Following years of decline, deaths from cardiovascular diseases, such as heart attack and stroke, have been rising dramatically since 2012.[i] Deaths from cardiovascular disease increased 4% between 2011 and 2017, according to researchers from the CDC’s National Center for Health Statistics.[ii]
While cardiovascular risk factors include age and family history, they also include personal habits, such as diet, weight, physical activities and smoking. According to the CDC,[iii] the top three risk factors for heart disease are elevated cholesterol, high blood pressure and smoking, with nearly half of Americans (47%) having at least one of these three risk factors. Other lesser recognized cardiovascular risk factors include high triglycerides and diabetes, even in patients whose conditions are controlled with statins and diabetes medications.[iv]
Understanding these risk factors is key for prevention.
Why is high cholesterol dangerous?
When LDL (the bad cholesterol) is elevated, it causes fatty deposits within your arteries to build up. This can reduce or block the flow of blood and oxygen your heart needs and can lead to chest pain and heart attack. Additionally, the blocking of blood flow is not limited to heart arteries and can occur in arteries elsewhere in your body, causing problems such as poor circulation, kidney failure and stroke.
According to the Cleveland Clinic,[v] everyone, regardless of gender, age or history of heart disease, should aim to maintain a low LDL cholesterol level of less than 100 mg/dL.
Why is high blood pressure dangerous?
According to the American Heart Association,[vi] high blood pressure puts an excess strain on your arteries, particularly with atherosclerosis, the hardening and narrowing of arteries due to the build-up of fat, cholesterol and other substances in the blood, together called plaque.
Blood clots are more likely to form when arteries harden with plaque. The accumulation of plaque and presence of blood clots can block arteries, preventing the flow of blood carrying oxygen and nutrients to various parts of the body. Heart attacks can happen when this blockage occurs in arteries serving the heart, causing damage or death in parts of the heart muscle.[vi]
Why is smoking dangerous?
The chemicals found in cigarette smoke can result in the narrowing of blood vessels when the cell lining becomes swollen and inflamed. The 2014 Surgeon General’s Report on smoking and health states that smoking is a major cause of cardiovascular disease and is to blame for approximately one out of every four deaths from cardiovascular disease.[vii]
While the risk of cardiovascular disease increases with the number of cigarettes smoked in a day, even people who go through fewer than five cigarettes per day may show signs of early cardiovascular disease, according to the Centers for Disease Control. However, the benefits of quitting smoking for heart health are apparent: Within a year, the risk of heart attack drops dramatically, and even people who have already had a heart attack can cut their risk of having another if they quit smoking.
Why are people who are being treated for diabetes and/or elevated cholesterol still at risk of cardiovascular disease?
Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes.[viii] The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease.[iv]
While diabetes is treatable, it greatly increases the risk of heart disease and stroke, even when glucose levels are under control. That’s because people with diabetes, particularly type 2 diabetes, may have conditions, like high blood pressure and abnormal cholesterol and high triglycerides, that contribute to their risk for developing cardiovascular disease.[iv] Statins are effective at reducing relative cardiovascular risk by approximately 25 to 35% regardless of baseline LDL-C, but are not able to reduce all cardiovascular risk.[ix]
What should you do if you believe you might be at risk for cardiovascular disease?
According to healthcare providers, if you have one or more of the risk factors identified above, you should schedule an appointment with your doctor to learn more and receive guidance on how best to address it.[x],[xi]
[i] Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O’Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019;139:e1–e473. doi: 10.1161/CIR.0000000000000659.
[ii] Curtin SC. Trends in Cancer and Heart Disease Death Rates Among Adults Aged 45-64: United States, 1999-2017. Centers for Disease Control and Prevention, https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_05-508.pdf
[iii] Fryar CD, Chen T, Li X. Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease: United States, 1999–2010. NCHS Data Brief, No. 103. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2012.
[iv] “Cardiovascular Disease & Diabetes.” American Heart Association, http://www.heart.org/HEARTORG/Conditions/More/Diabetes/WhyDiabetesMatters/%20Cardiovascular-Disease-Diabetes_UCM_313865_Article.jsp#.XWAS5ehKhhE
[v] “LDL Cholesterol & Heart Health.” Cleveland Clinic, my.clevelandclinic.org/health/articles/16866-cholesterol-guidelines–heart-health.
[vi] “How High Blood Pressure Can Lead to a Heart Attack.” American Heart Association, www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-a-heart-attack.
[vii] Smoking and Cardiovascular Disease. Smoking and Cardiovascular Disease, Centers for Disease Control and Prevention, https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_CVD_508.pdf
[viii] Deshpande AD et al. “Epidemiology of diabetes and diabetes-related complications.” Physical therapy vol. 88,11 (2008): 1254-64. doi:10.2522/ptj.20080020
[ix] Ganda OP, Bhatt DL, Mason RP, Miller M, Boden WE. Unmet need for adjunctive dyslipidemia therapy in hypertriglyceridemia management. J Am Coll Cardiol 2018;72:330-43.
[x] Khera A. “Four people who should see a preventive cardiologist.” UT Southwestern Medical Center. https://utswmed.org/medblog/prevent-heart-disease/
[xi] Zielinski AR. “10 Signs It’s Time to See a Cardiologist.” Northwestern Medicine. https://www.nm.org/healthbeat/healthy-tips/ten-signs-its-time-to-see-a-cardiologist