Top 5 Risk Factors for Heart Disease

man holding playing cards
A gambling man might want to keep his eye on his heart(s).
Jan Cobb Photography Ltd/Getty Images

If you're the gambling sort, here's a safe bet -- you're going to die from heart disease. It's the No. 1 killer in the United States, and it causes almost three out of every 10 deaths each year, more than any other single cause [source: CDC].

"Heart disease" is an umbrella term for a number of heart conditions. One of these conditions is coronary artery disease, excessive plaque buildup in the arteries that deliver oxygenated blood to your heart tissues. When these arteries get too narrow or clogged up, your heart doesn't get the fuel it needs to do its job. This condition may lead to angina, a feeling of tightness in the chest, and eventually result in heart attack.


Heart failure is also a form of heart disease. Heart failure implies that your heart suddenly stops beating, but that's not the case -- it refers to the diminished capacity of a damaged ticker. Heart failure often leaves you feeling exhausted or breathless, because your heart is having trouble delivering enough blood -- and the oxygen in that blood -- to every part of your body.­

Arrhythmia (abnormal heart rhythm) is also considered a form of heart disease. A diseased heart may begin to flutter or race and, in extreme cases, can prevent blood from properly moving through the heart's chambers.

One way doctors predict your likelihood of getting these conditions is through a little equation called the Framingham formula, which takes a bunch of risk factors and calculates how likely you are to get coronary heart disease. The problem is that the Framingham formula is pretty complex. So to make it easy for you, we're going to focus on five risk factors in this article.

First, we'll talk about the factor we all like to blame when we look at our oversized feet or our untamed eyebrows: genetics.


5. Genetics

family with I Love New York shirts
New York isn't the only thing this family's hearts have in common.
West Rock/Getty Images

Genetics is a big factor in determining your likelihood of future heart disease. When it comes to the family tree, you're most at risk if a direct rel­ative (a parent or sibling) has had a heart attack. If your father or brother has had one before the age of 45 -- or if your mother or sister has had one before the age of 55 -- you should be especially concerned [source: Haynes]. A history of heart disease in your extended family is a factor as well.

Your genes may make you more susceptible to heart disease, but they can also make you more prone to contributing factors such as obesity, high blood pressure or high cholesterol. African-Americans tend to have higher blood pressure, which contributes to heart disease [source: AHA]. In fact, studies have shown that African-Americans are twice as likely to die of heart disease than Caucasians [source: Med Care]. Native Americans, Native Hawaiians, certain Asian ethnicities and Hispanics are also at higher risk.


The way you were raised (take it up with your shrink) may play a role as well, especially where diet, smoking and drinking are concerned. Regardless, you must wrestle those genies back into the genetic bottle by trying extra hard to keep excess pounds off and living a healthy lifestyle.

Next we'll talk about the heart disease factor that makes this crazy world go around: gender.

4. Gender

man having a heart attack
Ladies, pay attention -- it's not just men having heart attacks.
Eric Myer/Getty Images

When it comes to the battle of the sexes, victory favors women through simple attrition. Men are, on average, 66 years old when they have thei­r first heart attack, and nearly 50 percent of men who have a heart attack by the age of 65 will die by the time they're 73 [source: CDC]. More men in America die from heart disease than from any other single cause, and it was responsible for 28 percent of all American men's deaths in 2003 [source: Mayo].

Women tend to develop coronary heart disease about 10 years later than men do, and for serious events such as heart attack or sudden death, there's a 20-year lag [source: AHA]. Although women on average outlive men (females born in 2005 can expect to live a little more than five years longer than a male born in 2005 [source: NVSR]), post-menopausal women are at equal risk of heart disease despite its later onset, and it claims nearly equal numbers of men and women every year [source: Harvard]. In some ways, women may put themselves at greater risk by overestimating the risk of heart disease for men, wrongly believing they're off the hook. Fortunately, there's enough time to learn the facts --women generally don't experience heart attack until age 70, but heart disease begins taking a toll years before that [source: Harvard].


3. Diabetes

box of prescription pills
Diabetes and heart disease are a little too close for comfort.
Plush Studios/Getty Images

Diabetes is an inability to self-regulate blood-glucose levels. It's also a contributing cause of heart disease. Diabetics are twice as likely as nondiabetics to suffer from heart disease [source: American Diabetes Association]. Worse still, they're five times more likely to have heart attacks [source: Haynes].

Diabetes affects many parts of the body, especially the kidneys. As systems lose full function, the heart is forced to work harder and carry even more of a load. The inner lining of the artery is already nicked up by products in the bloodstream such as sugars and lipids, and the excess sugars in a diabetic's blood cause even greater wear and tear. It doesn't help when the sugary blood is being sent through the body with greater force from high blood pressure, which diabetics are also more likely to have.


Type-2 diabetics (people with a form of diabetes that presents itself in adulthood) are treated statistically as if they've already had one heart attack -- as a reflection of the damage diabetes causes the heart. Type-2 diabetics tend to have poor exercise and dietary habits, putting greater strain on their hearts even before the onset of diabetes. Diabetics have a 65 percent chance of one day dying from heart disease or stroke, but they can fight these odds by closely monitoring their blood glucose levels, not smoking, exercising, lowering their cholesterol levels and controlling their blood pressure [source: Mayo].

