Risk Factors

Understanding Your Risk Factors For Heart Disease

There are circumstances and lifestyles than can increase the "risk" or probability of developing coronary artery disease. These are called "risk factors"

Some of these risk factors cannot be changed, but many can be controlled or modified to reduce the risk and severity of heart problems in the future.

Non-Modifiable Risk Factors

  • Family History
  • Gender
  • Older age

Modifiable Risk Factors

  • High Cholesterol (Total, LDL, Triglycerides)
  • High blood pressure
  • Smoking
  • Physical Inactivity
  • Diabetes
  • Obesity
  • Stress

Be sure you can answer all of the following questions with respect to risk factors for heart disease:

  • What risk factors for heart disease do I have?
  • Do I understand what the risk factor is?
  • Do I know why it is a risk for me?
  • Do I know how I can control it?
  • Do I know what my target for that risk factor is to ensure that it is under control?

Use the Chart below to help you answer these questions with respect to your risk factors.

High Blood Pressure

What is it? The pressure in the arterial system when the heart pumps blood out of the heart and when the heart is at rest

Why is it a Risk? How do I control it? What is the target?
  • High pressure on the arterial walls causes damage and can develop plaque in the arteries.
  • Increases the workload on the heart causing it to become strained, weakened and enlarged causing the pumping ability to weaken
  • Have it checked regularly
  • Take medication as prescribed
  • Exercise regularly
  • Reduce salt intake
  • Limit alcohol consumption
  • Decrease weight

<130/80 mmHg

Source: Canadian Hypertension Society (CHS) 2005 Recommendations

High Cholesterol - What Is It?

  • An essential substance found in all body cells
  • Carried in the blood by Low Density Lipoproteins and (LDL) High Density Lipoproteins (HDL)
Why is it a Risk? How do I control it? What is the target?
  • High levels of LDL cholesterol in our blood contributes to plaque formation in the coronary arteries and increases the risk for heart disease
  • Low levels of HDL cholesterol in our blood decreases the mechanism of eliminating the LDL
  • Decrease LDL by taking medication as prescribed, incorporate a low fat, low cholesterol and high soluble fibre diet
  • Increase HDL by participating in regular (5x/week), aerobic (walking, long duration, moderate intensity) exercise

Total Cholesterol

<4.5 mmol/L


<2.6 mmol/L

(< 1.8 is a therapeutic optimal level for those who have heart disease and diabetes)


>1.2 mmol/L for men

>1.3 mmol/L for women


<1.7 mmol/L



Source: National Cholesterol Education Program, Canadian Diabetes Association, American Heart Association

Diabetes - What Is It?

  • Increased blood sugar levels. The body is unable to manufacture or use insulin to turn the sugar into energy.
  • Type I body is unable to produce insulin
  • Type II body produces insulin but is unable to efficiently use it.
Why is it a Risk? How do I control it? What is the target?
  • Increased blood sugar levels can lead to injury of the arterial wall
  • In Type II diabetes the high levels of insulin circulating can lead to the cause of arterial plaque
  • Exercise daily
  • Maintain a health weight
  • Ensure a healthy cholesterol profile
  • Maintain a healthy blood pressure
  • Decrease high sugar and refined foods
  • If you have diabetes also:

  • Check your blood sugar levels regularly
  • Exercise daily
  • Attend a diabetes education clinic
  • Follow a diabetic diet

Fasting Blood Glucose:

<7.0 mmol/L

HbA1c <0.07

Source: Canadian Diabetes Association (CDA) 2003 Guidelines

Physical Inactivity - What Is It?

  • Participating in < 30 minutes of continuous activity 5 times/week
Why is it a Risk? How do I control it? What is the target?

Those who do not participate have a higher chance of having:

  • Increased body weight
  • Elevated resting heart rate and resting blood pressure
  • Low HDL cholesterol
  • Elevated LDL cholesterol
  • Low Cardiovascular fitness level
Commit to a lifetime, regular exercise regime
  • Whole body, moderate and continuous exercise for at least 30 minutes on most if not all days of the week

Source: American College of Sports Medicine

Obesity - What Is It?

Excess weight

Why is it a Risk? How do I control it? What is the target?

Leads to:

  • An overworked heart
  • More cholesterol in the blood
  • High blood pressure
  • Diabetes
  • Heart disease
  • Participate in regular exercise
  • Plan for steady permanent weight loss (1-2 pounds per week)
  • Eat lower fat foods
Waist measurement

  • Male <102 cm (40")
  • Female <88 cm (35")

Body Mass Index

  • <25

Source: CHS, CDA


There is no safe level smoking

Why is it a Risk? How do I control it? What is the target?
  • Nicotine causes injury to the artery wall and contributes to plaque build up and also constricts the artery wall
  • Carbon monoxide decreases the amount of oxygen carried in the blood resulting in more work on the heart
  • Quit
  • Ask for help
  • Seek aid through your doctor
  • Attend a quit smoking clinic
Smoke free for life

Stress - What Is It?

An external environmental factor

Why is it a Risk? How do I control it? What is the target?
  • When there is a negative reaction to the stress, the body can increase the heart rate and blood pressure, release hormones in the body. If this occurs over a prolonged time this can increase the work on the heart and can cause injury to the arterial wall contributing to plaque in the artery
  • Identify what causes stress
  • Determine a healthy way of coping with the stress
  • Healthy Management

Disability & Death Rate

Life expectancy has increased considerably in the last decade. Information from research studies such as the Harvard Longitudinal Study, indicate that we can expect to live to 85 years when one is congruent with the "predictors."

Learn More

All That Matters Is Systolic Blood Pressure (At least for those over 50 years of age)

High blood pressure (hypertension) in younger adults is caused by narrowing of the arteries and smaller arteries. In older adults the larger arteries play a more significant role in one's blood pressure. These large arteries become stiffer, lose some of their elasticity and do not "give" when the heart contracts which results in a higher blood pressure followed by a lower diastolic blood pressure. Usually the diastolic pressure has been used to determine if treatment is necessary and systolic pressure ignored.

Learn More

Tim Russert: A Tragedy - Sudden Death But Was It Unannounced?

It is difficult to understand the loss of an adult in the most productive phase of life. In general, it is believed that living to 85 years of age is an expectation, especially if following the predictors set forth by George Valliant, Director of the Harvard Longitudinal Study, and author of AGING WELL.

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Can't Quit Even If I Wanted To

Joseph Difranza has reported a possible explanation as to why it is so difficult to quit smoking, even when a smoker no longer gets pleasure from smoking. Biological evidence shows that when an individual smokes a cigarette, the nicotine level rises in the blood.

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Friends, Family, the Framingham Heart Study and Obesity 2007

The "person-to-person" spread of obesity is a recent observation of Nicholas Christakis and James Fowler (2007). These investigators examined the data from the Framingham Heart Study which included ~ 12,000 subjects.

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