Why heart attacks can happen to anyone

A heart attack can happen even if to those who are relatively young and fit, and genetics can play a role.

Prevention is extremely important, says Arora, and health screenings are a perfect way to find out if people are at risk for heart disease.Heart disease is the No. 1 cause of death in the United States, killing nearly 610,000 people every year. That is one out of every four deaths. High blood pressure, high cholesterol and smoking are key risk factors for heart disease. About half of Americans (47 percent) have at least one of these three risk factors.

University of Alabama at Birmingham physicians say that even people with no obvious risk factors can still have underlying heart disease or heart-related issues. Pankaj Arora, M.D., assistant professor of cardiology, says a person’s heart disease risk is affected by both environment and genetics.

“DNA is not destiny,” Arora said, referencing a recent New England Journal of Medicine Study. “You can lower your risk by staying fit and healthy even if you have bad genes, just as you can raise a low genetic risk by making unhealthy choices.”

Arora says he asks his patients if they might have a family history of heart disease.

“I’ll ask if their mother had a heart attack before 65 or if the father had one before 55,” he said. “If the answer is yes, I’ll ask if the heart attack happened because of lifestyle choices, or if they were living a healthy life and it still happened.”

He says that, if the mother or father was healthy and still had a heart attack, it is possible that one can consider genetic testing to determine genetic risk. Knowing patients are at high genetic risk for heart problems can allow them to be monitored more closely. There are hundreds of known common genetic variants contributing to coronary artery disease. Screening for them can be complicated and confusing, which is why it is not recommended for most people.

“DNA is not destiny. You can lower your risk by staying fit and healthy even if you have bad genes, just as you can raise a low genetic risk by making unhealthy choices.”

A heart attack happens when the blood supply to the heart is cut off. Cells in the heart muscle that do not receive enough oxygen-carrying blood begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart. Every year, about 750,000 Americans have a heart attack. Of these, 550,000 are a first heart attack, and 200,000 happen in people who have already had a heart attack.

Arora says prevention is key, and it is important to get regular health screenings and physicals to ensure a person’s heart health is on track.

“Know your blood pressure and cholesterol levels, especially if you are over 35,” he said. “This is when these invisible risk factors can start to creep up.”

He added that, if any of those levels are not where they should be, that provides patients knowledge about risk and what they should be doing about it.

“Even if you are born with a high genetic risk, your risk of having an event goes down if you keep up a good physical exercise routine,” he said. “Physical exercise, study after study, has shown to improve cardiovascular health and prolong your life, and that has not changed.”