythms. This factor can even impair a patient’s desire to comply with heart medicines. It can lead to chronic alcoholism. Somewhat related are seasonal variations: More deaths from heart disease occur in the winter months (December and January), and the fewest occur in the summertime. Short daylight hours in gloomy or rainy weather often cause emotional depression and alcoholism and therefore an increased risk of a heart attack.
Even physical characteristics can contribute as minor factors to heart attack. Some researchers have associated male-pattern baldness, hair in the ear canals, and creased earlobes with a high risk of coronary artery disease in white men.
Yet another risk factor is seen in the use of iron. A high dietary intake of iron may contribute to the process of atherosclerosis. Similarly, C-reactive protein (CRP) recently received special attention because CRP is shown to be one of the important coronary risk factors. Recent medical studies found the risk of developing atherosclerotic vascular disease among people with elevated CRP to be about 3 to 6 times higher than that of the general population. Atherosclerotic vascular disease, such as heart attack, is considered to be an inflammatory process of the blood vessels (including the coronary arteries). It’s extremely important to measure the blood level of the CRP in the absence of any inflammatory process, particularly a cold or flu. Unfortunately, at present, no direct therapy is available to treat a high CRP blood level. Some studies suggest that another minor factor-infectious agents (e.g., certain microorganisms and some viruses, such as Helicobacter pylori, the bacterium responsible for peptic ulcer, and the herpes virus)-may contribute to the risk of heart disease. However, bacteria alone do not cause coronary artery disease.
Until recently, estrogen was considered for many years to be beneficial among postmenopausal women in preventing coronary artery diseases, including heart attack. However, a new clinical study conducted by the National Institutes of Health demonstrated that estrogen replacement therapy no longer is shown to be beneficial in preventing coronary artery diseases in such women. Rather, this study showed estrogen to be a coronary risk factor. Further investigation will be necessary in order to clarify the somewhat controversial outcome.
Other miscellaneous factors are oral contraceptives (birth control pills) and gout. Some medical reports consider both to be minor risk factors. Factors with potential benefits are vitamins and supplements. For example, sufficient amounts of folic acid and vitamins B6 and B12 are important to prevent high levels of homocysteine. Vitamin E seems to reduce risk for coronary artery disease, but its use is still controversial. Vitamin C may improve function of the endothelium (inner layer of the blood vessel), a factor affecting blood flow. High intakes of beta-carotene and other carotenoids from dark-colored fruits and vegetables may reduce the risk of a heart attack.
Terms:
Hyperlipidemia – elevated levels of cholesterol or triglycerides (or both) in the blood.
Triglyceride – a lipid that is a lesser coronary risk factor.
Lipids – cholesterol and triglycerides.
Diabetes mellitus – the inability of the body to properly produce or respond to insulin.
Type A personality – a person with an aggressive, ambitious, and competitive character.
Homocysteine – chemical sometimes considered to be a coronary risk factor in abnormally high blood levels.
Endothelium – the inner layer of a blood vessel.
C-reactive protein (CRP) – a specific protein circulating in the blood that, at high levels, can predispose a person to a heart attack.
We can modify many other factors and even eliminate them altogether.
