Risk Factors

At the University of Ottawa Heart Institute, you have received the best available cardiac care to treat and manage your heart condition, but your heart disease is not cured.

Heart disease is a chronic health condition and, like any health problem, it can bring uncertainty and changes into your everyday life.

You can respond to these changes in different ways. Research tells us that learning about your risk factors, taking charge of your heart health, and staying involved in your health and health care will help you to continue to do the things that you wish to do.

The following three-step plan will help you learn to take care of your heart and preserve your health:

Step 1 Get to know your own risk factors and plan how to manage them. Use the Modifiable Risk Factors table to help you to identify your risk factors and think about how you might set some health goals.
Step 2 Participate in a Cardiac Rehabilitation Program. Work with specialists in nutrition, physical activity, stress management, return-to-work counselling, and other social and emotional services to develop a plan that is tailored to your specific needs.
Step 3 Learn how to live and work with heart disease. Use the information here to help you get through the normal bouts of anxiety and emotional ups and downs so that you can renew your sense of well being.

Causes of Heart Disease

Coronary artery disease is caused by a combination of genetic and lifestyle factors. These are called risk factors.

The following risk factors are important to be aware of but are not considered to be controllable:

  • Your age
    • As you get older, your risk of heart disease increases
  • Your gender
    • Men over the age of 55 are at higher risk of heart disease
    • After menopause, a woman’s risk of heart disease gradually becomes the same as a man’s
  • Your heredity
    • Your risk of heart disease is increased if close family members—a parent, brother or sister—developed heart disease before age 55 or, in the case of female relatives, before menopause.
  • Your ethnicity
    • First nations people and people of African or Asian descent are at higher risk of developing heart disease

The risk factors that you can control are:

  • Smoking
  • Excess body weight, especially around your waist
  • High blood pressure (hypertension)
  • Abnormal blood cholesterol levels
  • Lack of regular exercise
  • Glucose control, prediabetes and diabetes
  • Excessive stress levels
  • Depression

These are referred to as modifiable risk factors.

Modifiable Risk Factors for Heart Disease

Risk Factor Target Goals Information


No exposure to second hand smoke





Ideal range: BMI of 18.5 – 25
If your BMI is 30 or above, aim for a 5 – 10% reduction of your total body weight.


Women: Below 35 in (88cm)
Men: Below 40 in (102 cm)

Heart Healthy Nutrition


Weight Management

High Blood Pressure

Less than 140/90 in your doctor’s office and less than 135/85 at home

If you have diabetes or kidney disease: less than 130/80 in your doctor’s office and less than 125/75 at home

Heart Healthy Nutrition


Blood Pressure


Safe Medications

High Cholesterol

Total Cholesterol: below 4.0 mmol/L
HDL Cholesterol: above 1.0 mmol/L
LDL Cholesterol: below 2.0mmol/L
Non-HDL Cholesterol: below 2.6mmol/L
Triglycerides: below 1.7mmol/L

Heart Healthy Nutrition



Physical Inactivity

Aim for 30 to 60 minutes of moderate exercise (example: brisk walking) on most days of the week

Healthy Physical Activity

If you have Diabetes

Fasting blood glucose and before meals: between 4.0 and 7.0 mmol/L

A1C: 7% or less

Heart Healthy Nutrition



If you have Prediabetes

Fasting blood glucose and before meals: 4.0 and 6.0 mmol/L

A1C: less than 6.0%


Manage stress



Manage depression




How Smoking Affects Your Heart

The nicotine in smoke causes the arteries of the heart to narrow. The carbon monoxide released from cigarettes causes damage to the walls of the arteries encouraging the build up of fat on those walls.

Smoking also:

  • Raises your LDL (lousy) cholesterol
  • Lowers your HDL (healthy) cholesterol
  • Speeds up your heart rate
  • Increases your blood pressure

Smoking after a heart attack or angioplasty greatly increases the chances of a second heart attack and/or restenosis (re-blocking) of the coronary arteries.

If You Smoke, Quit!

  • Quitting smoking is the single most important thing you can do to positively affect your heart health.
  • The benefits of quitting occur within 20 minutes of your last cigarette and at one year your risk of a heart attack is reduced by 50%.

The Heart Institute’s Quit Smoking Program is available to all smokers who are interested in quitting.

We use proven techniques and individualized counselling to help people quit. To register for the Quit Smoking Program, please call 613-696-7069. There are other options for quitting smoking in our region. It is up to you to decide which option is best.

Keep in mind this one important tip: most people find that the more support they get while trying to quit, the better.

