Fixed versus changeable
A cardiovascular risk factor is anything that raises your chance of heart disease. The most important first step is sorting them into two piles. Non-modifiable factors are fixed: older age, being male (men develop disease earlier on average), and a family history of early heart disease — for example a father or brother with a heart attack before 55, or a mother or sister before 65.
You cannot change those — but they are not your destiny. They simply tell the doctor to watch the *other* pile more closely. The modifiable risk factors are the ones you and your doctor can actually move, and they do most of the work.
The big modifiable five
- High blood pressure — hypertension strains artery walls and accelerates plaque. Often silent, so it must be measured.
- Abnormal cholesterol — dyslipidemia, especially high LDL, supplies the raw material for plaque. Covered in detail in the next guide.
- Smoking — damages the artery lining and makes blood clot more easily. Quitting is the single most powerful change most smokers can make.
- Diabetes — high blood sugar damages vessels throughout the body and is treated as a major heart-risk condition in its own right.
- Excess weight and inactivity — obesity and low physical activity feed all of the above and cluster together as metabolic syndrome.
Why this framing matters
Sorting factors this way turns a vague worry into a concrete plan. You stop asking “am I doomed by my genes?” and start asking “which of my changeable factors gives the biggest payoff if I act on it?” For most people, blood pressure, cholesterol, and not smoking are where the largest, most reliable gains live.