Who Suffers a Heart Attack?

Age, gender, genetics, and lifestyle choices all play a role in risk of atherosclerosis and a heart attack. Some heart attack risk factors, such as age, gender, and heredity, are non-modifiable—you cannot change them. Many risk factors, however, are modifiable. Risk factors are cumulative: the more you have, the greater your risk of a heart attack.

Heart attacks are most common in people over 45 years of age; the peak incidence is among people aged 50–70. People younger than 45 who may suffer a heart attack include cocaine users, those with insulin-dependent diabetes, individuals with hypercholesterolemia, and those with a family history of coronary artery disease occurring at a young age. Age also affects the outcome of a heart attack: the majority of heart attack victims who die are over 65.

Between the ages of 40 and 70, men are more likely than women to have a heart attack. Among people more than 70 years old, however, the incidence is the same in men and women. The average age for a first heart attack among men is 66 years, and, among women, 70 years.

People from families with a history of coronary artery disease and heart attack have a greater likelihood of developing heart disease. People of different racial heritages also have different risk factors for the cardiovascular diseases that may contribute to the risk of heart attack. For example, severe high blood pressure is more common in African Americans than in Americans of Caucasian descent.

Cigarette, pipe, and cigar smoking, as well as secondhand smoke, all damage the coronary arteries, contributing to plaque formation and heart attack risk. Smoking also increases the risk of blood clot formation. Quitting smoking can greatly reduce your risk of a heart attack and improve both lung health and overall health. Over-the-counter smoking-cessation aids such as nicotine lozenges and gum are available, as are prescription medications. Consult your doctor for advice and strategies for quitting. (For more infor-mation, see the Quamut guide to Quitting Smoking.)

Hypertension is a risk factor for heart attack but is generally asymptomatic—meaning that you’ll know whether you have high blood pressure only if your doctor checks it regularly. Blood pressure may be controlled by exercising, decreasing salt intake, and maintaining a normal body weight. A variety of prescription medications are available for use when lifestyle modification fails to reduce blood pressure.

Cholesterol levels also contribute to the risk of a heart attack. Like hypertension, hypercholesterolemia is asymptomatic and requires blood tests to detect. Cholesterol can be controlled via a low-fat diet, regular exercise, and cholesterol- lowering medications known as statins.

Regular exercise is part of any healthy lifestyle. Exercise can help control cholesterol, lower blood pressure, and prevent or reduce obesity. Cardiovascular fitness reduces the overall risk of having a heart attack, and regular exercise will also make you look and feel better.

Excess body fat—even in the absence of other risk factors—increases heart attack risk. Obesity is also associated with hypertension, diabetes mellitus, and high cholesterol.

Insulin is a hormone, secreted by the pancreas, that enables the body to metabolize and utilize glucose, a form of sugar. Diabetes occurs when the body is incapable of producing or responding to insulin. Diabetes accelerates atherosclerosis and may adversely increase cholesterol levels.

How you deal with stress can affect your risk of a heart attack. Some people cope with stress by exercising, whereas others may smoke, drink alcohol, or overeat. Stress can also increase blood pressure. Learning healthy stress management techniques can help reduce heart attack risk.

Excessive alcohol consumption can increase blood pressure, cause arrhythmias (irregular heartbeats), contribute to obesity, and increase triglyceride levels. Conversely, moderate alcohol consumption may actually decrease risk.