More Information about Quitting Smoking

High Blood Pressure

Checking your own blood pressure at home
Click to enlarge (pdf)

How High Blood Pressure Affects Your Heart

High blood pressure makes your heart work harder, damages your blood vessels, and can also cause greater plaque build-up. All these factors eventually lead to heart damage. Controlling your blood pressure can reduce the progression of your heart disease and may reduce your risk of having a stroke.

To control your blood pressure:

  • Aim to make healthier food choices
  • Reduce intake of foods higher in sodium
  • Achieve and maintain a healthier body weight
  • Be active every day and follow your physical activity plan
  • Practice stress management techniques that work for you
  • Take your medications as prescribed
  • Become smoke free

More Information about High Blood Pressure

High Blood Cholesterol

Cholesterol and your heart infographic
Click to enlarge (pdf)

How Cholesterol Affects Your Heart

Cholesterol is a fat-like substance that is produced mostly in your liver, although some of the cholesterol in your blood comes from the foods you eat.

The most important types of cholesterol in your blood are:

  • Low density lipoprotein cholesterol or LDL
  • High density lipoprotein cholesterol or HDL

L is for “Lousy”:

  • LDL cholesterol carries fats to your body organs to be stored away for future use.
  • It causes a build-up of cholesterol (plaque) on the walls of the arteries in your heart.
  • High levels of LDL can damage artery walls.
  • Eating heart healthy can help lower your LDL.
  • Maintaining a healthy weight can lower your LDL.

H is for “Healthy”:

  • HDL cholesterol is good because it carries excess fats away from your body organs for elimination.
  • The more HDL you have in your blood, the better protected you are against the build-up of plaque in your arteries.
  • Regular exercise and quitting smoking can help increase HDL.

How You Can Improve Your Cholesterol

  • Be aware of your cholesterol levels
  • Aim to make healthier food choices
  • Achieve a healthy body weight (see Appendix 2 - Rate Your Weight)
  • If you smoke, stop (see Smoking)
  • Be active every day and follow your Physical Activity Plan (see Physical Activity)
  • Attend a nutrition workshop (see More Information about Heart Healthy Nutrition)
  • Take your cholesterol medications as prescribed by your doctor

More Information about Cholesterol

Web Sites

If You Have Prediabetes or Diabetes

How Glucose Affects Your Heart

Type 2 diabetes is a progressive disease. Up to 10 years before diagnosis, insulin resistance occurs causing blood glucose levels to rise particularly after meals (Prediabetes). This can lead to insulin deficiency. Insulin is a hormone that unlocks our body’s cell doors so that glucose can be taken up as fuel. These abnormalities lead to an inflammatory response in the vessel wall which favour growth of the atherosclerotic plaque and may cause instability and plaque rupture.

Keeping Your Blood Sugar Levels Healthy

  • Take your medications as prescribed
  • Learn about managing glucose by attending a diabetes education program (see More Information below)
  • Monitor and keep track of your blood sugars
    • Target: blood glucose before meals between 4.0 and 7.0 mmol/L
    • Target: blood glucose two hours after meals between 5.0 and 10.0 mmol/L
  • Aim to make healthier food choices
  • Be active every day and follow your Physical Activity Plan (see Physical Activity)
  • Achieve and maintain a healthy body weight (see Appendix 2 -  Rate Your Weight)
  • Visit to your family doctor or diabetes specialist regularly

Additional Meal Planning Tips

  • Eat regular meals. Aim to eat every four to six hours. Include a healthy snack if meals are more than four to six hours apart.
  • Eat breakfast.
  • Limit sugars and sweets such as sugar, regular soft drinks, fruit drinks, desserts, candies, jam, syrup and honey.
  • If you are thirsty, drink water or sugar free drinks. Drinking regular soft drinks, sweetened drinks or fruit juices will raise your blood sugar level. If you have a condition requiring fluid restriction, follow your personalized recommendations.
  • More information in the Heart Healthy Eating section,

More Information about Diabetes

It’s natural to have questions about what food to eat. A registered dietitian can help you make healthier food choices. If you have diabetes and are taking insulin, speak with your family doctor. You may need to see an endocrinologist (a doctor specializing in diabetes).

Community Diabetes Education Program of Ottawa

  • For adults with prediabetes or type 2 diabetes who are controlled with diet, pills or just starting insulin; no major health problems related to their diabetes
  • Teaching is also available for people with prediabetes
  • Group and individual sessions on healthy eating, getting active, testing blood glucose, stress and emotions, delaying or preventing complications and foot care
  • In English, French and other languages
  • Online self referral can be accessed at Diabetes Ottawa or call 613-238-3722

Diabetes Education Programs (Outside Ottawa)

  • To locate a diabetes education program near you, see Diabetes Canada at 1-800-BANTING (226-8464) or at info@diabetes.ca


  • The Complete Diabetes Guide for Type 2 Diabetes, Karen Graham RD CDE 2011

Web sites