The risk factors for cardiovascular disease have been categorized by the american heart association (AHA) as follows:
Major risk factors that cannot be changed (increasing age, male gender, and heredity)
Major risk factors that can be changed (elevated blood cholesterol levels, high blood pressure, cigarette smoking, and physical inactivity
Other contributing factors (obesity, diabetes, and stress).
Major Risk Factors That Cannot Be Changed
Approximately 55% of all heart attacks occur in people who are 65 years of age or older. This age group accounts for more than 80% of the fatal heart attacks.
Until recently, the incidence of coronary heart disease among women has been largely unexplored. Men have been the primary subjects in the coronary heart disease and risk factor studies because of the high incidence of both among men. However, coronary heart disease is also the leading cause of death and disability among women, accounting for almost 250,000 deaths annually. Women have less heart disease than men, particularly before menopause. The reasons for the difference include the following:
The female hormone estrogen protects the coronary arteries from atherosclerosis
Women have higher circulating levels of high density lipoprotein (HDL) cholesterol, which also protects the arteries.
After menopause, though, the heart attack rate among women increases significantly until the mid-60s, when women’s risk is equal to that of men the same age. An alarming trend in recent years is the increased incidence of heart attacks in premenopausal women who have been smoking cigarettes long enough for it to affect their health, especially when combined with oral contraceptive use.
According to the AHA, “A tendency toward heart disease or atherosclerosis appears to be hereditary, so children of parents with cardiovascular disease are more likely to develop it themselves.” A history of first degree male relatives (father, grandfather, and brothers) who died of coronary heart disease before the age of 55 or first degree female relatives (mother, grandmother, and sisters) who died of coronary heart disease before the age of 65 indicates a strong familial tendency. If the family history is positive, the modifiable risk factors must be controlled.
Major Risk Factors That Can Be Changed
Cholesterol is a steroid that is an essential structural component of neural tissue; it is used in the construction of cell walls and for the manufacture of hormones and bile (for the digestion and absorption of fats). A certain amount of cholesterol is required for good health, but high levels in the blood are associated with heart attacks and strokes.
The AHA suggests that Americans reduce cholesterol consumption to less than 300 milligrams per day (300 mg/day), that fat intake be reduced to a maximum of 30% of the total calories consumed, and that saturated fat be reduced to no more than 10% of the total calories. Many authorities are convinced that limiting total fat and saturated fat is more important than being overly restrictive of cholesterol.