A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to have a heart attack with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of having a heart attack. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
Smoking is a major contributing factor to cardiovascular disorders that can lead to a heart attack. Smoking irritates and narrows blood vessels, contributes to the build up of arterial plaque, and raises heart rate and blood pressure. As a result, cigarette smokers are twice as likely as nonsmokers to have a heart attack, and are more likely to die from a heart attack than nonsmokers. People who continue to smoke in the presence of established cardiovascular disease are at increased risk for repeated heart attacks and sudden cardiac arrest.
Nonsmokers who are exposed to smoking are at risk as well. Each year in the United States, over 35,000 deaths from cardiovascular disease are caused by passive smoking.
Physical inactivity doubles your risk for a heart attack or stroke. People who are usually inactive and then suddenly increase their physical activity are also at risk for having a heart attack. Talk to your doctor before you start any exercise program and gradually increase your intensity.
Regular moderate to intense exercise improves heart function and promotes healthy arteries. It also helps reduce the chance of other heart attack risk factors such as high blood pressure, high cholesterol, and diabetes.
Drinking too much alcohol can increase blood pressure, blood triglycerides that contribute to plaque build-up, and increase the risk of abnormal heart rhythms (arrhythmias). Drinking too much alcohol can increase blood pressure and lead to other heart problems.
There is some evidence supporting that moderate drinking lowers your risk of cardiovascular disease. Moderate means a maximum of 1 drink per day for women or 2 drinks per day for men.
It is important to remember however, that moderate ingestion of alcohol can affect your overall health. Based on currently available data, taking up regular consumption of alcohol is not encouraged for people who do not drink or drink sporadically.
Illicit drug use, especially cocaine, can cause heart damage from abnormal heart rhythms, infection, or heart failure. Heart attacks are more likely in people with cardiovascular damage. Drug users also have an increased risk of dying from sudden cardiac arrest.
Men aged 65 years and older who are taking testosterone therapy are more likely to have a heart attack. Testosterone therapy has been used to treat conditions like erectile dysfunction. Talk to your doctor about your risk of heart attack if you are taking testosterone therapy medications.
Cholesterol is a waxy substance crucial to many body processes. The body produces and uses what it needs, but cholesterol also comes from your diet. High levels of cholesterol in your blood can lead to plaque buildup in the arteries, a major contributor to heart attacks.
If you have high blood pressure, your heart is working harder than normal to pump blood throughout your body. Blood pressure is the force of blood on arterial walls. Over time, this excess force causes blood vessel damage, increasing the risk of cardiovascular disease. If you have high blood pressure and are not keeping your blood pressure in a specific target range, you have an increased risk of having a heart attack.
Even if you have no other risk factors, being obese or overweight will increase your risk of a heart attack. It also adds to your chances of developing high blood pressure, high cholesterol, and type 2 diabetes. These are all risk factors for cardiovascular disease and heart attack.
Glucose intolerance and diabetes are metabolic disorders in which the body does not produce or effectively use insulin. Diabetes is associated with an increased risk a heart attack and early death.
Metabolic syndrome is a condition is marked by elevated blood pressure, cholesterol, blood glucose, and body weight. Excess weight centered on the midsection is of particular concern. Having metabolic syndrome increases your risk of a heart attack as well as other disorders.
Obstructive sleep apnea (OSA) is a disorder characterized by repeated episodes of complete or partial airway obstruction during sleep. The disorder is associated with disrupted sleep patterns and decreased oxygen saturation (the amount of oxygen carried in the bloodstream). OSA has been linked to several disorders, including cardiovascular disease and early death. Complications of OSA include high blood pressure, heart failure, diabetes, stroke, and heart attack.
The heart has a normal decrease in function as we age. This decrease is generally not enough to cause problems, but can increase the risk of developing cardiovascular disease. Some changes include an increase in heart size, slower heart rate, and stiffer blood vessels and valves.
Men have a higher risk of cardiovascular disease over all, but women's risk increases dramatically after menopause. It is thought that the natural decrease in estrogen levels plays a role in this increase. As a result, heart attacks are more likely to occur in men over the age of 45, and in women over the age of 55.
