Risk Factors for Heart Disease

Medically Reviewed by James Beckerman, MD, FACC on June 30, 2023
5 min read

It can be quite a challenge to deal with coronary artery disease or CAD. It happens when plaque builds up in the walls of arteries that supply the heart. These can narrow and cause chest pain (angina) and later a full-blown heart attack. But some people feel nothing at all until late into the disease.

CAD, also called heart disease, or coronary heart disease, causes roughly 805,000 heart attacks and leads to 696,000 deaths each year in the U.S.  

Because heart disease is so common and often is silent until it strikes, it is important to recognize the factors that put you at risk.

There are risk factors for heart disease that you have control over and others that you don’t.  Uncontrollable risk factors for heart disease include:

  • Being male
  • Older age
  • Family history of heart disease
  • Being postmenopausal
  • Race (African American, Native American, and Mexican American people are more likely to have heart disease)

Heart disease risk factors that you can control revolve around lifestyle. These include:

  • Smoking
  • Unhealthy cholesterol numbers (see below)
  • Uncontrolled high blood pressure
  • Physical inactivity
  • Obesity (having a BMI greater than 25)
  • Uncontrolled diabetes
  • Uncontrolled stress, depression, and anger
  • Poor diet
  • Alcohol use

Research shows heart disease may be preventable more than half the time with simple changes in lifestyle.  Besides lowering your risk for heart attack and stroke, these changes often can improve your overall physical and mental health. Here are some ways you can change lifestyle factors to reduce your risk of heart disease:

Quit smoking. Smoking is the most preventable risk factor. Smokers have more than twice the risk of heart attack as nonsmokers and are much more likely to die from them. If you smoke, quit. Better yet, don’t start smoking in the first place. Even if you don’t smoke, constant exposure to other people’s cigarette smoke (secondhand smoke) raises your risk of heart disease. 

Improve cholesterol levels. Your risk for heart disease increases with unhealthy cholesterol numbers. The right levels can vary somewhat depending on your age, sex, overall health, and family health history. Ask your doctor about the right levels for you. In general, though, your levels should be as follows:

  • Total cholesterol: less than 200 mg/dL
  • “Good,” or HDL, cholesterol: 60 mg/dL or greater
  • “Bad,” or LDL, cholesterol: less than 100 mg/dL
  • Triglycerides: less than 150 mg/dL

A diet low in cholesterol, saturated and trans fats, and simple sugars, and high in complex carbohydrates can help lower cholesterol levels in some people. Regular exercise will also help lower "bad" cholesterol and raise "good" cholesterol in some cases.

If that’s not enough, your doctor may suggest a cholesterol medication, like a statin, to help lower levels. 

Control high blood pressure. About 67 million people in the U.S. have high blood pressure, making it the most common risk factor for heart disease. Nearly 1 in 3 adults have systolic blood pressure (the upper number) over 130, and/or diastolic blood pressure (the lower number) over 80, which is the definition of high blood pressure. Your doctor will assess your blood pressure numbers in light of your overall health, lifestyle, and other risk factors. You and your doctor can come up with a plan to help control blood pressure through diet, exercise, weight management, and, if needed, medication.

Control diabetes. If not properly controlled, diabetes can lead to heart disease and heart damage, including heart attacks. Control diabetes through a healthy diet, exercise, maintaining a healthy weight, and medication as prescribed by your doctor.

Get active. People who don't exercise have higher rates of heart disease compared to people who perform even moderate amounts of physical activity. A bit of light gardening or walking can lower your risk of heart disease.

Most people should exercise 30 minutes a day, at moderate intensity, on most days. More vigorous exercise could help even more, but talk to your doctor first.  Try to use large muscle groups and get your heart rate up. Aerobic activities that raise your heart rate include brisk walking, cycling, swimming, jumping rope, and jogging. You can also lift weights to increase strength and muscle endurance.

If motivation is a problem, make an exercise menu. Pick a couple of activities that sound like fun. That way, you always have some choices. Consult your doctor before starting any exercise program, especially if you have underlying health conditions or haven’t exercised in a while.

Eat right. Eat a heart-healthy diet low in sodium, saturated fat, trans fat, cholesterol, and refined sugars. Try to increase your intake of foods rich in vitamins and other nutrients, especially antioxidants, which may lower your risk for heart disease. Also eat plant-based foods such as fruits and vegetables, nuts, and whole grains.

Rethink your drink. Limit alcohol. Moderate drinking may be OK, but more than that isn't good for your heart health. What's moderate drinking? Up to one glass a day for women, and up to two glasses a day for men.

Maintain a healthy weight. Obesity by itself could raise your risk for heart disease. In addition, excess weight puts strain on your heart and often raises your risk of other heart disease risk factors like diabetes, high blood pressure, and high cholesterol. A balanced diet and regular exercise can help you keep a healthy weight. Talk to your doctor if you need a safe plan for weight loss or if you want to figure out the right body weight for your heart health.

Manage stress. Poorly controlled stress and anger can worsen heart disease. Some approaches include:

  • Relaxation methods like meditation, tai chi, yoga, guided imagery, deep breathing, and other approaches.
  • Talk therapy with a therapist or in a group setting for anger management, anxiety, or other issues.
  • Time management. If you schedule your time carefully, you’ll be less stressed about getting things done.
  • Realistic goal setting. Think carefully about what you can realistically get done. If you promise too much to yourself or others, you may create stress when you’re unable to deliver. 

Talk to your doctor. Discuss your lifestyle as well as your family's medical history with your doctor. Together you’ll be able to come up with a plan best suited to your needs.