Modifiable & Non-Modifiable Risk Factors for Heart Disease

About 50% of all Americans are at risk to develop heart disease. While some of those are non-modifiable risk factors, or out of your control, the majority of them are modifiable risk factors, or in your control. 

The even better news is that you can lower your risk of developing heart disease through lifestyle changes. Once you address the modifiable risk factors of heart disease, the effects of non-modifiable risk factors are minimal. ¹

I’ll talk more about the modifiable and non-modifiable risk factors for heart disease later and tell you how you can lower your risk of developing heart disease. However, did you know that heart disease and cardiovascular disease are very different? 

Heart Disease vs. Cardiovascular Disease

Heart disease and cardiovascular disease are terms often used synonymously together, however they couldn’t be more distinct. All heart diseases are cardiovascular disease, yet not all cardiovascular diseases are heart disease. Let me explain. 

Heart disease is a catch-all phrase conventional medicine uses for a variety of conditions that affect the heart’s structure and function, such as a heart attack or heart failure. Whereas cardiovascular disease is a bigger umbrella used for all types of diseases that affect the cardiovascular system –the heart, arteries, veins and blood vessels – such as atherosclerotic cardiovascular disease (ASCVD) or peripheral artery disease. 

The most common type of heart disease is coronary heart disease, a type of heart disease that develops when the arteries of the heart cannot deliver enough oxygen-rich blood to the heart . In fact, when someone talks about heart disease, they often are talking about coronary heart disease.² Heart disease kills more than 300,000 people each year. It doesn’t have to be this way. 

Being able to identify your modifiable risk factors can help you lower your risk of developing heart disease. Let’s discuss the risk factors and the difference between modifiable risk factors and non-modifiable risk factors of heart disease. 

Risk Factors for Heart Disease

Heart disease is caused by a combination of non-modifiable and modifiable factors. The non-modifiable and modifiable risk factors of heart disease are similar in men and women, however the signs of heart disease are not as recognizable in women as they are in men. 

Before I talk about the modifiable risk factors, or ones you can control, let’s discuss the ones that are out of your control, or non-modifiable risk factors. 

Non-Modifiable Risk Factors For Heart Disease

Non-modifiable risk factors are those that are out of your control, such as age, genetics, gender and race.³ While you cannot change your non-modifiable factors, you can control their effect on your overall risk. I will tell you how later, however here’s how these non-modifiable risk factors affect your risk of developing heart disease.  

Age

As you get older, your risk for heart disease increases. That’s the painful fact of aging. Adults 65 or older are more likely to develop heart disease than younger people.⁴ As a matter of fact, heart disease and cardiovascular disease becomes more of a threat after the age of 55 for men and 65 for women. However, heart disease can affect anyone regardless of age. 

As you get older, the changes inside your body aren’t as noticeable as the wrinkles and grey hair. The decrease in bone density and the narrowing arteries are just a part of the aging process. What’s more, your heart functions less effectively as you age. 

Sex

Heart disease is commonly known as a “man’s disease.” However, heart disease is the leading cause of death for women in the United States, killing 1 in 5 women every year. Men are at a higher risk of developing heart disease than women before the age of 50. However, as women reach menopause due to the drop of estrogen levels, the risk for heart disease is equal between men and women. 

Genetics

Genetic factors play a role in high blood pressure, heart disease, cardiovascular disease, and high cholesterol. However, it is also likely that people with a family history of heart disease share common environments which also increases their risk of developing heart disease. Your risk of developing heart disease increases if: 

• Your father or brother had heart disease or had a cardiac event such as a heart attack or stroke under the age of 55. 
• Your mother or sister was diagnosed with heart disease or had a cardiac event under 65. 

The risk for heart disease can increase even more when heredity combines with unhealthy lifestyle choices, such as smoking cigarettes and eating an unhealthy diet.