Stick around long enough, and you'll learn the hard way about the heart disease factor we'll talk about in the next section.

2. Age

older man holding a heart
Take care of your heart for a better chance at a long and happy life.
Deborah Jaffe/Getty Images

On average, your heart will beat up to 3.3 billion times before its final lub-dub [source: Roizen]. Any way you slice it, a workload that heavy causes plenty of wear and tear. As we age, not only do we have trouble finding our reading glasses, but our arteries harden, the ­walls of our hearts get thicker, and overall heart function decreases. In addition to the normal effects of aging, other contributing factors like high blood pressure and lack of exercise have been in play all those years, taking their tolls as well. All of this adds up to a pretty hefty statistic -- people age 65 and older make up 83 percent of all heart disease deaths [source: AHA].

Between the time we hit the big four-oh and the time we give up the ghost, men have an almost 1-in-2 chance of developing heart disease, and the odds are 1-in-3 for women [source: AHA]. While we can't stop time from marching onward, today's choices either exact a hefty toll or pay handsome dividends down the road. Obesity in middle age leads to an even higher chance of dying of heart disease when we get older [source: Science Daily]. Even if your heart strings are turning gray (good news: they don't, nor do they fall out), your heart can still be happy and healthy through your golden years.


In the next section, we'll learn how a healthy lifestyle can keep that heart ticking like an organ half its age.

1. Lifestyle

hand holding drink and cigarette
If a cigarette-and-booze combo is your idea of a good time, your body's going to get its revenge.
Henry Horenstein/Getty Images

Unlike other causes of heart disease such as genetics, gender or age, you can help prevent one major cause of heart disease -- your lifestyle. If you smoke, try your hardest to quit. Smoking increases blood pressure and damages your heart's tissues. Obesity is a big contributor to heart disease, so eat a low-fat diet and get exercise as often as you can, ideally for a half-hour at least four times a week. Drink like Ben Franklin's advice, but not like Ben Franklin's habits -- in moderation. A daily serving of alcohol may in fact improve your heart's health [source: AHA].

Lack of exercise and poor diet can increase the amount of low-density ("bad") cholesterol in your bloodstream. This accumulates as plaque inside your arteries, causing them to harden and narrow. A good diet and exercise can simultaneously lower bad cholesterol and raise "good" (high-density) cholesterol, which rids the body of the low-density variety­.


High blood pressure strains the heart, but exercise, a low-salt diet and medications can help. Stress is no good for your heart, and it can nudge you toward unhealthy comforts like alcohol, tobacco or overeating. If life gets you down, clear your head, exercise or take a nice relaxing nap in some yoga pants. Women using birth control pills are also at higher risk of heart attack, especially if they smoke [source: Haynes].

A smart diet, exercise and good lifestyle choices are entirely within your reach. For lots more information on heart disease, see the next page.

Lots More Information

Related HowStuffWorks Articles

More Great Links

  • American Diabetes Association. "Diabetes and Cardiovascular (Heart) Disease." (Oct. 26, 2008)
  • American Heart Association. "Risk Factors and Coronary Heart Disease and Stroke." Jan. 30, 2008. (Oct. 26, 2008)
  • American Heart Association. "Your Heart and How it Works." (Oct. 13, 2008).
  • Centers for Disease Control and Prevention. "Men and Heart Disease Fact Sheet." June 6, 2008. (Oct. 26, 2008)
  • Franklin Institute. "The Human Heart: An Online Exploration from the Franklin Institute." (Oct. 13, 2008).
  • Harvard Health Publications. "Gender matters: Heart disease risk in women." (Oct. 26, 2008)
  • Haynes, William, MD. "Risk Factors for Heart Disease: Frequently Asked Questions."
  • University of Iowa Hospitals and Clinics, Division of Cardiovascular Disease. Jan. 2004. (Oct. 26, 2008)
  • Mayo Foundation for Medical Education and Research. "Have diabetes? Stop cardiovascular disease in its tracks." May 4, 2007. (Oct. 26, 2008)
  • Mayo Foundation for Medical Education and Research. "Heart Disease." (Oct. 13, 2008).
  • Mayo Foundation for Medical Education and Research. "Men's top 10 health threats: Mostly preventable." Feb. 21, 2007. (Oct. 26, 2008)
  • Med Care. "Heart disease and prevention: race and age differences in heart disease prevention, treatment, and mortality." Holmes, J.S.; Arispe, I.E.; Moy, E. March 2005.
  • Murray, Michelle W. "Heart Disease: Tips for Prevention." University of Maryland Medical System. April 19, 2007.
  • National Vital Statistics Reports. "Life expectancy at birth, at 65 and 75 years of age by race and sex, 1900-2004; Deaths: Final Data for 2005." Volume 56, Number 10, Table 8.
  • Roizen, Michael F. M.D., and Mehmet C. Oz, M.D. "YOU: The Owner's Manual." HarperCollins. 2005.
  • Science Daily. "Obesity In Middle Age Raises Heart Disease, Diabetes Risk In Older Age." Jan. 12, 2006.