Know your risk
90% of heart attacks are caused by factors you can control.
52 countries. More than 30,000 patients. 9 modifiable risk factors that explain over 90% of risk.
The 9 risk factors
Population attributable risk (PAR) is the share of heart attacks in the population that this factor accounts for.
Bad cholesterol (lipids)
#1 risk factor in every world region
Smoking
No safe level, even 1-5 cigarettes a day raises risk
Stress and depression
45% of risk in women
Belly fat (waist size)
Waist-to-hip ratio matters more than BMI
High blood pressure
Damages arteries silently, hits women harder
Diabetes
More than doubles risk, especially dangerous for women
Fruits and vegetables daily
Eating them daily cuts risk by nearly one-third
Regular exercise
4+ hours a week of walking, biking, or gardening. 150 minutes a week is the goal.
Moderate alcohol
Do not start drinking for heart protection. Overall PAR without alcohol is nearly the same at 89.7%. Discuss with your doctor.
Risk factors multiply
They do not just add up. Each one you carry multiplies the others.
Men and women are not the same
Men
- •Smoking is the biggest lifestyle risk, at 43% PAR
- •The 9 factors explain 90% of heart attacks
Women
- •Stress and depression are 45% of the attributable risk
- •Diabetes and high blood pressure hit harder
- •The 9 factors explain 94% of heart attacks
What else smokes like a cigarette
Everyday exposures with cardiovascular damage comparable to a daily cigarette count.
Chronic stress and anxiety
about 5 cigarettes a dayA meta-analysis found chronic stress raises heart attack risk by 27%, comparable to the cardiovascular damage of smoking 5 cigarettes daily, since stress raises blood pressure and LDL cholesterol at the same time.
Source: Richardson et al., American Journal of Cardiology
Loneliness and social isolation
about 15 cigarettes a dayA meta-analysis found social isolation raises mortality risk by 26-32%, increases stroke risk by 32%, and coronary heart disease risk by 29%.
Source: Holt-Lunstad et al., Perspectives on Psychological Science, 2015
Sedentary lifestyle, no exercise
about 6-8 cigarettes a daySitting 8 or more hours a day raises premature death risk by 10-20%. INTERHEART found inactivity responsible for 12% of all heart attacks.
Source: American Journal of Public Health; INTERHEART
Poor diet, low in fruits and vegetables
about 4-5 cigarettes a dayA 2019 study of 195 countries found poor diet responsible for more deaths globally than smoking. INTERHEART found skipping daily fruits and vegetables accounts for 14% of heart attacks.
Source: Afshin et al., The Lancet, 2019; INTERHEART
Your 8-step action plan
Tap any step for the detail.
1Quit smoking
- •There is no safe level. Even 1-5 cigarettes a day raises your risk.
2Fix your cholesterol
- •Get a lipid panel.
- •Ask about ApoB.
- •Take statins as prescribed.
- •Eat less saturated fat, and more fish, nuts, and olive oil.
3Control your blood pressure
- •Know your numbers. The goal is usually under 130/80.
- •Take your medicine every day, even when you feel fine.
- •Cut salt to under 2,300 mg a day.
- •Try the DASH diet.
4Manage diabetes
- •Keep your A1C at goal.
- •Newer medicines like SGLT2 inhibitors and GLP-1s protect the heart directly.
- •Even 5-10% weight loss helps significantly.
5Reduce belly fat
- •Waist matters more than weight.
- •Men, aim for under 40 inches. Women, aim for under 35 inches.
- •Cut sugary drinks and ultra-processed foods first.
6Manage stress and mood
- •Talk to your doctor.
- •Try breathing exercises, meditation, or yoga.
- •Stay socially connected.
7Eat fruits and vegetables
- •Aim for 5 or more servings daily.
- •Frozen and canned count, as long as there is no added salt or sugar.
8Move your body
- •The goal is 150 minutes a week of moderate activity. Walking counts.
My personal heart health plan
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My key numbers
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You have the power to protect your heart.
Small changes add up. Work with your Heart House team to build a plan that works for you.
Study: Yusuf S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries. The Lancet. 2004.