Having family members that have had heart attacks increases your risk as well.
In general, African Americans have a higher incidence of high blood pressure than Caucasians and therefore, a higher risk of developing cardiovascular disease. Cardiovascular disease risk is also higher among Mexican Americans, American Indians, native Hawaiians, and some Asian Americans. Cardiovascular disease increases your risk of having a heart attack.
Alcohol and heart disease. American Heart Association website. Available at: http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Alcohol-and-Heart-Disease_UCM_305173_Article.jsp#.VxE5DE2FMdU. Updated March 14, 2014. Accessed April 4, 2014.
Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol. 2004;43(10):1731-1737.
Cocaine, other drugs, and heart disease. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Cocaine-Marijuana-and-Other-Drugs-and-Heart-Disease_UCM_428537_Article.jsp#.VxE5902FMdU. Updated September 20, 2012. Accessed April 4, 2014.
Coronary artery disease major risk factors. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T474255/Coronary-artery-disease-major-risk-factors. Updated April 29, 2016. Accessed October 6, 2016.
Coronary artery disease possible risk factors. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113766/Coronary-artery-disease-possible-risk-factors. Updated July 28, 2016. Accessed October 6, 2016.
Iversen B, Jacobsen BK, Lochen ML. Active and passive smoking and the risk of myocardial infarction in 24,968 men and women during 11 year of follow-up: the Tromsø Study. 2013;28(8):659-667.
Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736-747.
Njolstad I, Arnesen E, Lund-Larsen PG. Smoking, serum lipids, blood pressure, and sex differences in myocardial infarction. A 12-year follow-up of the Finnmark Study. Circulation. 1996;93(3):450-456..
Prescott E, Hippe M, Schnohr P, Hein HO, Vestbo J. Smoking and the risk of myocardial infarction in women and men: longitudinal population study. BMJ. 1998;316(7137):1043-1047
Second hand smoke (SHS) facts. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm. Updated March 4, 2014. Accessed April 4, 2014.
Sesso HD, Stampfer MJ, Rosner B, Hennekens CH, Manson JE, Gaziano JM. Seven-year changes in alcohol consumption and subsequent risk of cardiovascular disease in men. Arch Intern Med. 2000;160(17):2605-2612.
Stern S, Behar S, Gottlieb S. Cardiology patient pages. Aging and diseases of the heart. Circulation. 2003;108(14):e99-e101.
Sundquist K, Qvist J. The long-term effect of physical activity on incidence of coronary heart disease: A 12-year follow-up study. Prev Med. 2005;41(1):219-225.
Understanding your risk of heart attack. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp#.VxE71U2FMdU. Updated February 4, 2014. Accessed April 4, 2014.
Who is at risk for a heart attack? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/risks. Updated December 17, 2013. Accessed April 4, 2014.
10/23/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T474255/Coronary-artery-disease-major-risk-factors: Lin HJ, Lee BC, Ho YL, et al. Postprandial glucose improves the risk prediction of cardiovascular death beyond the metabolic syndrome in the nondiabetic population. Diabetes Care. 2009;32(9):1721-1726.
4/15/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T474255/Coronary-artery-disease-major-risk-factors: Dahabreh IJ, Paulus JK. Association of episodic physical and sexual activity with triggering of acute cardiac events: systematic review and meta-analysis. JAMA. 2011;305(12):1225-1233.
1/12/2012 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T474255/Coronary-artery-disease-major-risk-factors: Mora S, Buring JE, Ridker PM, Cui Y. Association of high-density lipoprotein cholesterol with incident cardiovascular events in women, by low-density lipoprotein cholesterol and apolipoprotein b100 levels: a cohort study. Ann Intern Med. 2011;155(11):742-750.
2/3/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T474255/Coronary-artery-disease-major-risk-factors: Finkle W, Greenland S, Ridgeway GK, et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PLoS One. 2014;9(1):e85805.
Last reviewed March 2016 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.