Risk Factors for Heart Disease

High Blood Pressure

High blood pressure is called the silent killer because there are no symptoms. The higher your blood pressure, the greater chance you have of heart attack, heart failure, stroke and kidney disease. An estimated 1 in 4 American adults have high blood pressure. Blood pressure is the amount of force applied by the blood flow against the artery walls every time your heart beats. This pressure helps the blood carry vital oxygen to all the limbs and organs in your body. When your blood pressure is too high, damage occurs. 

Risk Factors

  • Family history of high blood pressure
  • African American race
  • Age 35 and older
  • Overweight for your height and bone structure
  • Physically inactive
  • Excessive salt use
  • Excessive alcohol use
  • Diabetes, gout and kidney disease
  • Pregnancy
  • Use of birth control pills

Blood pressure measurements consist of two numbers:

  • Systolic — pressure of blood against your artery walls when the heart has just finished pumping contracting). It is the first or top number of a blood pressure reading.
  • Diastolic — pressure of blood against your artery walls between heartbeats, when the heart is relaxed and filling with blood. It is the second or bottom number in a blood pressure reading.

Blood Pressure Guidelines

Top (Systolic): Less than 120
Bottom (Diastolic): Less than 80


Top (Systolic): 120-139
Bottom (Diastolic): 80-89

Top (Systolic):  Greater than 140
Bottom (Diastolic): Greater than 90

High Cholesterol

Cholesterol is a wax-like, fatty substance made mainly by the liver. Your body uses cholesterol to produce certain hormones, vitamin D and the bile acids that help digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If you have too much cholesterol, the excess is deposited in arteries including the coronary arteries, where it contributes to the narrowing and blockages that cause heart disease.

If not enough oxygen-carrying blood reaches the heart, you may feel chest pain called angina. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.

Cholesterol Low Risk Values
Total Cholesterol: Less than 200 
HDL (good cholesterol): 40 and above 
LDL (bad cholesterol): Less than 100

Borderline High Risk Values
Total Cholesterol: 200-239 
HDL (good cholesterol): Less than 40 
LDL (bad cholesterol): 130-159

High Risk Values
Total Cholesterol: 240 or over
HDL (good cholesterol): Less than 40
LDL (bad cholesterol): 160 and over

* If you are diabetic or have one or more risk factors, check with your doctor because your cholesterol level goals may change.


Triglycerides are the main form of fats (lipids), circulating in your bloodstream. Most of your body fat comes in the form of triglycerides. Blood triglycerides are derived from two sources: the foods you eat -mainly sugar, animal products and saturated fats - and from the liver itself, especially during times when dietary fats are not available. High triglyceride levels may increase your blood's tendency to form clots, which is another important factor in clogged arteries.

A high triglyceride level alone - with no other risk factors for heart disease - raises your risk for coronary artery disease by 50 percent compared to people with normal levels. If you have both high triglyceride levels and high levels of LDL cholesterol, you have a 300 percent greater risk of coronary artery disease. Add high blood pressure (140/90 mmHg or greater) and your risk increases to 500 percent.

Triglyceride Levels
Normal: 150 mg/dL
Borderline High:  150-199 mg/dL
High: 200-499 mg/dL
Very high: 500 mg/dL or higher


Nearly 16 million Americans have diabetes and almost half of those do not even know they have it. Long-term, uncontrolled diabetes results in a variety of complications, the most serious of which is heart disease.

Diabetes is a disease in which your body does not produce enough insulin or doesn't use insulin properly. Your body needs energy or fuel for all its functions, so it makes a type of sugar called glucose for this purpose. Insulin is a hormone produced by the pancreas to help move glucose into the cells where it is needed. If the pancreas does not make enough insulin to move glucose into the cells, it stays in the bloodstream and your body does not receive the fuel it needs. The disease process in diabetes also damages the heart muscle.

Type I (juvenile diabetes) — is usually diagnosed at birth or in childhood and requires daily insulin use. In some cases, type I diabetes has shown improvement through exercise and a strict diet, enabling those with this type of diabetes to lower their insulin dose.

