A heart attack can strike suddenly and be fatal. While we can’t achieve immortality, putting off a heart attack as long as possible should be a goal for every adult. Your doctor should be your partner in identifying and mitigating heart attack risk factors, but often they focus on the wrong things. In this article, we’ll look at the true top risk factors for heart attack and steps you can take to reduce your risk.
The Top Risk Factors for Heart Attack
A 2021 study published in the Journal of the American Medical Association’s Cardiology journal looked at various medical conditions and their association with heart attack and coronary artery disease risk. By looking at the hazard ratios from this study, we can rank risk factors for heart disease and subsequent heart attack:
1. Type 2 Diabetes
Type 2 diabetes came out as the number one risk factor for heart attack. However, there are likely millions walking around undiagnosed. A fasting blood glucose test alone may miss many cases of prediabetes or early type 2 diabetes. Ask your doctor to also check hemoglobin A1c, fasting insulin, and C-peptide levels. These will uncover hidden diabetes raising your heart attack risk daily.
2. Metabolic Syndrome
Metabolic syndrome, characterized by insulin resistance and abdominal obesity, is highly associated with heart disease. Checking fasting insulin or C-peptide levels can help uncover this silent risk factor.
3. Hypertension
Doctors routinely check blood pressure, but not what’s causing hypertension. Like metabolic syndrome, it’s closely tied to chronically elevated insulin.
4. Obesity
While not directly causative of heart attacks, obesity is a marker of metabolic dysfunction that raises risk.
5. Smoking
Smoking promotes arterial inflammation and dramatically increases heart attack risk.
6. High Triglycerides
Elevated triglycerides are a stronger risk factor than high LDL cholesterol, but often overlooked.
7. Overweight
Even being moderately overweight adds risk compared to an optimal BMI.
8. Small LDL Particles
Small dense LDL particles are associated with greater heart disease risk than LDL level alone. You need an advanced test like NMR lipoprotein analysis to measure this.
9. High CRP
C-reactive protein is a marker of inflammation that predicts cardiovascular risk. It’s not routinely checked but could provide valuable information.
10. Inactivity
Lack of exercise is bad for health in many ways, including increasing heart attack risk. But it’s small potatoes compared to the top few risk factors.
11-14. Lipid Factors
Total cholesterol, LDL cholesterol, and other lipid markers trail far behind all of the above risk factors. But these are often the primary focus of doctors and drug treatments.
What You Can Do to Take Control of Your Heart Attack Risk
While the deck seems stacked against you, there are steps you can take to overcome the limitations of the current medical system and reduce your heart attack risk:
- Educate yourself – Look beyond what your doctors tells you and research heart disease risk factors independently. Studies like the JAMA one cited above provide excellent information.
- Request the right tests – Be proactive about getting proper screening for type 2 diabetes, metabolic syndrome markers like fasting insulin, inflammation levels with CRP, and advanced lipid profiles looking at LDL particle number. Don’t settle for just total cholesterol and LDL.
- Focus your efforts appropriately – Spend your time, energy, and money mitigating the biggest risk factors, starting with type 2 diabetes and metabolic dysfunction. Not fretting over LDL levels.
- Change your diet – Avoid processed carbs, added sugars, and refined oils. Eat more meat, seafood, eggs, non-starchy vegetables, nuts/seeds, olives/avocados, and other whole foods. This approach consistently improves all major heart attack risk factors.
- Exercise more – Increased physical activity provides benefits, so find realistic ways to move your body regularly. Just don’t count on exercise alone to undo a poor diet.
- Reduce stress – Chronic stress contributes to metabolic imbalance and inflammation. Make lifestyle changes to promote relaxation.
- Hold your doctor accountable – If they blow off your concerns about mishandled risk factors, find one who will partner more productively with you. Second opinions from functional and integrative medicine practitioners can also provide tremendous value.
While some heart attack risk is unavoidable as we age, optimizing diet, activity levels, and the screening tests you receive can help add years to your life by avoiding this deadly event. Take control of your health instead of relying on the flawed health care system. Prioritize the factors science confirms really matter, not outdated misguided dogma.
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