Heart disease is often silent, coming with few warnings. And many Canadians are at risk. According to the Heart and Stroke Foundation of Canada, 9 in 10 Canadians have at least 1 risk factor for heart disease and stroke.

But while many know about some risk factors, they’re not taking action. “People are clued into what they should be doing,” says Greg Killough, a spokesperson for the Heart and Stroke Foundation of Canada. “But there’s still work to be done. What is surprising is that we’re seeing heart attacks and stroke show up in younger and younger people.”

There is an upside, however, Killough says: You can prevent 80% of premature heart disease by making lifestyle choices that can reduce certain key risk factors.

5 risk factors you probably know about

  1. High blood pressure. “Get a baseline reading of your blood pressure,” says Killough, so your GP can track changes as you get older. Your blood pressure reading is based on 2 measures: The systolic (top) number is the measure of the pressure when your heart contracts and pushes out the blood. The diastolic (bottom) number is the measure of pressure when your heart relaxes between beats.
    The Heart and Stroke Foundation classifies high blood pressure as:
    • Medium risk – 121-139 / 80-89 (systolic over diastolic)
    • High risk – 140+ / 90+
  2. High cholesterol. Having high cholesterol – too much of the “bad” kind of fat (LDL cholesterol) and/or not enough of the “good” kind (HDL cholesterol) in your blood – increases your risk of heart disease. As well as measuring the levels of each type of cholesterol in your blood, your doctor will typically look at the amount of HDL in relation to your total amount of cholesterol, by dividing total cholesterol by HDL – and the lower the number, the better.
    The Harvard Medical School suggests that men with a total cholesterol-to-HDL ratio of 3.4 are at a low risk of heart disease; 5 is average risk; and 9.6 is high risk. The corresponding numbers for women are 3.3 (low risk), 4.4 (average risk) and 7 (high risk)
  3. A family history of heart disease or high cholesterol. “If your parent has heart disease, your risk is double that of the regular population,” says Dr. Beth Abramson, the director of the Cardiac Prevention and Rehabilitation Centre and Women’s Cardiovascular Health in the Division of Cardiology at St. Michael’s Hospital in Toronto. She adds that some people have genetic tendencies towards high cholesterol. She suggests you check in with your family doctor if heart disease is in your family.
  4. An unhealthy lifestyle. Smoking, eating foods high in saturated fat, being overweight and not being physically active can all raise your risk of developing heart disease, says Killough.
  5. Health conditions such as diabetes. Having diabetes can cause your body to produce plaques in the arteries of the heart, narrowing them and restricting blood flow to the heart. It can also damage the structure and function of the heart, and ultimately lead to heart failure. Fortunately, leading a healthy lifestyle with a good diet and physical activity can help reduce this risk.

4 risk factors you might not know about

Here are some other conditions that may play a role in the development of heart disease:

  • Early menopause. If a woman reaches menopause before age 50, that’s considered early, says Dr. Abramson, and that may play a part in her heart disease risk. “In early menopause, a woman is biologically older on the inside,” she says. That’s because the hormones estrogen and progesterone diminish, raising LDL levels, reducing HDL levels and possibly increasing blood pressure. Many women also experience an increase in body fat, making them more prone to blood clots and raised blood sugar levels, says the Heart and Stroke Foundation.
  • Having a pot belly. Sporting extra fat around the midsection may spell trouble for your heart, as “visceral” (belly) fat is “processed differently by the body and increases inflammation,” which can negatively affect the heart, according to Dr. Abramson. She says men often become apple-shaped, carrying fat around the middle, while women more often become pear-shaped, with fat collecting around their bellies, hips and thighs.
  • Doing shift work. While researchers aren’t totally clear on why shift workers may be at higher risk of heart disease, there has been an association between heart attacks, sleep deprivation and shift work, says Dr. Abramson. She believes many shift workers struggle with maintaining a healthy diet and regular sleep cycles, factors that may contribute to increased body weight and inactivity. She also believes that shift work may affect how the body processes hormones, further compounding these issues.
  • Stress. Being emotionally stressed may also wreak havoc on your heart. According to information on heart disease from the Government of Canada, high levels of stress or chronic stress may result in high cholesterol, increased blood pressure or disturbances in heart rhythm, which can increase the risk of developing heart disease.

What you can do now to lessen your risk

The Heart and Stroke Foundation suggests aiming for at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more. It also recommends reducing stress, choosing a healthy diet, maintaining normal blood pressure levels and discussing a family history of heart disease with a doctor.

And if you find you’re at high risk for heart disease, there is help through lifestyle modification or medication, says Dr. Abramson. “Manage those risks,” she says. “We need to treat this.”