A doctor named Salim Yusuf says there are nine risk factors that account for 90% of all heart attacks. And, we can do something about most of them.

The risk factors include:

* Smoking
* Abnormal cholesterol
* Diabetes
* High blood pressure
* Stress
* Abdominal obesity
* Sedentary lifestyle
* Eating too few fruits and vegetables
* Abstaining from alcohol


A report on CBS News.com's WebMD, says the factors are "equal-opportunity killers," all races, sexes and ages of people can fall victim to these same risks. The study included 30,000 people -- half were first heart attack survivors and half were healthy volunteers of similar ages, races and genders of the heart attack victims.

Generally, they found out
* The bigger the waist, the bigger the risk.
* The bigger the cholesterol particles, the bigger the risk.
* Smoking and a bad lipid ratio accounts for 2/3 of heart disease.
* Smoking alone increases heart attack risk 36%.
* Smoking 3 cigarettes a day wipes out the ptotective effect of aspirin.
* Smoking 3 cigarettes a day wipes out 2/3 of the protective effect of cholesterol lowering drugs.
* Stress doubles the risk of a heart attack.
* A good diet (vegetables & fruit), regular exercise and moderate alcohol intake reduce the risk of heart disease.

Of course diabetes and high blood pressure are factors that are harder to control. However, most people can have their hypertension controlled with medication and diabetes can respond well to weight reduction and dietary changes.

Something I cannot emphasize enough is that many people do not know they have hypertension until it is too late, especially if they are relying on a normal BP finding during physical exams or while getting the BP checked at the pharmacy or supermarket. I always had normal, or even low BP until my cardiologist checked it while I was squeezing a grip testing instrument in my extended right hand for about a minute. My BP shot from 120/70 to 140/110!

I had been having chest tightness (unstable angina) on exertion for months. Little did I realize it was caused by my high blood pressure, even when I would walk as little as four blocks, I would get the chest tightness. My cardiologist put me on Meapropolol, Modiuretic and Monopril starting in June. The anginal pain has disappeared and I am able to do all my normal activities, including mowing my very large yard with a walking mower this morning.

So if you are having angina pain and you don't think you have high blood pressure, ask the doctor to take it while you lay on your back, with your right arm extended in the air squeezing a small rubber ball as hard as you can. Ylou may be very surprised!

Dr. Yusuf is quite wrong in excluding heredity from his risk "theory."

Have they drawn a line on what is acceptable alcohol consumption? And what type of alcohol? I doubt that beer is beneficial. Or is it?

I'm not surprised at the statistics on smoking. It's the worst thing you can do for your health. Not only for cardiovascular disease, but all cancers as well. I've had uncontrolled hypertension (150/85) since I was a kid (mostly anxiety related). I'm now 27, and it's starting to worry me quite a bit because of all the bad stuff that long term hypertension can do. But the first thing my doc asked me was "Do you smoke"? I said "no", so he said not to worry about a thing.

My mother in law has never had a problem with cholesterol, nor has she had any BP problems. However, she has smoked her whole life. That single factor caused her to need a triple bypass at the age of 45.

Smoking ain't good folks.

Also, I am reading more and more studies that show that pulse pressure is probably more important than the BP measurements themselves. In that case, your BP of 140/110 would be more beneficial than your BP of 120/70. But at this point, nobody can agree on BP issues. Heck, the Wal-Mart & pharmacy BP machines in my home town still show 140/90 - 159/94 as "normal-high" hypertension. It would be nice of them to change the stickers! Who knows, maybe they'll go back to these standards after finding out that low blood pressure causes cancer or something. Hee hee.

Thanks for the stats!

Interesting, but to throw something else into the melting pot, how about the incompetence of the medical profession!

My husband had a major heart attack in March this year. He was very overweight and a Type II Diabetic. He was also a taxi driver (sedentary job). Ah-ha I hear. Overweight, lazy, eats too much junk food. Maybe even drinks too much!!! Apart from being overweight, wrong on all counts!

The first thing the doctors at the hospital said to him when the blood tests came back were "Do you know you have an underactive thyroid?" No. He didn't know, yet his mother had an underactive thyroid and his 22 year old son has too. He is a man who very seldom drinks, eats sensibly, lots of veg etc. and walked whenever possible. He has been put through medicals for his job and passed them all. Didn't have high blood pressure or anything like that.

The docs reckoned he's probably had underactive thyroid most, if not all of his life - he was 18st at age 16. They told him the underactive thyroid had made him put on weight, which in turn made him diabetic (dietary controlled) and ultimately led to the heart attack. Even when he was told he was diabetic, not one of these so-called "medical professionals" had the brain-power to order a thyroid test, especially because he was overweight and the symptoms he had pointed to thyroid trouble (this incidentally was before we met).

If only one of the doctors that had seen him had thought "Hmm, there could be a hormone problem here" instead of seeing him as a fat, lazy pig of a taxi driver he might not have had a heart attack.

If I sound bitter, then perhaps I am. I'm watching my beloved husband suffer because he can no longer provide properly for his family and it's destroying him emotionally. He's only just turned 50 and hasn't worked since March. Worse still, although non of us know how long we'll live, his life expectancy has probably been cut short and what for? Because our wonderful medical profession couldn't be bothered to do a simple blood test. By the way, we're in the UK.

Fiona