- Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States, according to the CDC.
- Some of the greatest risk factors include an unhealthy diet, inactive lifestyle, or experiencing things that might raise blood pressure, like excessive stress or depression.
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Heart disease is the leading cause of death in the US — according to the Centers for Disease Control and Prevention, one in four Americans die from heart disease each year.
Insider spoke with Dr. Eduardo Sanchez, the chief medical officer for prevention at the American Heart Association, about some of the biggest risk factors and what habits to avoid in order to best protect yourself from developing heart disease.
While there are four different kinds of heart disease, the risk factors often overlap for each one.
"There are seven major risk factors for developing heart disease," Sanchez said. "Those are smoking, unhealthy eating, a sedentary lifestyle, being overweight or obese, high blood pressure, high cholesterol, and pre-diabetes or diabetes. Every single one of those raises the risk of cardiovascular disease."
Here are 13 things science and experts have linked to heart disease.
Having high blood pressure is one major indication you may be at risk of developing heart disease.
According to the CDC, high blood pressure is one of the biggest risk factors for heart disease.
Although it can be highly dangerous, people with high blood pressure usually exhibit no symptoms that would alert them to the condition. Instead, blood pressure has to be measured either at home or by a professional.
If you do have high blood pressure, you may be prescribed medication to manage blood pressure levels or encouraged to create lifestyle changes such as a change in diet or exercise frequency and intensity.
"The beauty of some of the cardiovascular risk factors, namely high blood pressure, high cholesterol, diabetes, pre-diabetes, and overweight and obesity is that there are things that can be done to lower the chances that you'll get those risk factors," Sanchez said.
An unhealthy diet high in saturated fats, trans fat, and "bad" cholesterol can lead to high cholesterol and high blood pressure.
According to the CDC, unhealthy blood pressure and cholesterol levels can also be a major risk factor for heart disease, and diets high in saturated fats, trans fat, and cholesterol have been linked to heart disease and related conditions, such as atherosclerosis.
Sanchez recommends the DASH diet, which includes fruits, vegetables, and whole grains, and limits foods like salt, sugar-sweetened drinks, and red meat. The American Heart Association describes the diet as a way to manage "blood pressure and [reduce] your risk of heart attack, stroke, and other health threats."
High levels of sodium can raise blood pressure, which could lead to heart disease.
Cutting back on sodium can potentially protect against developing heart disease. Most of the sodium we consume comes from salt.
"The DASH diet is the dietary approach to stop hypertension," Sanchez said. "One aspect of the diet is to decrease sodium and increase potassium."
According to the AHA, the recommended daily intake of sodium is no more than 2,300 milligrams, and that cutting back your sodium intake by as little as 1,000 milligrams per day can "improve blood pressure and heart health."
People who skip breakfast have higher rates of heart disease.
Breakfast really can be the most important meal of the day. According to the American Heart Association, people who regularly eat breakfast tend to have lower rates of heart disease, and are also less likely to have high cholesterol and high blood pressure, which are both risk factors for heart disease.
Being overweight or obese can also be a risk factor.
Sanchez said obesity is a risk factor for heart disease. It is also listed by the CDC.
Obesity, which is categorized as "excess fat" by the CDC, is linked to higher "bad" cholesterol and triglyceride levels and to lower "good" cholesterol levels, which can lead to high blood pressure, diabetes, and heart disease.
Research indicates that excess stomach fat, in particular, may increase your likelihood of having a heart attack. According to a previous article by Business Insider, a 2018 study of nearly 500,000 middle-aged men and women in the UK found that those with more fat located in their stomach region were more likely to suffer heart attacks.
Not getting enough exercise can also increase your risk.
The CDC states that engaging in regular physical activity can help prevent heart disease, mostly due to the fact that exercise can prevent health conditions that often lead to heart disease.
Not exercising regularly or living an active lifestyle can lead to medical conditions that are risk factors, including obesity, high blood pressure, high cholesterol, and diabetes.
"At least 30 minutes of moderate physical activity, five days a week or more, is recommended by the AHA and the CDC," Sanchez said.
Depression and heightened stress have also been linked to heart disease.
According to Healthline, some studies have shown that those who experience depression may also have a higher likelihood of developing heart disease and that people with depression develop heart disease at higher rates than the general population.
"It works bi-directionally. There is evidence that persons with some mental illnesses, depression being one of them, have a higher likelihood of exhibiting certain risk factors including smoking and are also more likely to have cardiovascular disease," Sanchez said. "It's also been shown that those who have cardiovascular disease are more likely to have mental illnesses, depression being one of them."
