Heart-Healthy Living Understand Your Risk for Heart Disease

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The first step toward heart health is understanding your risk of heart disease. Your risk depends on many factors, some of which are changeable and others that are not. Risk factors are conditions or habits that make a person more likely to develop a disease. These risk factors may be different for each person.

Preventing heart disease starts with knowing what your risks factors are and what you can do to lower them.

• Have high blood pressure
• Have high blood cholesterol
• Have overweight or obesity
• Have prediabetes or diabetes
• Smoke
• Do not get regular physical activity
• Have a family history of early heart disease, for example if your father or brother was diagnosed before age 55, or your mother or sister was diagnosed before age 65
• Have a history of preeclampsia, which is a sudden rise in blood pressure and too much protein in the urine during pregnancy
• Have unhealthy eating behaviors
• Are age 55 or older for women or age 45 or older for men

Each risk factor increases your chance of developing heart disease. The more risks you have, the higher your overall risk.

Some risk factors cannot be changed. These include your age, sex, and a family history of early heart disease. Many others can be modified. For example, being more physically active and eating healthy are important steps for your heart health. You can make the changes gradually, one at a time. But making them is very important.

Women generally get heart disease about 10 years later than men do, but it’s still women’s #1 killer. After menopause, women are more likely to get heart disease, in part because estrogen hormone levels drop. Women who have gone through early menopause, either naturally or because they have had a hysterectomy, are twice as likely to develop heart disease as women of the same age who have not gone through menopause. Middle age is also a time when women tend to develop other risk factors for heart disease, such as high blood pressure.

Preeclampsia, which is high blood pressure during pregnancy, raises your risk of developing coronary heart disease later in life. It is a risk factor that you can’t control. However, if you’ve had the condition, you should take extra care to monitor your blood pressure and try to lower other heart disease risk factors.

Risk factors such as high blood pressure or cholesterol generally don’t have obvious signs or symptoms. A crucial step in determining your risk is to see your provider for a thorough checkup and risk assessment. Your provider may use a risk calculator to estimate your risk of having a heart attack, having a stroke, or dying from a heart or blood vessel disease in the next 10 years or throughout your life.

For example, the Atherosclerotic Cardiovascular Disease (ASCVD) Estimator considers your  cholesterol levels, age, sex, race, and blood pressure. It also factors in whether you smoke or take medicines to manage your high blood pressure or cholesterol.

Your provider can be an important partner in helping you set and reach goals for heart health. Ask about your risk for heart disease at your annual checkup. Since your risk can change over time, keep asking each year.

Questions to ask your provider at your annual checkup

• What is my risk of developing heart disease?
• What is my blood pressure? What does it mean for me, and what do I need to do about it?
• What are my cholesterol numbers? What do they mean for me, and what do I need to do about them?
• What is my body mass index (BMI) and waist measurement? Do I need to lose weight for my health?
• What is my blood sugar level, and does it mean I’m at risk for diabetes?
• What other screening tests for heart disease do I need? How often should I return for checkups for my heart health?
• How can we work together to help me quit smoking?
• How much physical activity do I need to help protect my heart?
• What is a heart-healthy eating plan for me? Should I see a registered dietitian or qualified nutritionist to learn more about healthy eating?
• How can I tell when I’m having a heart attack?

If you already are being treated for heart disease or heart disease risk factors, discuss your treatment plan with your provider. Ask questions if you do not understand something or need more information. You may want to write down questions before your appointment as well.

Questions to discuss about your heart disease prevention and treatment plan

• How does my treatment compare with what is recommended in the latest guidelines?
• How well is my treatment plan working for me?
• Are my risk factors for heart disease in a good range or getting better?
• If your provider recommends medicine or a medical procedure, ask about the benefits and risks.