While you are unable change some risk factors, others are under your control and you can change them if you want to.



For instance, you simply cannot do anything about your genes, or the fact that you are getting older, or that other family members have a history of heart disease or high cholesterol.

Some of the important risk factors that you can do something about include alcohol, stress, sleep problems, HRT, smoking and the birth control pill.

Coronary heart disease happens when the arteries that supply blood to the heart muscle become hardened and narrowed by the build-up of plaque on the inner walls, reducing the blood flow. Plaque is an accumulation of fat, cholesterol and other substances.

The consequences are that an artery can become totally blocked, preventing oxygen and nutrients getting to part of the heart. Then you have a heart attack, causing permanent damage to the heart muscle.

It is tempting to believe that surgeons can cure heart disease with a bypass or angioplasty. Certainly, these procedures help blood flow to the heart and take away the pain of angina, but they are no cure. The arteries are still damaged, and your blood vessels will get worse unless you change your habits and do something about the risk factors.

Make the changes gradually, one at a time, but keep going. It is easy to think that doing one thing differently means your risk is greatly diminished. You need to consider doing a range of things to have the best chances of lowering your risk properly.

It depends on how many risk factors you have. If you smoke and have high cholesterol, then you need to do something right now, since your risk of heart disease is real. Start by working on giving up smoking, something easily said but it can be a prolonged and difficult process. Then, once you have sorted that, you can look to lowering your cholesterol.

Stress is a common trigger for heart attacks. An upsetting emotional event, high-pressure work or home environments, uncontrolled anger can contribute to stress. People may turn to overeating, excessive drinking and smoking to try to control their stress, but these do more harm than good.

Stress-management classes and good personal relationships where you can share your troubles and feelings, along with regular exercise are good ways of combating stress. At the same time they lower your risk of heart disease.

Alcohol in moderation has been shown to lower the risk of heart disease. Complete abstinence lowers the risk, too, but research has pointed to moderate consumption protecting against heart disease by raising HDL cholesterol levels. So, if you avoid drink, this is not an invitation to start.

Moderation is the key. It is no more than one drink per day for women, and no more than two drinks per day for men. One drink is about 350ml of beer, 130ml of wine and 50ml spirits.

Heavy drinking causes more problems, by damaging heart muscle leading to heart failure, and a higher risk of heart disease than either non-drinkers or moderate drinkers. Even three drinks a day can raise blood pressure and triglyceride levels, and binge drinking can lead to stroke.

Sleep Apnoea is a serious condition where a sufferer often stops breathing for a short time while asleep. People with this condition are more likely to develop high blood pressure, heart attack, congestive heart failure and stroke.

It tends to develop in middle age, with men being twice as likely as women to suffer. Things such as obesity, smoking, alcohol and taking sleeping tablets contribute to it.

HRT has been shown to increase the risk of heart disease in trials. This does not affect every version of HRT, or every woman, but you and your doctor need to discuss your risks before starting treatment.

Birth Control Pill may worsen the effects of other risk factors including high cholesterol, blood pressure, diabetes, smoking and obesity. Once more, involve your doctor in discussions before you start.