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  • Written By:Michael Liston, MD, FACC

Since 1963, our government, science and medical leaders have marked this time of year to urge Americans to join the battle against a disease that takes one of every four lives of men and women in this country. Despite leading all causes of death and that proven prevention and risk factor modification show marked success in curbing it, 56 years later – heart disease remains the number one killer of Americans.

Risk factors fall into only two categories. Those you cannot control, such as your genetics, gender and race – and those you can control. Those include:

  • Elevated cholesterol
  • Diabetes
  • Hypertension
  • Obesity
  • Smoking

Health experts fingered these heart offenders decades ago, but a recent study in the Annals of Internal Medicine suggests the message still isn’t reaching the public. Researchers from Emory University looked at data from the Behavioral Risk Factor Surveillance System (BRFSS) to estimate just how much impact those five controllable risk factors had on managing cardiovascular disease. Those researchers determined that if we got rid of the “foul five” the number of heart disease deaths would be cut almost in half. To put that number in perspective, it would amount to more than 300,000 lives each year.

Realistically, that probably won’t happen any time soon. It hasn’t for decades. But, there has been progress, and hope for those who struggle with, or remain in denial about how much control they actually have in their own heart health. The American Heart Association (AHA) believes 80 percent of heart attacks and strokes are preventable and that starts with an honest understanding of your individual risk and half of everyone reading this has at least one major risk factor for cardiovascular disease, which may include a factor out of your control:

  • Gender: The majority of people who die of coronary heart disease are 65 or older – and are men, but at older ages, women who have heart attacks are more likely than men to die from them within a few weeks.
  • Heredity: Children of parents with heart disease are more likely to develop it themselves.
  • Race: African Americans, Mexican Americans, American Indians, native Hawaiians and some Asian Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. This is partly due to higher rates of obesity and diabetes.

By age 40, you should be well aware of your family history and other heart disease risk factors and assess your risk score with your doctor every five years. That assessment should occur more often if your risk factors are high or change.

Know your height, weight and waist circumference. Your waistline may be indicative of metabolic syndrome, which is another distinct risk factor. Know and monitor your blood pressure, cholesterol levels (total, LDL, HDL and triglycerides), and your blood sugar levels. Your doctor can provide these tests if you haven’t already had them.

The AHA also provides further risk assessment using a scoring system from a study known as the Framingham Heart Study to assess your risk of dying of coronary heart disease in the next 10 years. Designed to identify genetic and environmental factors influencing the development of cardiovascular and other diseases, it may be one of the most important ongoing public health studies in American medical history and can be found at the AHA website

In an effort to prevent one million heart attacks and strokes, The Health and Human Services department (HHS) “Million Hearts” campaign asks Americans to make healthy choices, by avoiding tobacco and reducing red meat and sodium intake, as well as improving care for people who already need treatment, by learning and remembering the ABCs:

A: Aspirin for those at risk;

B: Blood Pressure Control;

C: Cholesterol Control;

and ‘S: Smoking Cessation.

Remember, augmenting even one risk factor in your life now can make a big difference in the number and quality of years you live.