Risk Factors

This information is included by kind permission of the Salisbury (UK) and District Heart Support Group

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Certain characteristic and lifestyles point to an increased likelihood of Coronary Heart Disease. It is important to you that you are aware which risk factors are relevant to you.

Risk factors that we cannot do anything about are below:

  1. Family history of heart disease.
  2. Age
  3. Gender
  4. Cultural background

Factors we can do something about to reduce the risk of developing or worsening heart disease are as follows:


  1. Smoking
  2. Overweight
  3. Unhealthy diet
  4. Excessive alcohol
  5. No exercise


  1. High cholesterol
  2. High blood pressure
  3. Diabetes



Continuing to smoke when you know that you already have heart disease will double your risk of having another heart attack. It will increase the likelihood of you having Angina. Smokers under the age of 50 have an increased death rate by heart attack, 10 times greater than non-smokers of the same age. To stop smoking is the single most thing that you can do for yourself that will prevent further damage and increase your survival rate.

Smoking causes carbon monoxide to be present in the blood which competes with oxygen to be carried by red blood cells - the carbon monoxide usually wins! This means there is less oxygen available to the cells and the heart will especially notice this. This can cause the pain and discomfort of angina.

In addition the addictive agent nicotine acts as a stimulant to the heart. It stimulates the production of adrenaline, which raises the heart rate and blood pressure. High heart rates and blood pressure put more demands on the heart and in turn increase its demand for oxygen.

Other toxins produced by tobacco smoke cause damage to the inner surface of blood vessels making them more susceptible to deposits of cholesterol and more prone to starting the formation of tiny blood clots.

The platelets, which are cells in the blood, responsible for clotting, are rougher and more likely to stick together, forming a blood clot in the vessel. This can happen in arteries feeding the heart, leading to a heart attack or, those feeding the brain causing a stroke or, anywhere in the body causing various degrees of damage.

Blood Pressure

Blood pressure is the measure of effort the heart has to exert in order to keep pumping the blood round the body. You may have been told your blood pressure is 130 over 75 (written as 130/75). The first figure (130) is the pressure in your arteries when the heart is pumping; it is referred to as systolic by clinicians. This is the measured pressure of the blood on the artery walls when the left ventricle contracts and forces the blood out into the Aorta. The second figure (75) is the pressure in the arteries when the heart is relaxed, medically referred to as diastolic.

Normal blood pressure is subjective but usually taken to be below 140/85 millimetres of mercury (mmHg).

High blood pressure (HYPERTENSION) is when either figure is consistently raised i.e. greater than 140 systolic or 85 diastolic. High blood pressure does not usually make you feel unwell until serious damage has been done to the body. High blood pressure usually creeps up on us very slowly over a period of time, so we are unaware of it. However, it does make the heart work harder and it can cause structural damage to the blood vessel walls and sometimes to the heart itself.

If you have heart disease it is important to keep your blood pressure about 140/85. If you also have diabetes then the target is lower at 130/85. Research has shown that people with a lower than average blood pressure are less likely to suffer from heart disease, than those with an average blood pressure.

Low blood pressure is when either figure is constantly low i.e. less than 100 systolic and 50 diastolic. Low blood pressure may make you feel unwell, for example being light-headed when you stand up suddenly.

Usually no single cause can be found for high blood pressure but things that contribute to high blood pressure include:

Raised Blood Cholesterol

In general, narrowing of the coronary arteries (called atherosclerosis) causes heart disease. The arteries narrow because of deposits of fat (atheroma) being laid down in the artery walls.

The body produces several types of cholesterol. The important ones are low-density lipoprotein cholesterol (LDL Cholesterol) and high-density lipoprotein cholesterol (HDL Cholesterol). Atheromas develop from LDL cholesterol, which is why we call it the 'bad cholesterol'. However, HDL cholesterol helps to remove excess cholesterol from the blood and take it back to the liver to be recycled or excreted. HDL's we refer to as 'the good cholesterol'. The aim should be to have a low level of LDL's and a high level of HDL's.

The level and ratio of LDL's and HDL's can be dependant on the amount of saturated fat we eat. For a healthier diet it is recommended that very little saturated fat be eaten.

We also produce cholesterol in the liver. This is usually produced at night. The Statin tablets stop the liver from producing LDL cholesterol and this is why we take the Statin at night. By taking a Statin and improving our diet we can reduce the LDL cholesterol by 30 to 40%.


Having diabetes increases the importance of modifying or controlling any other risk factors. It causes structural changes to blood vessels and cells, speeding up the process of narrowing the arteries. It can also lower the level of 'the good cholesterols' making the individual more susceptible to the development of atheroma.

Blood glucose measurements and good control are very important in the person with diabetes, more so if they have heart disease.

Poor Diet

We know that some aspects of our diet promote the development of atheroma i.e. diets high in saturated fats. We also know that there are some foods, which help to protect the heart.

A healthy diet is one, which is:

Being Overweight

Being overweight puts more demands on your heart. It is linked with the development of high blood pressure, diabetes and raised LDL cholesterol.

Lack of Regular Exercise

The heart is a muscle and like any other muscle in the body it needs to be worked to stay healthy.

We know that physical activity improves general health and it reduces several of the risk factors for Coronary Heart Disease (CHD) by:

Cardiac Care Team - Author: Maggie Jones