What’s your risk of coronary heart disease?

Can you lower that risk?

Coronary heart disease refers to conditions that adversely affect your heart's structure and function. It accounts for about 30 percent of all deaths globally and 80 percent of cardiovascular disease deaths in developed countries. A decade and a half ago, European researchers in the INTERHART study identified nine modifiable risk factors that explained 90 percent of acute heart attacks globally (assuming that the risk factors were causative). More recently, other researchers developed a simpler INTERHART modifiable risk score, which included just six risk factors, based on an international population (average age 57 years) at low risk for cardiovascular disease.

The risk factors include 1) age (risk increases for older people, especially men); 2) apolipoprotein B:A1 ratio (the relative concentrations of bad (apolipoprotein B) and good (apolipoprotein A1) blood fats replaces LDL- (bad) cholesterol and HDL- (good) cholesterol concentrations as the best blood fat marker; 3) smoking (don’t do it); 4) second-hand smoke (avoid if possible); 5) diabetes (you can largely prevent it with Keep Moving and Eat Better); and 6) high blood pressure (you can largely prevent it with Keep Moving, Eat Better, and Defuse Chronic Stress).

Answer the following questions and the add the six associated score numbers to get your coronary heart disease risk score.

1) Age: Are you a man 55 years or older or a woman 65 years or older? If yes = 2 points, if no = 0 points.

2) Apolipoprotein B:A1 ratio: Is your ratio less than 0.633? If yes = 0 points. Between 0.633-0.792? If yes = 2 points. Between 0.792-0.983? If yes = 3 points. Greater than 0.983? If yes = 7 points. Because the apolipoprotein B:A1 ratio is relatively new, you probably don’t know your ratio. Your health care provider can draw a blood sample (no fasting necessary) to find your ratio.

3) Smoking: Never smoked? If yes = 0 points. Stopped smoking more than 12 months ago? If yes = 2 points. Current smoker of 1-5 cigarettes / day? If yes = 2 points. Current smoker of 6-10 cigarettes / day? If yes = 4 points. Current smoker of 11-15 cigarettes / day? If yes = 6 points. Current smoker of 16-20 cigarettes / day? If yes = 7 points. Current smoker of 20 cigarettes or more / day? If yes = 10 points.

4) Second-hand smoke exposure over the last 12 months: None or less than 1 hour per week? If yes = 0 points. One or more hours per week? If yes = 2 points.

5) Diabetes: Do you have diabetes? If yes = 6 points. If no = 0 points.

6) High blood pressure: Do you have high blood pressure? If yes = 5 points. If no = 0 points.

The total risk score ranges from 0-32 points, with more points denoting higher risk. Each 1-point increase in risk score predicts a significant 12 percent increase in acute heart attack. Looked at another way, participants with scores of 10 or higher had a significant 5.7-fold higher risk of an acute heart attack compared to participants with scores of 0-4. That’s a huge difference!

So what can you do to limit your risk of dying of a heart attack? Results from this study suggest that if you adopt the healthy lifestyle choices of Keep Moving, Eat Better, and Defuse Chronic Stress (and don’t smoke and avoid other peoples’ smoke), you’ll drastically reduce your risk of a heart attack.