What is the greatest risk factor for heart disease?

What are the most important protective factors? 

Some key protective factors you have under your control are
• weight control
• avoiding tobacco use and secondhand smoke
• relaxation or meditation
• dealing with stress, depression, and lack of social support
• physical activity
• proper food choices
• genetic factors

Most of these, like the lifestyle risk factors, are linked to your way of life. However, some protective factors are inherited. Just as there are genetic causes of high LDL levels, there are families with a history of longevity who inherit low cholesterol and LDL levels. Longevity has also been reported in families with high levels of HDL, the protective fraction of cholesterol. There is considerable evidence from studies of identical twins reared apart to show that the degree of overweight has a strong genetic basis. This also means that the important protective factor of remaining close to one’s ideal body weight has a fairly strong genetic component. In a similar vein, just as hypertension has a genetic component, so does the protective factor of having a blood pressure that is below the average for the population at large. For those who have inherited protective factors, it is still important to avoid tobacco and a sedentary lifestyle. For those who inherit a susceptibility to the risk factors of cholesterol, triglycerides,blood pressure, body weight, and Type 2 diabetes, it is even more important to adopt and maintain diet, exercise, and stress management routines in order to decrease the inherited risk tendency.

Think about your personal risk profile and focus first on the chapters that discuss the risk factors that apply to you. The best news is that you will find that the same corrective behaviors work to reduce or eliminate many different risk factors, and you may actually find it an enjoyable challenge to learn about these tools in the chapters that follow. When heart disease is advanced, or when the marvelous benefits of food and exercise, weight control, smoking cessation, and control of stress and depression are not sufficient, other means such as medications and surgery may be necessary.

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