Type II diabetes — once known as adult-onset diabetes, usually develops in adults and may be prevented or managed through diet and exercise.

Risk Factors

  • Obesity (especially women with an "apple" shape)
  • Previous childhood diabetes (Type I)
  • Family history of Type II diabetes
  • African American, Hispanic or Asian
  • Age over 40 years (risk increases with age)
  • Physical inactivity
  • Previously impaired glucose tolerance (IGT)
  • High intake of
  • red meats
  • processed meats
  • high-fat foods (french fries, high-fat dairy, eggs)
  • high sugar foods
  • Cigarette smoking


  • Always tired
  • Blurred vision
  • Always thirsty
  • Frequent urination
  • Losing weight without trying

The symptoms of diabetes can go unnoticed for years while the disease takes its toll. That's why it is a good idea to have an annual screening for diabetes after age 45 - especially for those in a high-risk category.

The normal blood glucose range in people who don't have diabetes is about 70 to 120. Blood glucose goes up after eating, but returns to normal one or two hours later.


Most adult smoking-attributable deaths are from:

  • Lung cancer
  • Coronary heart disease, and
  • Chronic airway obstruction

A woman's breathing ability improves twice as well as a man's after quitting.

Second-hand tobacco smoke has been proven to cause cancer in humans and is responsible for at least 3,000 lung cancer deaths each year as well as more than 35,000 cardiovascular deaths and the aggravation of asthma and lower respiratory tract infections.

The health effects of smoking may take years to show up, but will cause plaque to build up in the arteries, heart disease, lung cancer and chronic obstructive pulmonary disease (COPD), which includes emphysema. Yet smoking is the number one preventable cause of disease and death in the United States.

Today there are a variety of methods available to help you stop smoking. Any of the methods can work when used as part of a comprehensive, doctor-promoted cessation program. The key is to choose one and replace the time spent smoking with other healthy activities. Don't wait until smoking-related disease forces you to quit.

Ways to Quit Smoking

  • Cold Turkey
  • Nicotine Replacement Therapy
  • Nicotine Gum
  • Nicotine Patch
  • Nicotine Nasal Spray
  • Nicotine Inhaler
  • Non-Nicotine Medication

The American Lung Association offers a free, online smoking cessation program called Freedom from Smoking at For a free copy of other materials on quitting smoking, call any of these toll-free numbers:

  • Agency for Healthcare Research and Quality, 800.358.9295
  • Centers for Disease Control and Prevention, 800.CDC.1311
  • National Cancer Institute, 800.4.CANCER

Obesity and Overweight

Obesity is the excessive buildup of fat to the extent that health is impaired. It has reached epidemic proportions in the United States. In an effort to increase public awareness of the seriousness of obesity, the Surgeon General has issued a call to action to prevent and treat overweight and obesity and their associated health complications such as heart disease.

  • Nearly 31% or 59 million American adults are obese.
  • The prevalence of obesity, defined as a body mass index greater than 30 kg/m2 has increased from 12.8% in 1976-1980 to 30% in 1999-2000.
  • More than 64% of the US adult population have a BMI greater than or equal to 25 kg/m2.

Obesity is usually determined using the body mass index or BMI, which is based on a weight-to-height ratio.

BMI Categories 
Underweight = less than 18.5
Normal weight = 18.5 - 24.9
Overweight = 25 - 29.9
Obesity = 30 or greater

Waist Circumference

Waist circumference is another widely used measurement to determine abdominal fat content. An excess of abdominal fat, when out of proportion to total body fat, is considered a predictor of risk factors related to obesity. Women with a waist measurement of 35 inches or more are at risk of developing obesity-related health problems and heart disease.

A sound weight loss and management program begins with a visit to your doctor. He or she can assess your eating and exercise habits, and help you formulate a plan to lose weight in a safe manner. In addition, the following two sections on nutrition and exercise can help you get started.


Eating nutritious, heart-healthy meals is simple because of the variety of food choices available today. In fact, many fast food restaurants now offer an array of salads and broiled chicken sandwiches so eating right on-the-go is easier. To help you make informed choices, the U.S. Department of Health and Human Services and the U.S. Department of Agriculture have put together some dietary tips.

