New risk factors for heart disease

Just about everyone knows that genetics, weight and diet play a critical role in heart disease. But now research has pinpointed new risk factors that can affect our heart health.

Dr. Beth Abramson, director of the Cardiac Prevention Centre at St. Michael's Hospital, joined Balance Television host Dr. Marla Shapiro to talk about these new risk factors.

Abramson quickly pointed out the already well-known risk factors for heart disease, all of which still apply despite the new factors recently discovered.

• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Family history of heart disease -- having a woman in the family with heart disease before the age of 65 or a man before the age of 55 (close relative, such as a parent or sibling)

New Risk Factors

Waist circumference
"We know that when you have increased weight across the belly, your metabolism is slightly different; it puts off the cholesterol, it makes the blood pressure a little higher, it gives you a tendency to diabetes -- we call that metabolic syndrome," Abramson said. "The truth is that lifestyle, in addition to diet and exercise, can improve all these increased risk factors that we now know to be so important."

The body processes that fat differently, she said. A slim person with a little beer belly (apple shaped) is at greater risk than many women who put on weight across the hips (pear shaped). She warned that being a large pear shape with plenty of weight across the belly area is still a danger.

C-reactive protein (CRP)
Heart disease develops for many reasons, Abramson said. In addition to those risks already discussed, inflammation in the body and the blood vessels is important. The catch, she said, is that we can reduce that inflammation, or C-reactive protein, by losing weight, by exercising, by cutting down on some of the fat in our diet and not smoking.

To assess your risk for heart disease, visit your healthcare provider. By checking all the various factors, such as age, blood pressure and cholesterol, they can add up all the factors and determine a level of risk.

Diabetes
Interestingly, diabetes is what's called a risk equivalent. If you've had your first heart attack or you have diabetes without having had a heart attack, your risk is the same. It's as if you had heart disease, Abramson said. There are some very important medications, in addition to lifestyle and diet, that diabetics and people with heart disease should be on.

Blood pressure
People and doctors need to be retrained, she said, because what we though was a normal blood pressure many years ago is now actually considered a higher normal blood pressure.

"We actually have to start thinking that the lower the blood pressure the better," Abramson said. "You can't have too low a blood pressure if you're feeling well, if you're not dizzy, not fainting or light-headed."