Understanding Your Risk for Heart Disease
Risk factors are conditions that increase your risk of developing a disease. Risk factors are either modifiable, meaning you can take measures to change them, or non-modifiable, which means they cannot be changed.
Risk factors for heart disease are discussed below.
Non-modifiable Risk Factors
Age
According to American Heart Association computations, about 80 percent of people who die from cardiovascular disease are 65 years and older. Age itself increases your risk of developing heart disease.
Gender
Heart disease has long been considered to be primarily a men's disease. Although women tend to develop cardiovascular disease about 10 years later in life than men, the outcome for women is often worse.
Read more about women and heart disease.
Family history
Your risk for developing heart disease increases if you have a relative who developed heart disease early, before age 55. If your parents developed heart disease later in life, it may be age-related rather than genetic. While you cannot change your genes, it is important to know your family medical history and share it with your doctor.
Race
African-Americans are at great risk of developing cardiovascular disease.
Modifiable Risk Factors
High blood pressure
Blood pressure is recorded as two numbers with a ratio, like this: 120/80 mmHg. The top number, called systolic blood pressure, measures the pressure in the arteries when the heart beats. The lower number, called diastolic blood pressure, measures the pressure in the arteries between the heartbeats.
High blood pressure is defined as over 140/90 on at least two separate occasions on separate days. Blood pressure should be measured at each doctor's office visit starting at 18 years of age, but at least every two years. Target blood pressure is 120/80 mmHg regardless of age.
Many people have high blood pressure for years. If left untreated, it can lead to coronary heart disease, heart attack or stroke.
Until age 45, a higher percentage of men than women have high blood pressure. From ages 45 to 64, the percentages are similar. After that, a much higher percentage of women than men have high blood pressure.
Blood Pressure Classification | Systolic BP (mmHg) | Diastolic BP (mmHg) | |
Normal | < /> | and | < /> |
Prehypertension | 120–139 | or | 80–89 |
Stage 1 HBP | 140–159 | or | 90–99 |
Stage 2 HBP | >160 | or | >100 |
For persons older than 50, systolic blood pressure is more important than diastolic blood pressure as a cardiovascular disease risk factor. Starting at 115/75 mmHg, cardiovascular disease risk doubles with each increment of 20/10 mmHg throughout the blood pressure range.
People with systolic blood pressure of 120 to 139 mmHg, or diastolic blood pressure of 80 to 89 mmHg, should be considered pre-hypertensive. They will need to make healthy lifestyle changes to prevent cardiovascular disease.
Smoking
Smoking is the most preventable risk factor. Smokers have more than twice the risk of developing cardiovascular disease. On average, smoking costs 13 years of life to a male smoker and 14 years to a female smoker. Exposure to smoke — secondhand smoking — increases the risk even for non-smokers.
Cholesterol
The cholesterol profile includes LDL (bad) cholesterol, HDL (good) cholesterol, triglycerides and total cholesterol.
- LDL cholesterol LDL cholesterol (low density lipoprotein) contributes to artery blockages (plaques). Most people should aim for an LDL cholesterol level of 100 mg/dL or lower. If you are at very high risk for developing cardiovascular disease, or if you have already had a heart attack, you may need to aim for an LDL level below 70 md/dL.
- HDL cholesterol HDL cholesterol (high density lipoprotein) is a reverse-transport protein; it removes cholesterol from the arteries and takes it to the liver where it can be passed out of the body. High levels of HDL cholesterol lower your risk of developing cardiovascular disease. An HDL level of 60 mg/dL and over is considered excellent, providing you optimal protection.
- Triglyceride Triglyceride is the most common type of fat in the body. Many people who have heart disease or diabetes have high triglyceride levels. A normal triglyceride level is less than 150 mg/dL.
- Total cholesterol Total cholesterol is a measure of LDL cholesterol, HDL cholesterol and other lipids. The desirable level of total cholesterol is less than 200mg/dL.
Diabetes
Diabetes mellitus is defined as a fasting blood glucose (blood sugar) of 125 mg/dL or more. Diabetes increases your risk for developing cardiovascular disease.
There are two main types of diabetes. Type 1 diabetes is usually first diagnosed in children and young adults. Type 2 diabetes is the most common form and can develop at any age.
If you have diabetes, no matter which type, it means you have too much glucose in your blood, which can lead to serious health issues. Diabetes and heart disease share similar risk factors — high cholesterol level, high blood pressure and obesity.
Pre-diabetes
People with a fasting blood glucose level between 100 mg/dL and 125 mg/dL have an increased risk for developing Type 2 diabetes. If they do not make lifestyle modifications, they will likely develop diabetes within the next 10 years.
Pre-diabetes is reversible. If you lose weight, maintain a healthy diet and increase your physical activity, you may be able to prevent progression to diabetes.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.