Race

Family history and race are closely related non-modifiable risk factors of heart disease because people of the same race share the same genes.⁵ Unfortunately, the death rate for Black people is 33% higher than the overall population. This is due to the higher number of uninsured Blacks, which make up more than half of the uninsured population.⁶

What’s more, Black adults and Hispanic women have a higher rate of obesity and diabetes than white women. Studies suggest this is due to genetics. According to the CDC, 49.6% of Black adults had a prevalence of obesity, followed by Hispanic adults (44.8%), white adults (42.2%), and Asian adults (17.4%).⁷ 

As I mentioned earlier, while non-modifiable risk factors for heart disease are out of your control, you can limit their effect by lifestyle changes. The first step is to address the modifiable risk factors for heart disease. 

Modifiable Risk Factors for Heart Disease

The more risk factors you have, the greater your chances are of developing heart disease. While you cannot change your age, race, sex or family history, there are several modifiable risk factors of heart disease that are in your control. 

Smoking

Smoking greatly increases your risk for heart disease, including coronary artery disease (CAD), peripheral artery disease, heart attack, heart failure, and stroke.  

The tar in cigarettes increases the formation of plaque in blood vessels, making it harder for blood to carry nutrients and oxygen to organs. CAD occurs when arteries that carry blood to the heart muscle are narrowed by plaque or blocked by clots. Chemicals in cigarette smoke cause the blood to thicken and form clots inside veins and arteries, increasing your risk of heart disease or a heart attack.  

Smokers are not only two to four times as likely to develop heart disease but also more likely to die if they suffer a heart attack. Exposing nonsmokers is also considered a risk factor and secondhand smoke needs to be eliminated as much as possible. What’s more, nicotine in tobacco raises blood pressure and carbon monoxide reduces the amount of oxygen in your blood, increasing demand on the heart. 

The easiest way to modify this risk factor is to quit. By quitting smoking, you can cut your risk of stroke or heart attack in half in just a year.⁸ 

High Blood Pressure

According to the Centers for Disease Control, about 75 million American adults have high blood pressure. That’s about one-third of the population.⁹ 

High blood pressure, also called hypertension, occurs when the force of your blood pushing against the walls of your blood vessels is too high, like a hose that can’t handle the force of the water running through it. A normal blood pressure level is less than 120/80 mmHg. 

No matter your age, you can take steps each day to keep your blood pressure in a healthy range. Adding more green vegetables to your diet is one way to lower your blood pressure. Other ways to lower your blood pressure are to exercise, lose weight, reduce sodium in your diet, lower your stress, and cut back on alcohol and caffeine. 

High LDL Cholesterol

Out of all the modifiable risk factors related to heart disease, cholesterol is by far the most controversial and confusing. Cholesterol is a soft waxy substance that is manufactured in the body by the liver.  It also comes from dietary sources, specifically animal products such as meat and dairy.

Cholesterol is one of two types of lipids, along with triglycerides. The difference between triglycerides and cholesterol is that triglycerides are unused calories that provide your body with energy, while cholesterol is used to build cells and hormones. Cholesterol and triglycerides attach to lipoproteins. 

High density lipoproteins (HDL) are known as good cholesterol because they transport cholesterol from your blood to the liver. Low-density lipoproteins (LDL) are bad cholesterol because they take the excess cholesterol from the liver and deposit them on the artery walls, causing blockages.  

You can lower your cholesterol by changing your diet, losing weight, exercising, quit smoking, and lower your alcohol intake. 

Uncontrolled Diabetes

Uncontrolled diabetes contributes to a process called “glycation,” which is the result of insulin not properly metabolizing sugars. This excess sugar, which should be metabolized and used for energy, remains in your bloodstream and attaches to proteins and lipids (fats). These molecules then form harmful advanced glycation end products (literally AGE!) 

AGE molecules are destructive to the collagen in your body, including the arteries and blood vessels in your heart. They become brittle as a result, and plaque forms in your arteries and blood vessels. This vascular damage can lead to heart attacks and strokes. ¹⁰

The Glycated Hemoglobin or A1C test is the most common blood sugar test. It measures how many of your red blood cells are glycated, or coated with sugar. It provides your average blood glucose for 2 to 3 months without fasting or using a sweet substance. The normal range for glycated hemoglobin is  4.8 -5.4 mg/dl or less. You are considered prediabetic if your levels are  5.7 to 6.4 mg/dl, and diabetic if they are 6.5 mg/dl or higher. 

