Heart attacks are common, with more than 800,000 cases in the U.S. each year. Most are caused by coronary artery disease, where the arteries that supply blood to the heart become blocked for one reason or another — lifestyle, family history and medical conditions can all influence this.
"To get a sense of your own heart attack risk profile, you need to learn about all the factors that affect heart health in the first place," says Dr. Ali Rizvi, a cardiologist at Houston Methodist. "When you know your personal risks, you can work with your doctor to make informed decisions to keep you heart healthy in the long term."
How can you determine your personal risk of a heart attack? And what steps can you take to lower it? Dr. Rizvi answers these questions and more.
The most important heart attack risk factors
Your heart attack risk profile includes personal characteristics like your age, gender and family history. Your lifestyle and medical conditions can also play a role.
Some of the key risk factors include:
- High blood pressure (hypertension): When the pressure in your arteries is too high, it can impact your heart health, usually with no symptoms. Lifestyle changes and medications can help lower your blood pressure.
- High cholesterol: When the cholesterol levels in your blood are too high, plaque can build up in your arteries and decrease blood flow. Medications and lifestyle changes can help manage your risk.
- Smoking: Tobacco use can damage the blood vessels and heart, raising your blood pressure and reducing the amount of oxygen in your blood. Quitting smoking is a great choice for your health.
Risk factors we can't change
Some heart attack risk factors can be acted upon, others can't. This doesn't mean you should ignore or be unaware of the factors you can't change, which include:
Family history
If others in your family have had heart disease, you're more likely to develop it as well.
"Not all family heart history happens in our genes," Dr. Rizvi says. "Whether you live in an urban or rural area, your cultural food preferences and your family's eating habits can also factor into your heart attack risk."
(Related: Why Knowing Your Family Health History Matters)
Age
The natural effects of aging increase our risk of heart attack as we get older:
- The walls of the arteries and heart chambers may thicken.
- The valves that help move blood through the heart can stiffen or leak.
- Abnormal heart rhythms are more likely to develop.
"We also need to consider hormonal issues," Dr. Rizvi says. "Both male testosterone and female estrogen help protect the heart, and the production of both of these hormones declines as we age."
Gender
"It's true that men have a higher risk of heart attack than women," says Dr. Rizvi, "and that men and women can have much different experiences with heart attack and heart disease."
For example:
- Heart attack symptoms can be significantly different in women than in men. Women might feel pain in their arm or jaw, for example — not just their chest.
- Men are more likely to have their first heart attack at a younger age than women — as much as 10 years earlier.
- After a first heart attack, women are 20% more likely to develop heart failure.
Ethnic and racial heritage
"African American adults are more likely to have severe high blood pressure than other populations," Dr. Rizvi says. "Americans of South Asian descent have a higher risk of developing heart disease than the average American."
Research suggests that Hispanic men may have lower rates of cardiac-related death but a higher risk of stroke and heart failure. However, specific heart-health factors vary based on geographic origins.
Other heart-related health conditions that increase heart attack risk
In addition to high blood pressure and high cholesterol, other medical conditions can also affect your heart attack risk profile, such as:
- Obesity: Excess body fat adds extra strain on the heart, especially if it's visceral fat — which is commonly carried in the belly. This can lead to fatty material building up inside your arteries. Being overweight also makes it more difficult to control blood pressure, blood sugar and cholesterol.
- Diabetes: High blood sugar can damage blood vessels, and people with Type 2 diabetes are almost twice as likely to develop heart disease. Many people with diabetes also have high blood pressure.
- Sleep apnea: Breathing problems during sleep can put stress on your heart and blood vessels. Lower oxygen levels in the blood can also damage blood vessels in the heart.
- Metabolic syndrome: This group of conditions, including high blood sugar, blood pressure and cholesterol, as well as excess fat around the waistline, can cause chronic inflammation and blood vessel damage.
- Menopause: Menopause presents with symptoms such as hot flashes and night sweats and is linked to a higher risk of high blood pressure, high blood cholesterol and weight gain.
The importance of a heart-healthy lifestyle
"Decades of research prove diet and exercise play a major role in reducing the risk of heart attack," says Dr. Rizvi. "Many people find it easier to focus on smaller daily choices and build on that success over time."
You can reduce your risk by controlling these modifiable risk factors:
- Eat healthy: Choose fresh foods and avoid items high in saturated fats. To help lower your blood pressure, reduce your sodium intake.
- Get more physical activity: Exercise can lower your heart attack risk. Plus, getting active can help you manage related conditions such as obesity, high blood pressure, high cholesterol and diabetes. (Related: Am I Exercising Enough?)
- Cut back on drinking: Alcohol can raise your blood pressure. Experts recommend no more than one drink per day for women and no more than two for men.
- Quit smoking: Tobacco use raises the risk of heart attack in many ways. Quit smoking, and your heart will thank you.
(Listen: How to Make a Heart Healthy Diet Taste Better)
Heart disease screening and prevention
To explore your personal heart attack risk, talk with a doctor about getting a heart and vascular screening. In addition to listening to your detailed health history and giving you a physical exam, a cardiologist can use cardiac imaging, including CT scans and ultrasounds, to look for potential problem areas.
"We might spot thickened arteries or calcium buildup of plaque on the artery walls," Dr. Rizvi says. "We also check for blockages and other potential signs of cardiovascular disease."
(Related: Calcium Score: What Is a CAC Test & Do I Need One?)
