Risk factors like genetic make-up may not be in one's control but other aspects are. So start now to improve your heart health.

A 30-year-old man came to the emergency room with mild chest pain and vomiting. Initial diagnosis was indigestion but detailed investigations showed that he'd had a heart attack. Echocardiography and coronary angiography proved that blocks in all major coronary arteries. The patient was a smoker with a sedentary lifestyle, stressful working conditions as well as positive family history for heart illnesses. This is becoming a routine scene in India as younger patients are showing signs of cardiac problems.

Major risk factors

Coronary artery disease, the most common form of cardiovascular disease, is the leading cause of death in adults. Risk factors are divided in to two categories: major and contributing. Major risk factors are those that have been proven to increase risk of heart disease. Contributing risk factors are those that doctors think can lead to an increased risk. But their exact role has not been defined. This calculation is very simple: the more the risk factors, more the chances of getting disease.

Hypertension: Resting blood pressure is between systolic 120-130 mmhg and diastolic 70-80 mmhg. Once the pressure starts to rise, chances of heart disease and stroke increases.

High cholesterol levels: Cholesterol, a fat like substance carried in the blood, is found in all cells. The liver produces the cholesterol required to form cell membranes and to make certain hormones. Extra cholesterol comes from foods like meats, eggs and dairy products. Foods rich in saturated fat, like butter, red meat and coconut oil tend to raise cholesterol levels. High levels of LDL and low levels of HDL are bad news.

Diabetes: Certain racial and ethnic groups (Asians, Africans, Native Americans) have a greater risk of developing Diabetes. Sixty-five per cent of all diabetes patients die because of some form of cardiovascular disease. Diabetes has a strong correlation with major cardiac illnesses.

Obesity: Extra weight leads to hypertension, high cholesterol, Diabetes and in turn CAD. Using the BMI formula, BMI >25 is Over weight, >30 is Obese.

Smoking: Most people know smoking is related to lung cancer but do not realise that it is a major risk factor for cardiac and peripheral vascular disease too. Smoking causes fast heart rate, tightening in major arteries, high blood pressure and stroke.

Physical inactivity: A sedentary life is becoming the norm. Truncal obesity is a known risk factor for CAD as it is related to less physical activity. Thirty minutes of daily exercise at least thrice a week will help keep the heart healthy.

Gender: Men are at a higher risk than women.

Heredity: Heart disease runs in families.

Contributing factors include stress, birth control pills, binge drinking.

Good news

The good news is that some risk factors can be modified; unfortunately others can't. Indian food involves a lot of oil and butter. So choose the healthiest oil, use less of it and avoid fried stuff.

A blend of soybean and canola oil contains the least amount of saturated fatty acid. Olive and sunflower oil contains 80 per cent of polyunsaturated and 14 per cent monosaturated fatty acid. In contrast butter and coconut oil contain 90 per cent of saturated fatty acid. Canola oil is an excellent source of Omega-6 fatty acid, which is good for cardiovascular system

People can't change their genetic make-up but things like diet, exercise habits, stress levels, obesity control, alcohol intake and smoking are within one's control. Another must is to go for regular check-ups after age 40. It is never too late or too early to begin improving heart health.

The writer is a cardiologist based in New Delhi.