2-3

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2-3. PREDISPOSING FACTORS OF HEART ATTACK (RISK FACTORS)

Disease related to the heart and blood vessels are the greatest killers of people in this country. According to a 2005 American Heart Association study, sudden cardiac death from coronary heart disease occurs over 900 times per day in the United States. The risk in adults is estimated to be about 1 per 1,000 adults 35

years of age and older per year. Sudden cardiac death in the young (people less than 35 years old) is much less common than in older adults, occurring in only 0.5 to 1 per 100,000 per year. A review of published studies that report initial heart rhythms during cardiac arrest in children indicates that the majority (40 to 90 percent) of children have asystole (a-SIS'to-le) or pulseless electrical activity when first evaluated. However, ventricular fibrillation or ventricular tachycardia (ven-TRIK'u-ler tak"eh-KAR'de-ah) is found in about 7 to 14 percent of all children in cardiac arrest in the prehospital setting. About 60 to 70 percent of people who suffer myocardial infarction (MI) die before they reach a hospital. Most deaths from myocardial infarction occur within 2 hours following the heart attack. Death is usually caused by cardiac dysrhythmia (ventricular tachycardia), in which abnormal heart contractions prevent the normal circulation of blood. Some of the predisposing factors (those factors which make an incident more likely to occur) associated with heart attacks can be controlled. Controlling these factors makes a person less likely to have a heart attack.

a. Major Risk Factors. The four most important factors that predispose to heart attacks are listed below. All of these factors can be controlled.

(1) Cigarette smoking. A person who smokes more than one pack of cigarettes a day is twice as likely to have a heart attack than is a nonsmoker.

 

(2) Elevated (high) blood pressure. A person with a systolic pressure over 150 has more than twice the risk of heart attack (and four times the risk of stroke) than a person with a systolic pressure under 120. A diastolic pressure over 90 also increases the risk of heart attack.

 

(3) Elevated blood cholesterol. A person with a blood cholesterol level of 250 milligrams per deciliter (mg/dl) or higher has a greater risk of heart attack than does a person with normal blood cholesterol level.

 

(4) High fat, high cholesterol diet. A person who eats large amounts of foods that are high in fat and cholesterol runs a greater risk of heart attack than does a person who eats a normal diet.

b. Other Risk Factors. The following are also risk factors that, for the most part, are beyond the person's control.

(1) Age. Older persons are more likely to have heart attacks. About one-fourth of all heart attacks, however, occur in individuals under the age of 65.

 

(2) Sex. Males are more likely to have heart attacks than females.

 

(3) Diabetes. Diabetes increases the risk of heart attack; however, the risk may be lessened through medication and diet.

 

(4) Heredity. A person whose family has a history of cardiovascular disease is at greater than normal risk.

c. Unproven Factors. Some factors which are thought to make a heart attack more likely, but are not yet proven to do so, are:

(1) Obesity.

 

(2) Certain personality types.

 

(3) Stress.

 

(4) Lack of regular exercise (physical hypoactivity).

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