Risk factors of Ischaemic Heart Disease

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Causes of Ischemic Heart Disease

One of the main causes of ischemic heart disease is arteriosclerosis. It consists of chronic inflammation of the arteries that causes hardening and the buildup of cholesterol plaques (atheromatous plaques) on their walls, which promotes the formation of blood clots.

Atherosclerosis can affect all the arteries in the body and cause different symptoms depending on the organ affected. If it occurs in the arteries that supply blood to the brain, it can manifest as a stroke or cerebral vascular accident; if it occurs in the arteries of the legs, it can cause pain when walking, intermittent claudication, or shop window disease; if it occurs in the arteries that supply blood to the heart itself, it can cause angina or myocardial infarction.

Although coronary artery obstruction due to arteriosclerosis is less common in women than in men, there are non-obstructive causes of heart attack and angina pectoris, such as spontaneous coronary artery dissection, coronary spasm, or microvascular dysfunction (altered function of the innermost layer of small arteries or endothelium), among others, which are more prevalent in women.

Risk factors

Cardiovascular disease risk factors are connected to each individual’s personal characteristics, lifestyle habits or other health problems that may damage the arteries and lead to arteriosclerosis. Some of these factors cannot be altered, such as age or sex, but patients must pay special attention to preventing and controlling the remaining factors that they could be alterated. 

The risk factors for ischaemic cardiomyopathy are:

Elderly man with a cane

The chance of suffering an infarction increases with age. This increment is significant in men over 45 years and women over 55. This difference in age-related risk between men and women is due to the favourable influence of female hormones (oestrogens) on blood vessels.

DNA molecule or helix

Genetics. A family history of angina pectoris or infarction (heart attack) can imply a genetic predisposition. If your family background includes men under 55 or women less than 65 years old who have suffered an infarction, then this should be taken into account. If a family member has experienced an infarction at an older age it is most likely due to normal ageing rather than a genetic component. Although family disease parameters or indicators are also taken into account.

Cigarette

Smoking. Smoking is the biggest avoidable cause of disease, disability and death worldwide. It is associated with both heart and lung disease as well as various types of cancer. Smoking increases the risk of major cardiovascular events (e.g. infarction, stroke or death) by 25% in women and there is currently a growing tendency to smoke among young women in our society. Abstinence from smoking is associated with a reduction in the risk of infarction and death; inclusion in smoking cessation programmes have shown to be effective in helping individuals successfully stop smoking and improve their overall health.

Aneroid or manual sphygmomanometer with a warning signal

High Blood PressureThis is a continuous or sustained elevation in blood pressure. High blood pressure causes damage to the walls of the arteries and can accelerate the process of atherosclerosis. This can be achieved avoiding excess sodium in the diet, exercising regularly and properly following treatment to reduce blood pressure. 

Blood collection tube

HypercholesterolemiaYou should monitor the fat levels in your blood using analytical tests. Elevated LDL cholesterol (“bad” cholesterol) or triglyceride levels have been linked to a greater risk of coronary disease. However, a high HDL cholesterol level (“good” cholesterol) offers protection against an infarction. A healthy diet and regular exercise are excellent ways of increasing the amount of “good” cholesterol. 

The current objective for patients who have suffered a cardiovascular event is to reduce LDL to below 55 mg/dl and baseline levels by more than 50%.

Glucometer and a hand with a finger in which the lancet has been inserted to measure diabetes levels.

DiabetesThe increase in blood sugar (glucose) levels has been linked to a higher risk of heart attack. It is important to maintain good blood sugar control, either through oral medication or insulin.

Patients with a cardiac event and diabetes mellitus (DM) may more frequently present with nonspecific symptoms, which can lead to delays in diagnosis and access to treatment. 

Losing weight, following a healthy diet, and exercising regularly can greatly help control blood sugar levels.

A person lying on a sofa or bed representing sedentary lifestyles

Sedentary lifestyle. Sedentary behaviour is associated with increased obesity, high blood pressure, and poorer control of diabetes and cholesterol. Regular physical activity offers many benefits in managing these risk factors. It is recommended to engage in progressive physical activity for 30–60 minutes at least twice a week.

Swollen thyroid gland. Tyroiditis

Hormonal factors. Hormonal imbalance plays a highly significant role in the risk of coronary heart disease for women. For example, during fertility, there are gynaecological problems such as polycystic ovary syndrome and ovarian insufficiency that entail an oestrogen deficit. Around 10% of the female population has polycystic ovary syndrome. These imbalances entail greater risk of metabolic syndrome and cardiovascular disease. Other disorders such as endometriosis, involve higher oestrogen levels which, in turn, can increase risk. Although menopause cannot be considered as a risk factor as such, it is true that it marks a biological transition in women, producing a greater risk of cardiovascular disease due to the loss of the protective effect of oestrogen.

Obesity can be cause and/or risk factor of Rheumatoid Arthritis

ObesityBeing overweight is increasingly common in today’s society and worsens the other risk factors. Even losing just a little weight can be very beneficial for the cardiovascular system. Depending on the location of excess fat, there are two types of obesity: Peripheral (excess fat located in buttocks, thighs and arms) and Central (excess fat concentrated in the abdomen). Excess abdominal fat can double the risk of cardiovascular disease. Central obesity is more common among women than men, particularly affecting those after the menopause.

Cannabis, pills and a syringe

Drugs and other toxic substances. Some drugs, e.g., cocaine or amphetamines, can modify how the arteries work and cause a vascular spasm; the artery contracts and stops the blood flow. Cocaine consumption is a relatively common cause of heart attacks, especially in the younger population.

Person with symbols on the head representing stress, anxiety, confusion, disorientation, headache or migraine

Stress or depression. Stress, whether acute or sustained over time, can initiate hormonal and inflammatory mechanisms that can damage the arteries in the long term. 

Microscope

Other diseases. Preeclampsia during pregnancy or the presence of autoimmune diseases can increase the risk of suffering a heart attack over the years.

Factory with a smoky, polluting chimney

Environmental factors. Air pollution increases the risk of coronary heart disease, heart failure, arrhythmias, cerebrovascular disease and pulmonary thromboembolism. Legislative measures and environmental strategies are necessary to reduce the effects of climate change in health, as well as promote green spaces.

Substantiated information by:

Judith Saura Araguas
Manel Sabaté Tenas
Marta Farrero Torres
Marta Parellada
Mercè Roqué Moreno
Rut Andrea Riba

Published: 20 February 2018
Updated: 9 June 2025

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.

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