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Risk Factors

Do you know your risk for heart disease? Learn what increases our cardiovascular risk and how we can reduce or control risk factors that we may have.

  • Am I at risk for heart disease?
  • To estimate a patient’s risk for heart disease, doctors take into account a number of factors such as age, gender, blood pressure, cholesterol, and family history. Using this information, doctors can estimate whether a patient is considered to be at low, medium or high risk for heart disease. Online tools are also available to help patients estimate their risk for heart disease.
  • Can mental health affect heart health?
  • Yes. Although there’s still much to learn, research suggests there is a close connection between mental and cardiovascular health. Studies have shown that patients with a mental illness, like depression, are at increased risk for heart disease. It’s also possible that having heart disease increases risk for depression and can worsen outcomes. It’s important to discuss all aspects of health, including mental health, with your doctor.
  • What causes coronary microvascular dysfunction?
  • It’s likely that risk factors for coronary microvascular dysfunction are similar to those of coronary artery disease. Risk factors may include high blood pressure, smoking, diabetes, older age, inactivity, overweight/obesity and family history of heart disease.
  • If I have prediabetes, will I develop diabetes in the future?
  • Although prediabetes drastically increases risk for the full-blown disease, there are ways to reduce risk of developing diabetes in the future. Healthy lifestyle choices including a balanced diet and regular physical activity can help prevent the development of type 2 diabetes. Losing weight, even just 7% of your body weight, can also help ward off diabetes later in life.
  • Who is considered high-risk for surgery?
  • Although all types of surgery carry some risk of complications, certain conditions can increase risk of complications from surgery, such as obesity, diabetes and heart disease. When considering surgery, it’s important to discuss possible risks and benefits of treatment plans with your doctor.
  • Is there a "safe" level of exposure to secondhand smoke?
  • No, there is no known safe level of exposure to secondhand smoke. Breathing in any amount of secondhand smoke can be dangerous, which is why many states have passed laws that prohibit smoking in public places, such as workplaces, restaurants and bars.
  • Are diet drinks bad for heart health?
  • Previous studies have linked frequent diet drink consumption to increased cardiovascular risk, but further research is needed on the topic. Until we learn more about the relationship between diet drinks and heart health, moderation is key when it comes to the consumption of diet drinks.
  • What is secondhand smoke?
  • Secondhand smoke, also referred to as environmental tobacco smoke, includes the smoke that comes from the lighted end of a tobacco product (sidestream smoke) and the smoke exhaled by a smoker (mainstream smoke). Similar to tobacco use, secondhand smoke is a “known human carcinogen,” which means that it’s known to cause cancer.
  • What are the health consequences of secondhand smoke?
  • Exposure to secondhand smoke can have lasting health effects and research shows that there is no safe level of secondhand smoke. Exposure to secondhand smoke can cause lung cancer, heart disease, asthma and many other serious health conditions.
  • Is depression common among heart patients?
  • Yes, depression is relatively common among patients living with heart disease. Not only has depression been linked to heart disease, patients living with depression often have worse outcomes than individuals without this condition. If you’re worried that you might suffer from depression, it’s important to talk with your doctor to better understand the condition and possible treatments.
  • Are mental health and heart health related?
  • Although additional research is needed on the topic, there is a clear link between mental health and cardiovascular health. Many studies have suggested that having a positive attitude or outlook on life may reduce cardiovascular risk, while high stress levels and depression can increase risk for heart disease. As a result, it’s important to work with your doctor on improving both mental and physical health to reduce cardiovascular risk.
  • What is coronary artery calcification?
  • Coronary artery calcification (CAC) is the buildup of calcium in the arteries, which can cause blood vessels to narrow and lead to the development of heart disease.
  • How much caffeine can I safely have in one day?
  • The Food and Drug Administration (FDA) recommends that adults have no more than 400 milligrams of caffeine a day, which is equivalent to about four to five cups of coffee. However, the FDA notes that there is no safe level for children.
  • What are the risk factors for heart disease?
  • The most common risk factors for heart disease include increased age, tobacco use, diabetes, high blood pressure, high cholesterol, obesity, stress, illegal drug use, lack of physical activity and family history of heart disease.
  • How is inflammation linked to heart health?
  • Inflammation is the body’s response to injury or infection. Although it’s not proven that inflammation actually causes heart disease, research shows that many heart disease patients have heightened markers of inflammation. It’s possible that inflammation may be a sign of heart disease or a response to it, and further research is needed to better understand the role of inflammation on cardiovascular risk.
  • How are diabetes and chronic kidney disease related?
  • Diabetes is the leading cause of kidney disease, accounting for roughly 44% of kidney failure cases in the United States each year. Patients with diabetes should work closely with their doctor to monitor their kidney function and take steps to help reduce risk for developing chronic kidney disease, like by eating healthy and controlling blood sugar levels.
  • Can the cardiovascular system be damaged as a result of shock when one awakens frightened from a nightmare?

