Controllable vs. Uncontrollable Risk Factors: 6 Ways to Take Control of Your Heart Health

March 20, 2024

Person monitoring their heart rate on their watch

Protecting your heart from disease may not be the first words that come to mind when you think self-care, but it should definitely be a frontrunner when you consider all it has to offer, and how much of it is in your control.

Vrinda Trivedi, MD
Vrinda Trivedi, MD

“Maintaining good heart health allows you to feel well and show up for the people you love,” says MU Health Care cardiologist Vrinda Trivedi, MD.

To help you understand how to take better care of your heart and yourself, Dr. Trivedi explains the risk factors for coronary artery disease: what you can modify, what you can’t and how to navigate your heart health successfully.

Controllable vs. Uncontrollable Heart Disease Risk Factors

Like many health conditions, heart health has risk factors that you can't change, such as:

  • Age: The risk of heart disease increases in men around 55 and women at 60 (after menopause).
  • Sex: Heart disease is more common in men than women.
  • Genetics: Inherited traits may predispose you to high blood pressure and heart disease.

Having one (or more) uncontrollable, or nonmodifiable, risk factors can be daunting, but they don't single-handedly determine your heart health. Actually, Dr. Trivedi says, managing the risk factors you can control makes the biggest impact.

"People have almost all the control over their heart health," she notes. "Research shows that people who adopt healthy lifestyle behaviors in young adulthood have low cardiovascular risk in their middle and older ages."

The earlier you adopt those lifestyle behaviors, the better. But it's never too late. "There's always going to be some benefit to making changes, regardless of where you are in life," Dr. Trivedi says. "Even if you've had a heart attack or stroke, we're still going to tackle modifiable risk factors in the same way, and it's called secondary prevention."

How to Reduce Your Risk of Coronary Artery Disease

Almost half of all Americans live with at least one major risk factor for coronary artery disease. There are many ways to reduce your risk, but Dr. Trivedi shares her top six:

1. Don't Use Tobacco

Tobacco use is a major risk factor for heart disease. People who smoke cigarettes are four times more likely to have a heart attack or stroke as compared to people who don't, according to Dr. Trivedi.

When you inhale cigarette smoke, the chemicals can cause inflammation in your blood vessels. This inflammation can result in plaque buildup in the blood vessels supplying the heart muscle (coronary arteries), ultimately resulting in decreased blood flow and an increased risk of heart attacks. Any amount or type of tobacco increases your risk of developing and dying from heart disease.

2. Monitor Your Blood Pressure

The biggest challenge with heart disease risk factors is that some of them can be silent until they become a complication, Dr. Trivedi says. High blood pressure (hypertension) is one of those silent risk factors. Knowing your blood pressure and then normalizing it, if necessary, is a critical preventive measure.

"Lowering blood pressure to a healthy range can decrease your risk of developing a stroke by 40% and a heart attack by 25%," Dr. Trivedi says. If you are young and your high blood pressure is you only cardiovascular risk factor, your doctor may recommend lifestyle changes, such as reducing salt, exercising and losing weight. If you have multiple risk factors or already experienced a cardiac event, they may prescribe medication to lower your blood pressure.

3. Know Your Cholesterol Numbers

Even if you have no known family or personal history of heart disease, you should still understand your cholesterol levels and have them routinely checked. By age 21, every adult should have a lipid profile blood test at least every four to six years.

"Having a high level of LDL (low-density lipoprotein) cholesterol is a risk factor because it deposits in your blood vessels and leads to plaque formation," Dr. Trivedi says. "We emphasize keeping the LDL ("bad") cholesterol less than 55 for those with known coronary artery disease." But the criteria for normalizing cholesterol levels can vary based on your history of heart disease.

4. Prevent (or Control) Diabetes

Having Type 2 diabetes can accelerate the process of plaque buildup in the coronary arteries, doubling your risk of heart disease or stroke and putting you at higher risk for developing heart disease at a younger age.

"Taking action to prevent or control diabetes not only decreases the risk of having a heart-related event," Dr. Trivedi says, "but it also reduces your risk for other major heart disease risk factors."

5. Make Heart-Healthy Food Swaps

Making healthy food choices that are good for your heart shouldn't feel restrictive or complicated. Switching even a few ingredients for heart-healthy options can help you cut back on salt, sugar and unhealthy fats.

Dr. Trivedi recommends:

  • Cooking at home instead of eating out to cut down on sodium and control the ingredients you eat.
  • Following a Mediterranean diet, which emphasizes plant foods, lean protein and healthy fats.
  • Making over your meals by adjusting your portion sizes and choosing healthier ingredient options.

"Eating with heart health in mind has many benefits," Dr. Trivedi says. "It helps prevent diabetes, manage weight and reduce blood pressure."

6. Get Your Heart Rate Up

There are many ways to move your body, but moderate-intensity exercise has definite benefits for your heart. When exercising at moderate intensity, your target heart rate should be between 60% and 75% of your maximum heart rate, estimated by subtracting your age from 220.

For example, the maximum heart rate of a 40-year-old is 180 bpm (beats per minute). During moderate-intensity exercise, that person should aim to keep their heart rate between 108 and 135 bpm. Don't have a heart rate monitor? Pause and check your pulse. Being able to talk but not sing also indicates that your heart rate is in the right range.

Getting enough exercise also helps keep your heart healthy in other ways. It positively affects your stress and mental health, weight loss and daily habits such as sleep and hydration. Aim for 150 to 300 minutes of moderate-intensity exercise weekly.

Want to Improve Your Heart Health? Start Here

Knowing that your heart health is in your hands should feel empowering, not overwhelming. To help you navigate your heart health, Dr. Trivedi recommends taking these steps:

  • Gather your family's health history: Your risk of heart disease increases if you have a close relative who had a heart attack or stroke at an early age or if inherited lipid disorders — which affect how the body breaks down cholesterol — run in the family.
  • Get a yearly check-up: Primary care should be your first stop for heart health. Your doctor can help you follow preventative guidelines for heart disease, identify risk factors and refer you to a cardiologist when appropriate.
  • Learn the symptoms of heart disease: Recognizing the signs of a heart issue is critical for getting the care you need as soon as possible. Remember, the signs of heart attack in women are different from what men experience.
  • Make a plan: Work with your doctor and loved ones to create a heart-healthy lifestyle that includes exercise, a whole-food diet and preventive care.

"Heart health involves years of consistent actions and choices that ultimately yield meaningful results," Dr. Trivedi says. "Each good decision matters. That's why it's never too late to prioritize your heart, but it's also never too early."

Next Steps and Useful Resources



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