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Age, sex and genetics are just a few factors that can affect your risk of developing coronary heart disease
We’ve all questioned the trustworthiness of our ticker from time to time. It’d be hard not to! After all, heart disease is the leading cause of death in both the U.S. and the wider world.
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We can’t change our past or control our future. But knowing our personal risks for coronary heart disease (CHD) can still be empowering. Whether this quiz is the wake-up call you need to prioritize your health and wellness, a cause to celebrate your hard work or a way to pass the time, we hope it offers you some insight into the different factors impacting your heart health.
Don’t worry, there are no right or wrong answers on this quiz. Just opportunities to learn!
There are two numbers involved in measuring blood pressure: systolic and diastolic. Systolic blood pressure measures the amount of force your blood exerts on the walls of your arteries while your heart is contracting (pumping blood). Diastolic pressure — which is always lower — is the same measurement, but it’s for your heart at rest, in between beats.
What counts as high blood pressure, or hypertension? According to the American Heart Association, a person has hypertension if:
According to cardiologist Ashish Sarraju, MD, hypertension strains the heart and increases wear and tear on blood vessels, making blockages more likely.
It’s worth noting that, while it’s rarer, people with chronic low blood pressure (hypotension) are also at risk for heart disease. It’s a Goldilocks thing — you want your blood pressure to be in the “just right” range. Not too high or too low.
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Men and people assigned male at birth (AMAB) have a higher risk of CHD than women and people assigned female at birth (AFAB) do. But the risk of CHD goes up during and after menopause, more or less evening out the risk.
The older you get, the more likely you are to develop CHD. According to the National Institute on Aging, your risk goes up significantly at age 65. That’s because, Dr. Sarraju says, the longer you live, the more likely you are to develop (or exacerbate) other risk factors.
Maybe your blood pressure climbs as you get older, which is extremely common. Or maybe you — as many people do — become less physically active. The hormone fluctuations that are a natural part of the aging process also reduce the flexibility of your arteries, which can eventually lead to atherosclerosis. And it takes time for plaques to develop and clog your arteries.
You get the idea: Your heart doesn’t work in isolation. It ages right along with the rest of you, responding to both the passage of time and the other changes occurring throughout your body.
The genetic (inherited) make-up of some individuals increases their chances of developing CHD.
When you look at your biological family tree, Dr. Sarraju recommends you do more than just take note of the branches that include heart disease. You should also think about how closely you’re related to those individuals — and how old they were when they developed CHD.
It’s especially important to let your providers know if you have relatives who developed heart disease before the age of 50 or had high cholesterol at a young age. It could be a sign of an inherited condition called familial hypercholesterolemia (FH). While an FH diagnosis is nobody’s idea of a good time, Dr. Sarraju explains that an early diagnosis can be life-changing — in a good way. Preventive treatment for FH may significantly reduce your risk of heart disease.
High cholesterol (hyperlipidemia) can contribute to the build-up of plaques in your bloodstream. Those plaques can clog the blood vessels leading to your heart, narrowing them and potentially blocking blood flow. Cholesterol can be high for many reasons, some of which (like your diet) are in your power to change. But Dr. Sarraju is quick to note that high cholesterol can also be hereditary.
Total cholesterol greater than 200 mg/dL is considered borderline high, and above 240 mg/dL is high. You also want your LDL cholesterol (the “bad” cholesterol) to be less than 100, and your HDL cholesterol (the “good” cholesterol) to be 60 or higher.
Not sure what your cholesterol level is? Contact your provider and tell them you’d like to get a lipid panel done. It’s a simple blood test that will provide quick insight into your cardiovascular health. If it turns out your cholesterol is too high, your provider may suggest you take medications called statins to lower it.
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At this point, it’s common knowledge that smoking is bad for your health. It’s normal to think first about conditions like chronic obstructive pulmonary disease (COPD) and lung cancer, but smoking also does a number on your heart. In fact, it’s the most important of the known, changeable risk factors for CHD.
Nicotine speeds up the heart and narrows the arteries, making it harder for enough blood to get through. And prolonged use of nicotine patches and nicotine lozenges also raises your risk for heart disease. That’s why Dr. Sarraju says it’s important for nicotine replacement therapy to be short-term. It definitely shouldn’t be your whole smoking cessation plan.
If you’re ready to quit smoking but aren’t sure how to go about it — or if your previous attempts haven’t worked out — speak to a provider. They’ll be happy to help you through the process.
