The highest death rates in the United States today are associated with coronary artery disease (heart disease), cancer, and stroke. There is a number of significant risk factors for these diseases, some of which a person can modify to lower the risk of heart disease and stroke. A risk factor is a personal characteristic which has been shown to change a person’s risk for developing the associated disease. For coronary artery disease and stroke, these risk factors are essentially the same. There are some things you can’t change (non-modifiable risk factors) and some things you can affect (modifiable risk factors) all of which may contribute to your risk of heart disease and stroke.
Non-Modifiable Risk Factors
Everyone gets older; there is nothing that can be done about it. As we age, our risk for heart disease changes. As your age advances, it becomes even more important to control the factors you can (modifiable risk factors).
Males have a higher rate of heart disease than females and they tend to develop these risks earlier in life. Therefore, men should pay more attention to other risk factors and seek to make changes sooner in life. Similarly, women should discuss this information with the men in their lives, and seek to implement personal changes as well.
Everyone is born with their own individualized set of genes. There is nothing that can be done to change your genetics. (At least not yet. Who knows what science will come up with in the future?) You might have heart disease, obesity, or high blood pressure in your family. These genetic factors do increase your personal risk for heart disease and stroke, but there still are ways to lower these risks.
Modifiable Risk Factors
Smoking can cause many health problems and is one of the worst things a person can do to affect personal risk for stroke and heart disease. In fact, one out of every five deaths can be attributed to smoking. Within a few weeks of quitting smoking, a person can start to feel improvements (breathing easier, etc.). Additionally, over time, the risk associated with heart disease and other diseases significantly decreases. There are many options for smoking cessation; please talk with your doctor about which one will work for you. It’s never too late to quit.
High Blood Pressure
High blood pressure is known as the “silent killer” because most people have no significant symptoms until it has become quite elevated and significant damage has occurred. Many people with high blood pressure go without a diagnosis for many years. Others take extended periods of time to get their blood pressure under control or do not achieve recommended goals for blood pressure lowering. Elevated blood pressure wears on many parts of the body: the heart, the blood vessels, the kidneys, and the brain. Your blood pressure should be below 140/90. Things a person can do to help control blood pressure include seeing a physician on a regular basis, having your blood pressure monitored regularly, maintaining a healthy weight, limiting salt in your diet, exercising regularly, and quitting smoking. If needed, there are medication options available that your physician can prescribe to help you control your blood pressure.
High cholesterol is another risk factor which can be modified, but it must be checked and monitored regularly. Similar to high blood pressure, people often have no symptoms of high cholesterol; it can go uncontrolled for years before actually being diagnosed. Elevated cholesterol levels can lead to atherosclerosis, which is a significant finding in heart disease. Your LDL (bad cholesterol) levels should measure below 130 depending on your individual risk for heart disease. If you have already been diagnosed with heart disease and/or you have additional risk factors, acceptable LDL levels are from 70-100. Another bad form of cholesterol is the triglyceride level, which should be below 160. Cholesterol management includes regular physician visits, monitoring blood levels, weight management, diet modification, exercise, and possibly medication.
Diabetes is a far too common problem in America. In some states, the rate for adults with diabetes is over 25% of the population! Elevated blood sugars can lead to organ damage. Controlling blood sugar is absolutely necessary to decrease risk for heart disease. The recommended levels for control of blood pressure and cholesterol are lower for diabetics than for non-diabetics. Management of diabetes could fill an entire article by itself and still not be comprehensive, but basic management should include the following: regular physician visits (primary care physician, diabetic specialist, ophthalmologist, etc.); controlling blood sugar levels, cholesterol levels, and blood pressure; getting regular exercise; and diet management. There are many different options for medication that can help control diabetes. Discuss with your physician which options are best for you.
Obesity is an epidemic in America today and is another significant risk factor for heart disease. Obesity leads to excessive strain on multiple organs of the body and adds cumulative damage when someone also has some of the above diseases. Controlling weight may not be easy, but it is possible. Some of the best ways to lose weight and/or maintain a healthy weight are lifestyle modifications, regular exercise, and decreased portion sizes at mealtime. There are other possible options including medications and bariatric surgery. Talk to your physician about these options to determine what is best for you. Exercise and weight loss can lead to improved blood pressure, cholesterol levels, and blood sugar. In fact, in some patients, weight loss can even lead to “curing” high blood pressure, high cholesterol, and diabetes.
All readers should seriously consider these tips. Discussing both modifiable and non-modifiable risk factors with your physician will help you determine which treatment plans and options will be best for your situation.
Casey Henich, MD, is Board Certified in family medicine. He earned his medical degree from Ross University School of Medicine, North Brunswick, NJ and completed a residency at the University of Oklahoma Health Science Center, Oklahoma City, OK. He has been a practicing provider since 2009 and joined Granger Medical in 2012.
Originally printed in Granger Medical Clinic’s magazine, Spring 2014.