  • I wouldn’t worry about being startled or frightened to death in your sleep. While it’s true that your body responds to fear by pumping out stress hormones like adrenaline, it does this while you are awake too, and we don’t often see people frightened to death at surprise parties or scary movies. If you have a healthy, structurally normal heart I wouldn’t worry about this at all. If you have a history of serious heart problems, especially if you’ve had a heart attack, congestive heart failure, or a history of abnormal heart rhythms, then I’d suggest discussing your risk of sudden death (whether awake or asleep) with your heart doctor, who knows your specific situation and can hopefully reassure you.

    Sleep in general is very important to your health, and studies have shown that not enough or poor quality sleep is associated with problems such as obesity, high blood pressure, and diabetes. A particularly dangerous condition that can affect sleep is called obstructive sleep apnea, where your air supply intermittently gets cut off while you sleep, and you wake up gasping for breath. This can have a serious harmful impact on your health, and if you or anyone you know has a history of heavy snoring or stops breathing at night, they should bring that up to their doctor and perhaps get tested.

    Best regards,

    Sandeep Das, MD, MPH, FACC

  • How do fertility treatments impact heart health in women?
  • Common complications associated with fertility treatments include multiple pregnancy, bleeding or infection, ovarian hyperstimulation syndrome, and premature delivery. Although long-term research on fertility treatments and cardiovascular risk is sparse, research suggests that fertility treatments do not have a negative impact on cardiovascular health.
  • How does family history impact my risk for heart disease?
  • There are some risk factors for heart disease that we can control, such as high blood pressure and high cholesterol, and some that we can’t, including family history. Individuals with a family history of heart disease have a naturally predisposed risk and are more likely to develop heart disease than those without a family history. Patients with a family history of heart disease should talk with their healthcare provider to discuss monitoring heart health and addressing any risk factors that they can change.
  • What is metabolic syndrome?
  • Metabolic syndrome is a cluster of risk factors that can greatly increase risk for heart disease and type 2 diabetes. These risk factors include a large waistline, high triglyceride level, a low HDL or “good” cholesterol, high blood pressure and high blood sugar. Individuals with three or more of these risk factors are considered to have metabolic syndrome, and the more risk factors one has, the greater their risk for heart disease and diabetes.
  • Where is secondhand smoke a problem?
  • Secondhand smoking is extremely harmful to health, increasing risk for cancer, heart disease, and other serious health conditions. The main places where you should be concerned about exposure to secondhand smoke include at work, in public places, at home and in the car. These are the four places where people are most likely to be exposed to secondhand smoke, and it’s important to avoid exposure to secondhand smoke whenever possible.
  • What is smokeless tobacco?
  • Smokeless tobacco is tobacco that is not burned, and includes snuff, chewing and dipping tobacco. Smokeless tobacco contains cancer-causing agents, and users have an increased risk of developing oral cancer, esophageal cancer and pancreatic cancer. Smokeless tobacco is no safer than cigarettes and use of these products is strongly discouraged. For more information or help quitting, see our resource page.
  • Is smokeless tobacco addictive?
  • Yes. Smokeless tobacco contains nicotine, which is addictive. Cigarettes and smokeless tobacco contain similar levels of nicotine, and are both known to cause cancer. For more information or help quitting, see our resource page.
  • How can pets promote better health?
  • Pet ownership has been shown to reduce stress levels and promote physical activity among owners, which helps improve heart health. However, more research is needed to better understand whether owning a pet, especially a dog, directly reduces risk for heart disease.

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