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Am Fam Physician. 2010;82(3):275

See related article on coronary heart disease

What is a heart attack?

A heart attack (also called a myocardial infarction [MY-oh-CARD-ee-ul in-FARK-shun]) happens when part of the heart does not get enough blood. Fats build up in the blood vessels and block the blood supply to the heart. This is called coronary artery disease or coronary heart disease (CHD).

Am I likely to have a heart attack?

Several things can increase your risk of a heart attack. Some things, such as your age and sex, cannot be changed. But others, such as high blood pressure and high cholesterol, can be treated.

Major risk factors for CHD include diabetes, high blood pressure, high cholesterol, male sex, older age, smoking, and a father who had a heart attack before 55 years of age or mother who had a heart attack before 65 years of age.

Several online calculators can estimate your risk of a heart attack. One of these is available at http://www.med-decisions.com/H2HV2/. To use this calculator, you need to know your blood pressure and cholesterol levels, and whether you have diabetes. After you enter your information, it estimates your risk of having heart-related chest pain, having a heart attack, or dying within the next 10 years. It also tells you if your risk is higher than other people your age.

What can I do to lower my risk?

Eat a healthy diet, exercise, and maintain a healthy weight. If you smoke, you should quit. Your doctor can help you with quitting. If you have high blood pressure or high cholesterol, your doctor can give you medicine to lower it. For some people, taking an aspirin every day can reduce the risk of a heart attack. Your doctor can help you decide whether taking aspirin is right for you.

Before you decide to take medicine to help with your risk factors, you and your doctor need to find out how likely you are to have a heart attack. Then you can talk about how much the medicine is likely to lower your risk. For example, if your risk is very low, taking an aspirin every day may do more harm than good.

Where can I get more information?

Your doctor

American Academy of Family Physicians

American Heart Association

National Heart, Lung, and Blood Institute

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