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Risk Factors for Heart Disease

Heart disease includes coronary artery disease, which involves damage to the heart arteries. It also includes congestive heart failure and other heart issues. The coronary arteries provide the oxygen your heart needs to pump blood to the rest of your body.

A risk factor is something that increases your chance of having a disease. Risk factors such as smoking or high cholesterol levels can damage arteries. You can’t control some heart risk factors. These include your age or having a family history of heart disease. But there are many heart risk factors you can control. This can reduce your risk for heart disease.

Unhealthy cholesterol levels

Cholesterol is a fatlike substance in your blood. It can build up along the artery walls. This is called plaque. Over time, plaque narrows the arteries. This reduces blood flow to your heart or brain. If a blood clot forms or a piece of plaque breaks off, it can block the artery. This can cause a heart attack or stroke. Your risk for heart disease goes up if you have high levels of LDL ("bad") cholesterol. Or if you have high levels of triglycerides. This is another fatty substance that can build up. You’re also at risk if you have low HDL ("good") cholesterol. HDL helps clear the bad cholesterol away. You're at risk if you have any of these: 

  • HDL cholesterol of 40 mg/dL or lower

  • LDL cholesterol of 100 mg/dL or higher

  • Triglycerides of 150 mg/dL or higher

Unhealthy diet

Diets high in saturated fats, trans fats, and cholesterol have been linked to heart disease and coronary artery disease. By cutting back on saturated fat and trans fat, you can lower your LDL ("bad") cholesterol and triglyceride levels. LDL is one of the main substances that causes heart attacks. Stay away from most trans fatty acids by eating less of these foods:

  • Margarine

  • Cookies

  • Crackers

  • French fries

  • Doughnuts

  • Other snack foods that have partially hydrogenated oils

Replace less healthy foods by eating a diet with a lot of:

  • Fruits

  • Legumes

  • Vegetables

  • Whole grains

  • Nuts

  • Lean fish or lean animal protein

Drinking too much alcohol also raises the risk for heart disease. It can raise blood pressure levels. And it raises triglyceride levels.


This is the most important risk factor you can change. You’re at risk if you use any kind of tobacco or nicotine. This includes:

  • Cigarettes

  • E-cigarettes

  • Chew tobacco

  • Cigars

  • Pipe

If you smoke, it's never too late to help your heart. Ask your healthcare provider about nicotine replacement products and smoking-cessation support. Quitting smoking is the single biggest way to reduce your risk for coronary artery disease.

High blood pressure

High blood pressure occurs when blood pushes too hard against artery walls. This damages the artery walls. Scar tissue forms as it heals. This makes the arteries stiff and weak. Plaque sticks to the scarred tissue. This narrows and hardens the arteries. High blood pressure also makes your heart work harder to get blood out to the body. It raises your risk for heart attack and especially stroke. The brain tissue is very sensitive to high blood pressure damage. You're at risk if your blood pressure is 120/80 or higher. Experts now label blood pressure between 130 to 139/80 to 89 as stage 1 hypertension.

Chronic kidney disease

Chronic kidney disease is another cardiac risk factor. Talk with your healthcare provider about ways to control kidney disease if you have it.

Negative emotions

Chronic stress, pent-up anger, and other negative emotions have been linked to heart disease. This is because stress increases the levels of a hormone that raises the demand on your heart. Over time, these emotions could raise your heart disease risk.

Metabolic syndrome

This is caused by a mix of certain risk factors. It puts you at extra high risk for heart disease, stroke, and diabetes. You have metabolic syndrome if you have 3 or more of these:

  • Low HDL cholesterol

  • High triglycerides

  • High blood pressure

  • High blood sugar

  • Extra weight around the waist


Diabetes occurs when you have high levels of sugar (glucose) in your blood. This can damage arteries if not kept under control. Having diabetes also makes you more likely to have a silent heart attack—one without any symptoms.

The A1C test is a common blood test that diagnoses type 1 and type 2 diabetes. It can also check how well you are managing diabetes. If your A1C level is between 5.7 and 6.4, you have prediabetes. Once your A1C reaches 6.5, you have diabetes. Your healthcare provider will help you figure out what your A1C should be. Your target number will depend on your age, general health, and other factors. Your treatment plan may need changes if your current number is too high.

Extra weight

Extra weight makes other risk factors, such as diabetes, more likely. Extra weight around the waist or stomach increases your heart disease risk the most.

You're at risk if your:

  • Waist measures more than 35 inches (women) or 40 inches (men)

  • Body mass index (BMI) is higher than 25

Lack of physical activity

Experts recommend at least 150 minutes of moderate-intensity physical activity per week for substantial health benefits. You're at risk if you exercise less than 30 minutes per day, on fewer than 5 days a week.

When you’re not active, you’re more likely to develop diabetes, high blood pressure, high cholesterol levels, and extra weight.

Most people with heart disease have more than one risk factor. As your number of risk factors increases, so does your risk for heart disease and coronary artery disease. Talk with your healthcare provider about your heart risk factors. Find out how you can improve them or remove them completely.

Online Medical Reviewer: Ronald Karlin MD
Online Medical Reviewer: Stacey Wojcik MBA BSN RN
Online Medical Reviewer: Steven Kang MD
Date Last Reviewed: 4/1/2022
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