Major Risk Factors for Coronary Heart Disease, Heart Attack, and Stroke
Coronary heart disease (also called coronary artery disease or CAD) involves plaque buildup in the arteries supplying the heart, which can lead to a heart attack (myocardial infarction). A stroke occurs when blood flow to the brain is blocked (ischemic) or interrupted by bleeding (hemorrhagic). These conditions share many risk factors due to common underlying processes like atherosclerosis, but some are more prominent for one than the others.
Risk factors fall into two categories: non-modifiable (cannot be changed) and modifiable (can be managed through lifestyle, medication, or treatment). Most major risks are modifiable, and addressing them can significantly lower the chances of these events.
Shared Major Risk Factors (Apply to All Three)
These are the most important and well-established factors, supported by organizations like the WHO, CDC, and American Heart Association:
* High blood pressure (hypertension) — The top modifiable risk factor; damages arteries and promotes plaque buildup.
* High blood cholesterol (especially high LDL/"bad" cholesterol) — Contributes to artery narrowing.
* Smoking/tobacco use — Damages blood vessels, raises blood pressure, and promotes clotting; even secondhand smoke increases risk.
* Diabetes — High blood sugar damages vessels; people with diabetes have 2–4 times higher risk.
* Obesity/overweight — Often linked to other risks like hypertension and diabetes.
* Physical inactivity — Increases weight, blood pressure, and cholesterol levels.
* Unhealthy diet (high in salt, saturated fats, sugars; low in fruits/vegetables) → Leads to obesity, hypertension, and high cholesterol.
* Harmful alcohol use — Can raise blood pressure and contribute to obesity. (I'm surprised that it is couched as "harmful." Many studies show that ANY alcohol use is harmful.)
These behavioral factors (diet, inactivity, smoking, alcohol) manifest as intermediate risks like elevated blood pressure, glucose, and lipids.
Non-Modifiable Risk Factors (Shared)
* Age → Risk rises significantly after age 45 for men and 55 for women (post-menopause).
* Family history → Early heart disease or stroke in close relatives increases risk.
* Sex → Men generally at higher risk earlier; women's risk rises after menopause.
* Ethnicity/race → Higher rates in certain groups (e.g., non-Hispanic Black, South Asian, Indigenous populations), often due to higher prevalence of modifiable risks.
Additional or More Specific Risks
* Atrial fibrillation (irregular heartbeat) — Strongly linked to stroke (increases risk 5-fold) due to clot formation; also raises heart attack risk.
* Previous heart disease or stroke/TIA — Greatly increases risk of recurrence.
* Stress, poverty, or air pollution — Emerging contributors, per WHO.
Less common:
* Certain conditions like sickle cell disease (for stroke) or drug use (e.g., cocaine for heart attack).
Controlling modifiable risks through quitting smoking, healthy eating, exercise, and medical management can prevent most cases.