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 Risk factors

Most scientists agree that the following things affect the risk of coronary heart disease. Some may apply to you, but others may not.

Family history
Alcohol intake
Physical activity
Blood pressure
Hormone replacement

There are several factors that increase a person's risk of coronary heart disease (CHD) but cannot be changed. They include:

Age and CHD
CHD usually occurs in men over age of 40 or in women after menopause, and most people who die of heart attacks are over the age of 65.

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Sex and CHD
Men have a higher risk of heart attack than women do, and men usually have heart attacks at earlier ages. However, coronary heart disease is not just a man's disease. It is the leading cause of death among both women and men in the United States.

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Family history and CHD
A person with a close relative who had a heart attack (especially before the age of 65) may be at higher risk of CHD.

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Most risk factors for CHD can be modified to reduce risk, either through lifestyle changes or through medication, if needed. These include:

Tobacco smoke and CHD
The chemicals in tobacco smoke increase the build-up of plaque in artery walls and promote the development of blood clots that can cause heart attacks. Smoking increases the risk of coronary heart disease itself, and it also enhances the detrimental effect of other risk factors like diabetes, high blood pressure (hypertension) and high cholesterol. Smokers have more than twice the risk of heart attack compared to non-smokers. Exposure to tobacco smoke, including cigar, pipe or any kind of second-hand smoke, increases your chance of coronary heart disease.

In addition to heart disease, tobacco also increases your risk of stroke, peripheral vascular disease, emphysema, bronchitis, osteoporosis and cancers of the lung, bladder, kidney, pancreas, cervix, lip, mouth, tongue, larynx, throat and esophagus. For many people, quitting smoking is the single best thing they can do to improve their health.

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Weight and CHD
The risk of coronary heart disease goes up as body weight increases. This is especially true for people who carry extra body fat around the waist (called "apple-shaped"). Extra weight puts extra strain on the whole body, increasing the risk of diabetes, high blood pressure and high cholesterol. Maintaining a healthy weight has been proven to not only decrease the risk of heart disease but also decrease the risk of cancer of the colon, kidney, breast and uterus.

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Diet and CHD
There are many dietary factors that you can use to lower your risk of heart disease. Foods like fruits, vegetables, cereal fiber, whole grains fish, nuts and liquid vegetable oils decrease the risk of CHD. Certain vitamin supplements, like B complex supplements, are also helpful in decreasing risk.

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Alcohol intake and CHD
Moderate alcohol (about one drink a day for women and two for men) has been shown to decrease the risk of CHD. Limited use of alcohol may also decrease the risk of developing diabetes. However, non-drinkers should not start drinking. Alcohol use has many of its own risks like increasing blood pressure, body weight, heart failure, addiction, suicide and accidents. People who limit their use of alcohol also have a lower risk of colon cancer, breast cancer, and stroke.

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Physical activity and CHD
Exercise is one of the best ways to help maintain a healthy weight. Not only is exercise good for the heart, it also helps prevent other diseases such as stroke, osteoporosis, diabetes and colon cancer. Even just 30 minutes of moderate exercise (like walking) daily can decrease your risk of disease.

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Blood pressure and CHD
Blood pressure is the force created when the heart pumps blood. When a person has high blood pressure (hypertension), the heart has to pump harder and the arteries are under increased pressure, which can lead to injury of the artery walls, atherosclerosis, and coronary heart disease. High blood pressure is also associated with an increased risk of stroke and kidney damage. Some people are able to control their blood pressure with diet and exercise, while others need medication.

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Diabetes and CHD
Diabetes increases the risk of CHD in part by increasing the risk of high blood cholesterol and high blood pressure. It may also promote injury to the artery walls and formation of blood clots. Avoiding smoking, staying physically active and maintaining a healthy weight can all help control or prevent adult-onset diabetes. Medication is also available if needed.

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Cholesterol and CHD
Two types of cholesterol are important in CHD: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL can increase the build-up of cholesterol in artery walls, causing atherosclerosis. It is considered the "bad" or unhealthy cholesterol, and high levels increases the risk of CHD. HDL, on the other hand, helps remove cholesterol from the blood and helps prevent cholesterol build-up in the arteries. It is known as "good cholesterol". Blood tests can show if your LDL is too high or if your HDL is too low. Diet, exercise, weight control and avoiding smoking can all help control your cholesterol levels. Your doctor can also prescribe medications if necessary.

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Hormone replacement and CHD
The ways that postmenopausal hormones affect the risk of CHD are still not well understood. If you are taking or considering taking hormone replacement therapy, make sure to discuss the risks and benefits with your doctor.

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  Copyright 2008 President and Fellows of Harvard College |