You’ve probably heard it before: Experts recommend 30 minutes of moderate-intensity exercise five times a week. If that time commitment or level of physical activity feels unattainable, don’t despair: When it comes to your cardiovascular health, every little bit helps. Do what you can, as often as you can, and slowly build to a five-day-a-week routine.
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As the name suggests, regular cardio workouts are a particularly great way to improve your heart health and reduce your risk of developing CHD. In addition to improving your circulation and increasing the amount of oxygen in your blood, over time, cardio can also reduce both your blood pressure and your heart rate. It may even help raise your “good” HDL cholesterol and reduce the “bad” LDL cholesterol.
If you have a disability that limits your ability to engage in physical activity, have a conversation with your provider about it. Together, you can determine what kind and amount of exercise is appropriate for you. Remember: Any activity is good activity, from chair yoga to pool walking, from breathing exercises to physical therapy. Your provider may even be able to point you in the direction of accessible exercise facilities.
According to Dr. Sarraju, it’s best to limit your consumption of the following types of food:
When it comes to heart health, the gold-standard eating plan is the Mediterranean diet. In fact, studies have shown it’s significantly more effective for reducing heart disease risk than a reduced-fat approach. And unlike crash or fad diets, the Mediterranean diet is sustainable in the long term, which is key to keeping your heart healthy as you get older.
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According to the U.S. Centers for Disease Control and Prevention (CDC), people living with diabetes — be it Type 1 or Type 2 — are two times more likely to develop heart disease than people who don’t have diabetes. Those are scary statistics, but here’s the thing: The lifestyle changes that doctors recommend for managing diabetes also have a positive impact on your heart health.
Want to be more proactive about lowering your hemoglobin A1C? Talk to your provider and, if available, get connected with a diabetes care and education specialist. You can also find help through the American Diabetes Association.
“You almost gave me a heart attack!”
“That call just raised my blood pressure.”
“Calm down! Don’t have a coronary!”
We’ve long understood the connection between stress and heart health — so much so that we reference it in casual conversation. And as time’s gone by, that relationship has been validated by researchers.
“Chronic stress can damage our heart both directly and indirectly,” Dr. Sarraju states. Let’s start by reviewing the direct impact.
When we’re under stress for prolonged periods of time, our cortisol levels go up. Cortisol is a stress hormone that impacts every part of our body, including the systems that regulate our blood pressure. It also causes chronic inflammation.
Cortisol is actually supposed to suppress inflammation. But when you’re in a constant state of fight or flight, your body basically gets used to all that cortisol, making it ineffective. Chronic inflammation is linked to cardiovascular disease, as well as weight gain and blood sugar issues.
Stress also hurts our heart indirectly. That’s because many of us — for perfectly natural reasons — cope with stress in unhealthy ways.
We lie awake at night worrying. We indulge in “comfort foods.” We smoke like chimneys or down cup after cup of our caffeinated beverage of choice. We numb ourselves with alcohol or drugs. And we let self-care activities like exercise or mindfulness practices fall by the wayside.
That might make you feel better in the short term. But Dr. Sarraju explains that those coping strategies actually increase our cortisol levels in the long term, creating a vicious cycle.
If your stress levels feel unsustainable or unhealthy, it’s time to talk to your provider. They can test your inflammation and cortisol levels. They can also refer you to mental health professionals who can help you learn better (and more effective!) ways to cope with stress.
Now that you've taken the quiz, you might be wondering, what's your score? But you're more than a number — and assessing CHD risk is complicated. Sure, numbers are valuable. And there are lots of resources out there that treat CHD risk as a quantifiable thing. But it’s also important to qualify risk. To allow for gray areas, complexities, exceptions and uncertainties. After all, very little in life is certain.
In reviewing the risk factors we’ve compiled, you’ve probably noticed that there’s only so much we can do about our CHD risk profile. We don’t get to trade in our relatives’ medical histories for new ones — and we’ve yet to discover the mythical fountain of youth. But there are some elements of our overall health that we can change. And when we make heart-healthy choices, we tip the scale ever-so-slightly back in our favor.
Not sure how to quit smoking, cope with stressful situations or reduce your blood pressure and cholesterol? Dr. Sarraju recommends speaking with your provider. Not only can they advise you, but they can also connect you with a wide range of resources, including other healthcare specialists. With their help, you can play the best possible hand with the cards you’ve been dealt.
Learn more about our editorial process.
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