Several health conditions, your lifestyle, and your age and family history can increase your risk for heart disease. These are called risk factors. About half of all Americans (47%) have at least one of three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.
Some risk factors for heart disease cannot be controlled, such as your age or family history. But you can take steps to lower your risk by changing the factors you can control.
What health conditions increase the risk of heart disease?
High blood pressure: High blood pressure is a major risk factor for heart disease. It is a medical condition that happens when the pressure of the blood in your arteries and other blood vessels is too high. The high pressure, if not controlled, can affect your heart and other major organs of your body, including your kidneys and brain.
High blood pressure is often called a "silent killer" because it usually has no symptoms. The only way to know whether you have high blood pressure is to measure your blood pressure. You can lower your blood pressure with lifestyle changes or with medicine to reduce your risk for heart disease and heart attack.
Unhealthy blood cholesterol levels: Cholesterol is a waxy, fat-like substance made by the liver or found in certain foods. Your liver makes enough for your body's needs, but we often get more cholesterol from the foods we eat.
If we take it more cholesterol than the body can use, the extra cholesterol can build up in the walls of the arteries, including those of the heart. This leads to narrowing of the arteries and can decrease the blood flow to the heart, brain, kidneys, and other parts of the body.
There are two main types of blood cholesterol: LDL (low-density lipoprotein) cholesterol, which is considered to be "bad" cholesterol because it can cause plaque buildup in your arteries, and HDL (high-density lipoprotein) cholesterol, which is considered to be "good" cholesterol because higher levels provide some protection against heart disease.
High blood cholesterol usually has no signs or symptoms. The only way to know whether you have high cholesterol is to get your cholesterol checked. Your health care team can do a simple blood test, called a "lipid profile," to measure your cholesterol levels.
Diabetes mellitus: Your body needs glucose (sugar) for energy. Insulin is a hormone made in the pancreas that helps move glucose from the food you eat to your body's cells for energy. If you have diabetes, your body doesn't make enough insulin, can't use its own insulin as well as it should, or both.
Diabetes causes sugar to build up in the blood. The risk of death from heart disease for adults with diabetes is higher than for adults who do not have diabetes. Talk with your doctor about ways to prevent or manage diabetes and control other risk factors.
Obesity: Obesity is excess body fat. Obesity is linked to higher "bad" cholesterol and triglyceride levels and lower "good" cholesterol levels. Obesity can lead to high blood pressure and diabetes, as well as heart disease. Talk with your health care team about a plan to reduce your weight to a healthy level.
What behaviors increase the risk of heart disease?
Your lifestyle can increase your risk for heart disease.
- Eating a diet high in saturated fats, trans fat, and cholesterol has been linked to heart disease and related conditions, such as atherosclerosis. Also, too much salt (sodium) in the diet can raise blood pressure.
- Not getting enough physical activity can lead to heart disease. It can also increase the chances of having other medical conditions that are risk factors, including obesity, high blood pressure, high cholesterol, and diabetes. Regular physical activity can lower your risk for heart disease.
- Drinking too much alcohol can raise blood pressure levels and the risk for heart disease. It also increases levels of triglycerides, a fatty substance in the blood which can increase the risk for heart disease.
- Women should have no more than one drink a day.
- Women should have no more than two drinks a day.
- Tobacco use increases the risk for heart disease and heart attack:
- Cigarette smoking can damage the heart and blood vessels, which increases your risk for heart conditions such as atherosclerosis and heart attack.
- Nicotine raises blood pressure.
- Carbon monoxide from cigarette smoke reduces the amount of oxygen that your blood can carry.
- Exposure to secondhand smoke can also increase the risk for heart disease, even for nonsmokers.
How do genetics and family history affect the risk of heart disease?
When members of a family pass traits from one generation to another through genes, that process is called heredity.
Genetics factors likely play some role in high blood pressure, heart disease, and other related conditions. However, it is also likely that people with a family history of heart disease share common environments and other factors that may increase their risk.
The risk for heart disease can increase even more when heredity combines with unhealthy lifestyle choices, such as smoke cigarettes and eating an unhealthy diet.
Do age and sex affect the risk of heart disease?
Heart disease is the number one killer of both men and women. Heart disease can happen at any age, but the risk goes up as you age.
Do race and ethnicity affect the risk of heart disease?
Heart disease and stroke can affect anyone, but some groups are more likely to have conditions that increase their risk for cardiovascular disease.
Heart disease is the leading cause of death for people of most racial and ethnic groups in the United States, including African Americans, Native Americans and Alaska Natives, and white people. For Asian Americans and Pacific Islanders and Hispanics, heart disease is second only to cancer.
- Fryar CD, Chen T-C, 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; 2012. Accessed May 9, 2019.
- National Diabetes Statistics Report, 2017. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Preventions, 2017. Accessed May 9, 2019.
- National Center for Health Statistics. Health, United States, 2017. Table 19: Leading Causes of Death and Numbers of Deaths, by Sex, Race, and Hispanic Origin: United States, 1980 and 2016. Hyattsville, MD: National Center for Health Statistics; 2018. Accessed May 9, 2019.
Content last updated December 9, 2019