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Who's At Risk?

From the National Heart, Lung, and Blood Institute

Certain traits, conditions, or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk factors. Risk factors also increase the chance that existing CHD will worsen.

Women generally have the same CHD risk factors as men. However, some risk factors may affect women differently than men. For example, diabetes raises the risk of CHD more in women. Also, some risk factors, such as birth control pills and menopause, only affect women.

There are many known CHD risk factors. Your risk for CHD and heart attack rises with the number of risk factors you have and their severity. Risk factors tend to "gang up" and worsen each other's effects.

Having just one risk factor doubles your risk for CHD. Having two risk factors increases your risk for CHD fourfold. Having three or more risk factors increases your risk for CHD more than tenfold.

Also, some risk factors, such as smoking and diabetes, put you at greater risk for CHD and heart attack than others.

More than 75% of women ages 40 to 60 have one or more risk factors for CHD. Many risk factors start during childhood; some even develop within the first 10 years of life. You can control most risk factors, but some you can't.

Major risk factors for heart attack that you can control include:

  • Smoking
  • High blood pressure
  • High blood cholesterol and high triglyceride levels
  • Overweight and obesity
  • Lack of physical activity
  • Diabetes (high blood sugar) and pre-diabetes
  • Metabolic syndrome
  • An unhealthy diet
  • Stress or depression
  • Anemia
  • Sleep apnea

Risk factors that you can't control include:

  • Age and menopause. Before age 55, women have a lower risk for CHD than men. Estrogen provides women with some protection against CHD before menopause. After age 55, however, the risk of CHD increases in both women and men.

  • Family history of early CAD. Your risk increases if your father or a brother was diagnosed with CHD before 55 years of age, or if your mother or a sister was diagnosed with CHD before 65 years of age. Also, a family history of stroke—especially a mother's stroke history—can help predict the risk of heart attack in women.

  • Preeclampsia. Preeclampsia is a condition that develops during pregnancy. The two main signs of preeclampsia are a rise in blood pressure and excess protein in the urine. These signs usually occur during the second half of pregnancy and go away after delivery. However, your risk of developing high blood pressure later in life increases after having preeclampsia. Preeclampsia also is linked to an increased lifetime risk of heart disease, including CHD, heart attack, and heart failure. (Likewise, having heart disease risk factors, such as diabetes or obesity, increases your risk for preeclampsia.)

Research is just starting to show some other risk factors:

  • Inflammation Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow.

  • High blood levels of a protein called C-reactive protein (CRP) CRP measures inflammation in the body.

  • Inflammatory diseases, such as lupus and rheumatoid arthritis

  • Low bone density and low intake of folate and vitamin B6

  • Migraine headaches This is especially true for women who have migraines with auras (visual disturbances), such as flashes of light or zig-zag lines.

  • Broken heart syndrome extreme emotional stress can lead to severe (but often short-term) heart muscle failure. Broken heart syndrome is also called stress-induced cardiomyopathy or takotsubo cardiomyopathy.

Last updated April 11, 2012