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FAQ (Health)

 Dr. George Jacob
Heart Infocenter


Heart Attack (Myocardial Infarction)

Who's At Risk for Heart Attack?

Heart attacks strike both men and women. However, some persons are more likely than others to have a heart attack. Some of the risk factors for heart attack are beyond your control, but most can be modified to help you lower your risk of having a first-or repeat-heart attack.

Factors that increase the risk of a heart attack

Factors you cannot control

Pre-existing coronary heart diseases, including:

A previous heart attack, 
A prior angioplasty or bypass surgery, or 


Men: The risk increases after age 45
Women: The risk increases after age 55.


Family history of early heart disease-a father or brother diagnosed before age 55; or a mother or sister diagnosed before age 65.

Factors you can control


Cigarette smoking greatly increases the risk of fatal and nonfatal heart attacks in both men and women. It also increases the risk of a second heart attack among survivors. Women who smoke and use oral contraceptives have an even greater risk than smoking alone. The good news is that quitting smoking greatly reduces the risk of heart attack. One year after quitting, the risk drop to about one-half that of current smokers and gradually returns to normal in persons without heart disease. Even among persons with heart disease, the risk also drops sharply one year after quitting smoking and it continues to decline over time but the risk does not return to normal.

High blood pressure. (hypertension)

High blood pressure makes the heart work harder. It increases the risk of developing heart disease, as well as kidney disease and stroke.

To help prevent or control high blood pressure, you should: lose excess weight; become physically active; follow a heart healthy eating plan, including foods lower in salt and sodium; limit alcohol intake; and, if you are prescribed a medication, take it as directed.

To learn more about hypertension, see hypertension.

High blood cholesterol.

The level of cholesterol in the bloodstream greatly affects the risk of developing heart disease. The higher the level of blood cholesterol, the greater the risk for heart disease or heart attack.

Why? When there is too much cholesterol (a fat-like substance) in the blood, it builds up in the walls of arteries. Over time, this buildup causes arteries to become narrowed, and blood flow to the heart is slowed or blocked. If the blood supply to a portion of the heart is completely cut off, a heart attack results.

Various factors affect cholesterol levels: diet, weight, physical activity, age and gender, and heredity.

High cholesterol is treated with lifestyle changes-a heart healthy eating plan, physical activity, and loss of excess weight-and, if those do not lower it enough, medication. Medications include statins, bile acid sequestrants, nicontinic acid, and fibric acids.

Overweight and obesity

Being overweight or obese increases your risk of heart attack. It also increases your risk of developing high blood cholesterol, high blood pressure, and diabetes-each of which also increases your chance of having a heart attack. So, if you are overweight, even a small weight loss-just 10 percent of your current weight-will help to lower your risk of developing those diseases.

Two of the measures that assess whether or not a person is overweight are:

Body mass index (BMI) - BMI is a measure of weight relative to height.

Waist circumference - Waist circumference measures abdominal fat. The risk for developing heart and other diseases increases with a waist measurement of more than 40 inches in men and more than 35 inches in women.

Avoid gaining weight. If you are obese, you need to lose weight. To lose weight and to keep it off, you will have to change your lifestyle. It combines a hearty-healthy, low-calorie, nutritious eating plan with regular physical activity.

Physical inactivity.

The risk of heart attack increases if you are physically inactive or you lead a sedentary lifestyle. Physical activity improves cholesterol levels, helps control high blood pressure and diabetes, and keeps weight under control. It also increases physical fitness, promotes psychological well-being and self-esteem, and reduces depression and anxiety. Thus exercise and physical activity provides multidimensional benefits.

Those who have already had a heart attack also benefit greatly from being physically active.

To protect your heart, you need to do 30 minutes of a moderate-intensity activity on most and, preferably, all days of the week. If 30 minutes is too much at one time, you can break it up into periods of at least 10 minutes each.

If you have been inactive, you should start slowly to increase your physical activity. Check with you health care provider before starting a physical activity program. This is especially important if you are over age 55, have been inactive, or have diabetes or another medical problem.


Diabetes mellitus damages blood vessels, including the coronary arteries of the heart. Up to 75 percent of those with diabetes develop heart and blood vessel diseases. Diabetes also can lead to stroke, kidney failure, and other problems.

Research shows that the same steps that reduce the risk of heart disease also lower the chance of developing type 2 diabetes. And, for those who already have diabetes, those steps, along with taking any prescribed medication, can also delay or prevent the development of complications of diabetes, such as eye disease and nerve damage.

According to the research, a seven percent loss of body weight and 150 minutes of moderate-intensity physical activity a week can reduce the chance of developing diabetes by 58 percent in those who are at high risk. The lifestyle changes cut the risk of developing type 2 diabetes regardless of age, ethnicity, gender, or weight.

More more information on diabtes, see Diabetes.

Effect of Multiple Risk Factors

Risk factors do not simply add their effects. Rather, they multiply each other's effects. So, having multiple risk factors for heart attack makes you very susceptible to having one. Conversely, reducing even a few risk factors that you can control can have a marked effect on your susceptibility to having a heart attack.

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