Women's Health Matters

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Risk Factors for Ischemic Heart Disease

Speak to your health-care professional about your personal risk of heart disease and what you can do to lower that risk. The following are risk factors for ischemic heart disease:

Smoking as few as four cigarettes per day makes you seven times more likely to develop heart disease. If you smoke, the best thing you can do for your heart is to quit.

High Blood Pressure
High blood pressure increases your risk of a heart attack by three times and doubles your risk of stroke. High blood pressure is very common: 40 percent of women over the age of 65 have high blood pressure. You should aim for a blood pressure reading of 135/85 or lower.

High Cholesterol
Increased levels of 'bad' LDL cholesterol (as opposed to ‘good’ HDL cholesterol) narrows the coronary arteries and contributes to the development of heart disease. To find out what your cholesterol levels are, ask your doctor for a blood test. Physical activity, quitting smoking, limiting how much alcohol you drink and eating healthy foods are all important for maintaining a healthy cholesterol level.

People with diabetes tend to have other risk factors for heart disease, including high blood pressure and blood cholesterol, and obesity. Women with diabetes are seven times more likely than other women to have a heart attack, and are at greater risk than men with diabetes.

Physical Inactivity
Physical inactivity contributes to low levels of HDL or 'good cholesterol,' being overweight, high blood pressure and stress. Regular exercise strengthens the heart and allows it to pump blood more efficiently. It is recommended that you do some kind of aerobic exercise (such as walking, jogging or cycling) for at least 30 minutes, on most days of the week.

Waist Size
People who are overweight are more likely to have a heart attack, especially if the weight is around the waist and upper body (as compared to extra weight around the hips).

If you are a woman and your waist measures more than 31.5 inches (or 80 cm), you are at increased risk for developing heart disease, high blood pressure and diabetes.

The ideal BMI (body mass index) is between 18.5 and 24.9. If you want to calculate your BMI, click here. (Note that this guideline does not apply to children, pregnant women, breastfeeding women or athletes. It can also be inappropriate for people with a muscular build and older adults. Note too that the BMI does not take into consideration where a person’s fat lies.)

Psychosocial Issues
Stress, depression, social isolation and a lack of social supports are associated with higher rates of cardiovascular disease. Stress affects the body, makes the heart work harder, and can make high blood pressure worse. Depression can affect a person’s recovery and outcome from a heart attack. Everyone has some stress in their life but learning how to cope with it is good for your heart health.

Family History
A woman is at greater risk for heart disease if one of her male blood relatives (her father or brother) had heart disease at age 55 or less, or if a female blood relative (her mother or sister) had heart disease at age 65 or less.

Low income is associated with a higher rate of coronary heart disease and stroke and with a higher mortality rate after a heart attack. People living in poverty are more likely to have other risk factors, such as high blood pressure, diabetes and chronic stress; and are less likely to have time to exercise, or have access to the medications and health care they may need.

With menopause, a woman’s estrogen level decreases while her blood pressure and levels of cholesterol and other blood fats increase. After menopause, a woman’s risk of heart disease is higher than before menopause. Women start to exceed men in risk for cardiovascular disease around 10 years after menopause.

Three-quarters of Canadian adults have at least one of the three major modifiable risk factors for cardiovascular disease:

  • Smoking
  • High blood pressure (high blood pressure is still considered a risk factor even if under control by medication)
  • High blood cholesterol


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  • A publication of:
  • Women's College Hospital