Chances are you or someone you know has heart disease. After all, it has been the #1 cause of death for Americans since 1921 (1). Yikes! For many of us, it’s important to know the risk factors for heart disease – and to take whatever steps we can to reduce our risk.

Before we jump in, let’s take a breath. First, if you are here because you think you may be having a heart attack, call 911 or your emergency services line right now. Trust me, they would rather see you 10 times and have it be a false alarm, then to have you not seek care the 1 time it’s happening. Call. Now.

Also, this article and its content are not a substitute for medical advice. It may not be appropriate for you, you certainly shouldn’t use it as a way to gauge your heart disease risk, and it is not comprehensive. If you follow the information on this website without consulting your personal medical provider, you do so at your own risk.

Risk Factors for Heart Disease That You Cannot Change

Let’s start with the shorter list. The risk factors for heart disease that cannot be changed.

• Age: Getting older increases risk. Over age 65, more women than men die from heart disease, at a rate of about one woman every minute (2).
• Sex: Men have greater risk than women and generally have heart attacks earlier. Women’s risk increases post-menopause.
• Family history: Risk increases for children whose parents have heart disease.
• Race and ethnicity: People who are Black, Asian, Mexican, Hawaiian, and/or Native American have higher risks.
• Social determinants of health: People with less access to health care or to healthy foods, for example, have higher risks.
• Medical conditions such as chronic kidney disease, rheumatoid arthritis, and preeclampsia increase risk(3).

Can’t be changed. Cool, cool. Okay, so… now what? Go see a medical provider to discuss heart health and follow their advice consistently. Then, shrug it off. No need to stress about things that can’t be changed.

Focus on the next list of risk factors for heart disease that can be controlled. Which, thankfully, is much longer.

Risk Factors for Heart Disease That You Can Change

Doing your best on these risk factors for heart disease can help to reduce risk.

• Manage blood sugar levels and/or diabetes.
• Improve cholesterol by increasing HDL and decreasing LDL and triglycerides.
• Bring blood pressure down or manage hypertension.
• Quit smoking/vaping and reduce exposure to secondhand smoke.
• Drink alcohol in moderation. Don’t drink alcohol excessively.
• Address excess body fat, especially around the stomach area.
• Get more active. Reduce sedentary and sitting time.
• Improve diet quality. Eat more of the food with fiber and unsaturated fats. Eat less of the foods that are high in saturated or trans fats, refined carbohydrates, added sugars, and sodium.
• Get the right amount of good quality sleep.
• Reduce stressors and practice strategies to reduce chronic stress.
• Manage mental health issues such as depression, and anxiety (3).
• Get more connected with social support and community (4).

DYK that food can help with many of these things. True story.

Check out my article that includes the Basics of Heart Healthy Eating and learn about working with me on nutrition to reduce heart disease risk.

How to Start Reducing Your Risk Factors for Heart Disease

You may be thinking… uhhhhhh, that’s so much, where do I start? Or… uhhhhh I can’t do all that, I think I’ll grab some donuts and hit the couch.

No food shaming for donuts here. They are delicious and even donuts can fit into a heart-healthy diet with planning.

Start small by picking one thing to work on first.

I encourage my patients to choose either the thing they think will be easiest to do, or the thing they think will have the biggest impact. Focusing on one thing will likely have an impact on the other things anyway. And with a lot less overwhelm.

A Word About Weight and Heart Disease

I am a weight neutral provider, and I see healthy people in many different body shapes and sizes. I dislike Diet Culture and do my best to pull people out of it. Here’s why and a bit of a rant. I also believe in body autonomy; therefore, I support my patients if they want to lose weight or don’t give a flip about weight.

So yes, excess body weight is on the list of risk factors that can be changed. Please know that I put it on the list begrudgingly. I recognize how difficult weight loss can be for so many reasons that have nothing to do with people’s motivation or efforts.

Lots of thin people have heart disease and lots of people with excess body weight are super heart healthy. So, what gives? Amirite? See Weight Does Not Equal Health and Are You Healthy? for personal stories about my weight and health.

Most research states that weight is a risk factor because it is associated with other risk factors, like diabetes and high blood pressure. But some research is also indicating that excess weight is associated with heart disease on its own (5). Where a person carries weight also comes into play with excess weight in the mid-section increasing risk (3).

And remember, associations don’t prove causation. These things are just linked together in some way.

For some fun correlations to illustrate this point, see Spurious Correlations and you can prove that “it’s Wednesday my dudes” searches are responsible for Boeing’s stock prices… or that eating margarine leads to happier marriages (or at least less divorce filings) (6)… In which case, post those memes and bring me the margarine! #justsayin

Behaviors Matter – Not Just Outcomes – For Reducing Risk Factors for Heart Disease

Here’s a fun twist you may not have heard… When people improve dietary choices, become more active, manage stress, get good sleep, and address mental health and isolation, heart disease risk may be reduced… wait for it… even if labs or weight don’t change.

What? Yes!

In other words, don’t get caught up in the outcomes. Be consistent with changing the daily habits – the things that can be controlled – and let the outcomes be whatever they will be.

The behaviors themselves make a difference.

Now, likely, some labs will change from implementing these habits and maybe the scale will too. I don’t know. But I don’t want anyone to get discouraged if they don’t change, or they change slowly. It is still having a positive impact on reducing heart disease risk.

And if labs and weight change, then great! Risk is reduced even more.

Medical Nutrition Therapy

Are you ready to work on reducing your risk factors for heart disease while enjoying delicious food? Let’s do it!

Working with people on reducing risk for heart disease and managing existing heart disease is one of my most favorite things to do! That includes working on any (or all!) of those risk factors that can be changed with food and nutrition. (Which is a lot, yo).

Click right here to get to Alexia’s provider page with Nourish, choose a date/time and start the scheduling process.

• One of the first screens when you start will let know if your health insurance is accepted by Nourish.
• Before you finish the booking process, you will enter your insurance information and get an estimate of the expected costs.

And, of course, you can reach out l if you have questions or want to be hooked up with another amazing RD at Nourish. I’m happy to help! 

About Alexia Lewis RD

Hi there! I’m Alexia and I believe in science, humor, and delicious food.

Heart health is my jam. I love to write and speak publicly on this topic and all aspects of living a heart-healthy lifestyle.

I believe you shouldn’t sacrifice your mental health in pursuit of better physical health. You deserve to be both happy and healthy. You don’t have to choose just one.

I am a master’s level nutritionist who is also a registered and licensed dietitian in multiple states in the USA, a certified personal trainer, and certified health coach. I also invested in becoming a culinary nutritionist and weight management specialist. In other words, I got you.

References

1. American Heart Association Newsroom: More Than Half of US Adults Don’t Know Heart Disease Is Leading Cause of Death Despite 100 Year Reign, posted 01/24/2024.
2. Go Red for Women: Common Myths About Heart Disease: https://www.goredforwomen.org/en/about-heart-disease-in-women/facts/common-myths-about-heart-disease, reviewed 02/16/2024
3. American Heart Association: Understand Your Risks to Prevent a Heart Attack: https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack. Reviewed 12/19/2024.
4. Methodist Debakey Cardiovasc J. 2021 Sep 24;17(4):15–27.  doi: 10.14797/mdcvj.846.
5. Johns Hopkins Medicine: Weight A Silent Heart Risk: https://www.hopkinsmedicine.org/health/wellness-and-prevention/weight-a-silent-heart-risk, no date.
6. Tyler Vigen: Spurious Correlations: https://www.tylervigen.com/spurious-correlations, no date.