Cardiovascular disease encompasses a wide range of conditions, and includes conditions that affect the heart and the blood vessels.

Cardiovascular disease is the number one cause of death in the United States. Many risk factors are associated with cardiovascular disease and most can be managed with lifestyle and medical interventions, but some cannot. The aging process and genetic factors (hereditary or family predisposition) are risk factors that cannot be changed. Until age 50, men are at greater risk of developing heart disease than women, though menopause increases a woman’s risk, up to as much as three times the risk prior to menopause.

Many people with cardiovascular disease have elevated or high cholesterol levels.¹ Low HDL cholesterol (known as the “good” cholesterol) and high LDL cholesterol (known as the “bad” cholesterol) are more specifically linked to cardiovascular disease than total cholesterol.² A blood test, administered by most healthcare professionals, is used to determine cholesterol levels.

Atherosclerosis (hardening of the arteries, often affecting those that supply the heart with blood) is the most common cause of heart attacks. Atherosclerosis and high cholesterol usually occur together,³ though cholesterol levels can change quickly and atherosclerosis generally takes decades to develop.

The link between high triglyceride levels and heart disease is not as well established as the link between high cholesterol and heart disease. According to some studies, having high triglyceride levels is an independent risk factor for heart disease in some people.⁴

High homocysteine levels are not consistently associated with cardiovascular disease risk,⁵ but according to some studies, homocysteine levels have been identified as an independent risk factor for heart disease.⁶ Homocysteine can be measured by a blood test that must be ordered by a healthcare professional.

Hypertension (high blood pressure) is a major risk factor for cardiovascular disease, and the risk increases as blood pressure rises.⁷ Glucose intolerance and diabetes constitute separate risk factors for heart disease. Smoking increases the risk of heart disease caused by hypertension.

Abdominal fat (central adiposity), or a “beer belly,” versus fat that accumulates on the hips, is associated with increased risk of cardiovascular disease and heart attack.⁸Overweight individuals are more likely to have additional risk factors related to heart disease, specifically hypertension, high blood sugar levels, high cholesterol, high triglycerides, and diabetes. Per criteria agreed upon by the International Diabetes Federation; NHLBI; AHA; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity, the presence of three or more of the aforementioned symptoms is a diagnosis of metabolic syndrome. Below is the specific criteria for a diagnosis of metabolic syndrome:

• Central or abdominal obesity (measured by waist circumference):
  • Men - 40 inches or above
  • Women - 35 inches or above
• Triglycerides greater than or equal to 150 milligrams per deciliter of blood (mg/dL)
• HDL cholesterol:
  • Men - Less than 40 mg/dL
  • Women - Less than 50 mg/dL
• Blood pressure greater than or equal to 130/85 millimeters of mercury (mmHg)
• Fasting glucose greater than or equal to 100 mg/dL