Controllable Risk Factors
Tobacco Use
Tobacco use and exposure to secondhand smoke can increase your risk of heart and vascular disease by damaging artery walls and thickening the blood. All forms of tobacco, not just cigarettes, contain nicotine, which may cause blood vessels to constrict and increase your blood pressure and heart rate.
This can lead to atherosclerosis (thickening of the artery walls because of deposits of cholesterol, lipids and other waste matter). No matter how much or how long you have used tobacco, your heart and vascular disease risk drops once you quit. Tobacco is the leading cause of preventable death and disability in the United States today, so talk with your health care provider for more information about combination pharmacotherapy to help you quit.
When Smokers Quit
Within 20 minutes of smoking that last cigarette, the body begins a series of changes that continues for years. All benefits are lost by smoking just one cigarette a day, according to the American Cancer Society.
20 minutes after that last cigarette- Blood pressure drops to normal
- Pulse rate drops to normal
- Body temperature of hands and feet increases to normal
- Carbon monoxide level in blood drops to normal
- Oxygen level in blood drops to normal
- Chance of heart attack decreases
- Nerve endings start regrowing
- Ability to smell and taste is enhanced
- Circulation improves
- Walking becomes easier
- Lung function increases up to 30 percent
- Coughing, sinus congestion, fatigue, shortness of breath decrease
- Cilia regrow in lungs, increasing ability to handle mucus, clean the lungs and reduce infection
- Body's overall energy increases
- Excess risk of coronary heart disease is half that of a smoker
- Lung cancer death rate for average former smoker (one pack a day) decreases by almost half
- Stroke risk is reduced to that of a nonsmoker 5-15 years after quitting
- Risk of cancer of the mouth, throat and esophagus is half that of smoker's
- Lung cancer death rate is similar to that of nonsmokers
- Precancerous cells are replaced
- Risk of cancer of the mouth, throat, esophagus, bladder, kidney and pancreas decreases
- Risk of coronary disease is that of nonsmoker
Source: American Cancer Society, Centers for Disease Control
High Cholesterol Levels
Total Cholesterol
A total cholesterol level of less than 200mg/dL is desirable and your heart attack risk is relatively low as long as you don't have other risk factors. A cholesterol level of 200-239 mg/dL is borderline high risk and you should lower your intake of foods high in saturated fat and cholesterol to reduce your total cholesterol. A cholesterol level of 240 mg/dL or more is high risk and you are twice as likely to have a heart attack as a person with a cholesterol of 200 mg/dL. If your cholesterol levels are in the borderline high or high risk categories, ask your health care provider to interpret your results and for advice to lower your cholesterol.
| Desirable | Less than 200 mg/dL |
| Borderline High Risk | 200 to 239 mg/dL |
| High Risk | 240 mg/dL and higher |
Low Density Lipoprotein (LDL) Cholesterol
LDL is the main carrier of cholesterol in your blood. A high level of LDL increases your risk of heart disease, so you want your LDL to be as low as possible.
| Optimal * | Less than 100 mg/dL |
| Near Optimal | 100 to 129 mg/dL |
| Borderline High | 130 to 159 mg/dL |
| High | 160 to 189 mg/dL |
| Very High | 190 mg/dL or higher |
*If you have already been diagnosed with heart disease, it is recommended that your LDL be less than 70 mg/dL
High Density Lipoprotein (HDL) Cholesterol
HDL is considered "good" cholesterol because it seems to protect you from a heart attack. Unlike other lipid levels, you want this number to be as high as possible. An HDL level less than 40 mg/dL creates a major risk factor for heart disease. Higher than 40 mg/dL is recommended, and higher than 60 mg/dL is considered protective against heart disease.
| High (Desirable) | More than 60 mg/dl |
| Acceptable | 40-60 mg/dl |
| Low (Undesirable) | Less than 40 mg/dl |
Triglyceride Level
A triglyceride is a lipid (fat) that is used by the body for energy. High triglyceride levels can result from being overweight, drinking too much alcohol, having diabetes or other disorders.
| Normal | Less than 150 mg/dL |
| Borderline High | 150 to 199 mg/dL |
| High | 200 to 499 mg/dL |
| Very High | 500 mg/dL or higher |
Are you below or above one or all of the recommended values? Too much cholesterol could stick to the walls of your arteries and be a factor in developing atherosclerosis. If your values exceed the guidelines, consult your health care provider.
Source: American Heart Association 2004
Obesity and Overweight
The obesity epidemic continues to grow in the United States and in the year 2003, 65 percent of adult Americans were considered overweight or obese. If you are overweight, you may also have a high body fat content. Although some fat is necessary to protect organs, fat is an inactive tissue to which your heart must pump blood. Having a lot of extra body fat means extra work for your heart, which can result in a higher heart rate and/or blood pressure.
Body Mass Index (BMI) is one way to determine if you are overweight and/or obese. A BMI of 25 or more indicates an increased risk of heart disease in men and women. BMI is calculated using your weight divided by your height. You should speak with your health care provider concerning your BMI before beginning a weight management program.
Lack of Physical Activity
In July 1996, the U.S. Surgeon General reported that exercise is vital for good health. Exercise can help strengthen heart muscle, burn calories, control blood sugar, lower blood pressure, reduce stress and help control your weight. The American Heart Association recommends 30 to 60 minutes of regular, moderate-intensity physical activity 3 to 5 days a week.
High Blood Pressure
According to the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC), 50 million Americans have high blood pressure and 25 million have borderline hypertension. In May 2003, the national classification system of blood pressure was revised by the JNC.
| Target Blood Pressure | 115/75 |
| Normal | Less than 120/80 |
| Pre-Hypertension | 120 to 139/80 to 89 |
| Hypertension | |
| Stage One | 140 to 159/90 to 99 |
| Stage Two | 160 or higher/100 or higher |
Even with normal blood pressure, your risk of stroke, heart attack or heart failure increases if your levels are above 115/75. High blood pressure, or hypertension, increases the workload of the heart and can cause your heart to become weak and enlarged over time. It also increases your risk for heart attack, stroke, congestive heart failure and kidney failure. High blood pressure can be controlled through your food plan, exercise, stress management and, if necessary, medications. You should consult with your health care provider for further information about high blood pressure.
Diabetes
Over time, diabetes causes blood vessels to become smaller and more fragile, which doubles the risk of developing heart and vascular disease. You cannot control whether you have diabetes but, once diagnosed, you can control and/or maintain your blood glucose levels through exercise, your food plan and, if necessary, medications.
A good way to determine if you are keeping your blood glucose levels under control is by having an HbA1C test, which looks at your average blood glucose levels for the past three months. You want this level to be less than or equal to 7 percent. Please consult with your health care provider for further information.