"If you assess and address a person's mental health and depression through medication, therapy, or even physical activity, those processes are more likely to take care of their cardiovascular disease issues," Sanchez continued. "One of the symptoms of depression can be a lack of motivation. If you can treat the depression, you increase the likelihood of activating the person to do all the things they need to do to be healthier and prevent heart disease."
According to Healthline, working on stress management techniques and removing oneself from high-stress situations are ways to prevent developing heart disease.
The flu can be a serious risk when it comes to heart health.
The influenza virus cannot only leave you bedridden and feeling under the weather, but it can also have adverse effects on your heart health.
According to research published by the New England Journal of Medicine in 2018, the risk of having a heart attack is six times greater in the week after being infected with the influenza virus than in the year before or the year after the first week.
Delivering a premature baby has been linked to a greater risk of heart disease.
Having a premature delivery is not a cause of heart disease. However, according to a study from the American Heart Association's journal "Circulation," women who have delivered premature babies, or before 37 weeks gestation, had a 40% greater risk of developing cardiovascular disease later in life, compared to those who'd had full-term pregnancies and deliveries.
"Preterm delivery is independently predictive of cardiovascular disease, even after adjustment for multiple cardio-metabolic risk factors, and the association is only partially mediated by the postpartum development of traditional cardiovascular risk factors," the authors of the report wrote. "Ultimately, preterm delivery may be a useful prognostic tool to identify high-risk women early in life who would benefit from early screening, prevention, and treatment."
Having multiple children could also increase your risk of heart disease.
One study by Atherosclerosis Risk in Communities, or ARIC, showed that the more children a woman has, the likelihood she will develop conditions such as heart disease, strokes, and heart failure later in life increases.
A study from the American Heart Association's journal "Circulation" also looked at the link between multiple pregnancies and heart disease.
"We found that an increase in the number of pregnancies was associated with a higher risk of future atrial fibrillation," one author said. "For example, women with four or more pregnancies were approximately 30% to 50% more likely to develop atrial fibrillation compared to women with no pregnancies."
Too much alcohol can also raise blood pressure and the risk of heart disease.
"Drinking too much alcohol is correlated with lots of different health problems," Sanchez said. "There is possibly a negative inflammatory effect that can happen with people who consume too much alcohol. It also has a vascular effect that can lead to an increase in blood pressure. We tell people, 'If you don't drink alcohol, don't start.' If you do drink alcohol, drink only in moderation.'"
The CDC also warns against consuming too much alcohol, stating that there's a strong link between excessive alcohol consumption and heart disease.
According to the CDC, drinking too much alcohol can raise blood pressure levels and increase levels of triglycerides, a fatty substance found in the blood which can increase the risk for heart disease.
Both the CDC and Sanchez recommend that moderate consumption of alcohol entails that women consume no more than one alcoholic drink per day, while men should have no more than two.
Smoking also increases the risk of heart disease and heart attacks.
It probably comes as no surprise that smoking can be extremely hazardous to your health.
"The combination of negative lung effects and vascular effects dramatically increase the likelihood of developing heart disease," Sanchez said. "In the scheme of things, and as we look at all of the major risk factors, if we had to choose a few of those to address and correct immediately, blood pressure control and tobacco use would be the first things we would tackle. They both have a disproportionate effect on heart attacks and strokes."
Nicotine is known to raise blood pressure, one of the key risks in developing heart disease.
Cigarette smoking can also damage the heart and blood vessels, which, according to the CDC, increases your risk for heart conditions like atherosclerosis and increases your risk of having a heart attack.
Secondhand smoking can also lead to an increased risk of heart disease in non-smokers.
It's not just smokers who may be affected by cigarette smoking's effect on heart health. The CDC also says that secondhand smoke can have adverse effects on others' health, and increases the risk for non-smokers to develop heart disease as well.
When it comes to successfully preventing heart disease, Sanchez encouraged changing your unhealthy habits right away.
"It's never too early to not start smoking, be physically active, and eat healthily," he said. "Any of us who are parents should be modeling that behavior for our kids. That will contribute to a longer, healthier life."
"As it relates to high blood pressure, high cholesterol, weight, and one's glucose status, persons should be regularly going to their doctors at least once a year, or in some cases, it's OK to wait a little longer," Sanchez said.
"It is never, never, never too early to start preventing heart disease, but it's also never too late to start addressing these risk factors and any other cardiovascular or other health condition you have to improve your health from where you are right now to where you can be."
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