7 Steps to Better Health

  1. Eat a variety of foods to get the energy (calories), protein, vitamins, minerals and fiber you need for good health.
  2. Maintain a healthy weight to reduce your chances of having high blood pressure, heart disease, a stroke, certain cancers and Type II diabetes.
  3. Choose a diet low in fat, saturated fat and cholesterol.
  4. Eat plenty of vegetables, fruits, and grain products that provide needed vitamins, minerals, fiber and complex carbohydrates.
  5. Use sugar only in moderation.
  6. Use salt and other forms of sodium only in moderation.
  7. If you drink alcoholic beverages, do so in moderation.

Daily Dietary Guidelines Based on the Food Pyramid

  • Fats, Oils and Sweets — Use Sparingly
  • Milk, Yogurt and Cheese  (fat-free or low-fat) — 2 to 3 servings
  • Meat, Poultry, Fish, Dry Beans, Eggs and Nuts — 2 to 3 servings
  • Vegetables — 3 to 5 servings
  • Fruit — 2 to 4 servings
  • Bread, Cereal, Rice and Pasta* — 6 to 11 servings
      *Choose whole-grain products whenever possible

About Fats

Less than 30 percent of the total calories you need per day should come from any type of fat and less than 10 percent of the total calories needed per day should come from saturated fat. Choose the right type of fats for better health.

Best = Monounsaturated
Olive, natural peanut, and Canola oils, avocados

Fair = Polyunsaturated
Safflower, sunflower, corn, soybean, sesame

Worst = Saturated and trans fats, Animal meats & fats (butter, sweet cream, cheese, whole milk), hydrogenated* vegetable oil or shortening, tropical oils, processed foods, non-dairy creamers

*Hydrogenation: A chemical process that changes liquid vegetable oils into solid fats by whipping hydrogen into them. This process increases the amount of saturated fat.

For more information, the complete 40-page booklet, Nutrition and Your Health: Dietary Guidelines for Americans, may be viewed and downloaded from


If you are over the age of 35, have high blood pressure, high cholesterol, been sedentary for awhile, feel weak or out of breath or have any other medical complications, you should see your doctor before you begin any new fitness program.

The human body is designed for activity. Every cell, nerve, organ and muscle - the very fiber of our bodies - is replenished and revitalized with exercise. Dozens of scientific studies show that cardiac risk can be reduced anywhere from 30 to 50 percent by regular exercise.

How to Get Started...

Take a walk. Brisk walking is one of the easiest and most enjoyable exercises you can do. Best of all, it's free! You can fit in a good walk practically anytime or anywhere: before work, during work breaks or after work. Start a walking group with your neighborhood friends or work buddies. Make it a family affair. Set aside time for the whole family to enjoy a walk together. Just be sure to walk in a well-lit, populated area for safety. Orlando Regional Healthcare's LifeSteps program at the Florida Mall is a great and safe place to begin.

Practice the 3 UPs

Limber up
There's nothing like a good stretch to work out the kinks. And there are dozens of videos, books and classes available on stretching and Eastern exercises such as yoga and tai chi. The martial arts also offer an excellent way to limber up and gain self-confidence, not to mention learning to protect yourself.

Kick your feet up
The Central Florida area offers a wide variety of places to enjoy an evening out dancing. Some even offer free lessons. Community centers, technical schools, colleges and private facilities offer dance lessons such as ballet, clogging, tap, ballroom, jazz, modern, square dance, hiphop, Irish and country-western. Don't forget about aerobics and Jazzercise classes, too.

Pump it up
Developing strength is an important part of any exercise program. Research shows that women need strength training in addition to aerobic exercises to lower the risk of osteoporosis. Naturally, your heart muscle gets a good workout while you're lifting weights. But don't worry about becoming too big. You can tailor your strengthening program to accomplish your desired goals.

The Orlando Health Wellness Center offers a comprehensive, personalized exercise program that begins with an evaluation by a certified exercise physiologist and includes nutrition counseling upon request and a variety of fun classes. Start a new tradition today. Call (407) 237-6351 for more information or to join.