There are many risk factors associated with coronary heart disease and stroke. Some cannot be changed (non-modifiable risk factors) while others can be controlled (modifiable risk factors). Having a single risk factor does not predict that you will suffer from these conditions.
However, these factors compound each other and the more risk factors you have and the more uncontrolled they are, the greater the likelihood that you will suffer a heart attack or stroke.
Modifiable risk factors
• High blood pressure (hypertension) plays a significant role in heart attacks.
• High cholesterol. This may include high total cholesterol, high levels of triglycerides, high levels of low-density lipoprotein (LDL) or low levels of high-density lipoprotein (HDL) cholesterol.
• Tobacco use increases the risk of cardiovascular disease significantly.
• Physical inactivity increases the risk of heart disease and stroke by up to 50%. A lack of physical exercise is also associated with obesity.
• Diabetes. Having diabetes makes you twice as likely to develop cardiovascular disease compared to a non-diabetic.
• Unhealthy diets. A diet high in unhealthy fats, salt, sugar and carbohydrates is a risk factor for hypertension, obesity and diabetes which may lead to CVD.
• Psychological stress, social isolation, anxiety and depression are also risk factors.
• Excessive alcohol use can directly damage the heart and increases the risk of liver disease.
• Certain medicines may increase the risk of heart disease such as the oral contraceptive pill and hormone replacement therapy (HRT).
Non-modifiable risk factors
• Ageing. The risk of stroke doubles every decade after the age of 55.
• Family history. If a first-degree blood relative has had a heart attack or stroke before the age of 55 (for a male relative) or 65 years (for a female relative) your risk is increased.
• Gender. As a man you are at greater risk of heart disease than a pre-menopausal woman. Once past the menopause however, a woman’s risk is similar to that of a man.
• Ethnic origin. People with African or Asian ancestry are at higher risk than other racial groups.
Take home messages
• Many of the risk factors for CVD are silent. Testing yourself regularly for these conditions can help detect them early and allow you to control them before you have a heart attack or stroke.
• Being diagnosed with one or more of these risk factors is not the end of the world. Through regular check-ups with your doctor, improving your lifestyle, and taking prescribed medication, most of these can be controlled and your risk of CVD reduced.
• The 4 easiest things to do to reduce your risk are: Exercise, stop smoking, lose weight and eat healthier.
Dr Cameron Meyer (MBChB, BSc), Business Manager, Intercare Centre for Lifestyle Management.
References: Cardiovascular disease risk factors.