LetsGetChecked’s home diabetes testing is a great way to test hemoglobin A1c levels. They also offer at-home diabetes and heart test, which also tests triglycerides, cholesterol, HDL cholesterol, LDL, cholesterol, and HDL% of total cholesterol. You can also get a basic at-home lipid panel test. The results are available online so you can share them with your functional medicine doctor. 

If you are diabetic, controlling your blood glucose levels will lower your risk of heart disease. Changing your diet to eliminate carbohydrates, sugar and alcohol is a great place to start. Most diabeteic diets aim for no more than 45% of calories from carbohydrates. Exercise and relieving your stress will also help you get your uncontrolled diabetes back under control. 

Physical Activity

Your heart is a muscle. Just like other muscles in your body, the more you work out your heart, the stronger it becomes. If you live a sedentary lifestyle, your heart is going to deteriorate like your muscles and become weak. 

If you haven’t noticed, exercise is an important modifiable risk factor of heart disease that can affect other risk factors. It can boost your body’s HDL cholesterol, which will help lower your bad cholesterol levels. It helps regulate blood glucose levels. 

Aerobic activity uses your heart and lungs for a long period of time. It also helps your heart use oxygen better and improves blood flow. Doing 30 minutes of aerobic exercise such as walking, swimming, light jogging, or biking can significantly lower your risk of heart disease. 

Obesity and Diet

Obesity is a common problem in the U.S. Nearly 1 in 3 Americans are considered obese. Obesity is linked to an increased risk of heart disease and is closely related to diet. However, it can be a bit misleading. If you have a body mass index (BMI) of 25 or higher, you are considered obese. What BMI doesn’t take into consideration is fat composition, age, bone structure, and gender. However, it is still used as a measurement of obesity because it is not always wrong. 

Your diet is one of the top contributors to heart health. A diet high in processed foods, refined sugars, and unhealthy fat will do tremendous damage to your heart and lead to obesity and weight gain. 

Obesity and being overweight are linked to several modifiable risk factors of heart disease including high cholesterol, high blood pressure, and type 2 diabetes. 

That’s why it’s important to eat a nutrient-dense diet and eliminate toxic and inflammatory foods. Here are some nutrient dense foods I suggest to lower your risk of heart disease: 

• Wild-caught fatty fish such as salmon
• Green leafy vegetables
• Healthy fats such as avocado, olive oil, almonds, pecans, and walnuts
• Foods high in magnesium such as spinach and walnuts
• Berries
• Dark chocolate 

Your body doesn’t naturally produce fatty acids like omega 3, so it’s important to get these vital nutrients through food. Foods such as wild-caught salmon contain high levels of omega-3s, which support a healthy blood flow and viscosity and can support an optimal hormonal balance.

Now that you understand the difference between modifiable and non-modifiable risk factors of heart disease, I’m going to tell you how you CAN lower your risk. 

How to Lower Your Risk of Heart Disease

It’s never too late to take care of your heart and lower your modifiable risk factors of heart disease. By making lifestyle changes such as exercising more, changing your diet, losing weight, and relieving stress, you can lower your number of modifiable risk factors for heart disease. Remember, the less number of modifiable risk factors the less effect non-modifiable risk factors have on your risk of developing heart disease. 

Another way to lower your risk of heart disease is to support your heart health. CoQ10 and activated B vitamins support healthy cholesterol levels, circulation, and vascular health and neutralize oxidative damage from free radicals. CoQ10 is a heart-supporting enzyme and free radical fighter. This enzyme is naturally found in organ meats such as sardines and grass-fed beef liver, but the levels in these foods are relatively low.

Now that you have the tools necessary to take control of your heart health and lower your risk of heart disease, don’t wait. You cannot do anything to change your non-modifiable risk factors of heart disease, however, you can limit their effect by lowering the number of modifiable risk factors.