Causes of Most Heart Attacks Found

Previously, researchers thought that only about half of heart attacks were explained by risk factors such as smoking or cholesterol. But now they say that the cause of almost all heart attacks can be pinpointed to one or more of the following:

• Smoking
• Abnormal cholesterol
• Diabetes
• High blood pressure
• Stress
• Abdominal obesity
• Sedentary lifestyle
• Eating too few fruits and vegetables
• Abstaining from alcohol

These risk factors are equal-opportunity killers -- black or white, Asian or American, young or old, man or woman -- all can fall victim by these same risks. Diet, exercise, and moderate consumption of alcohol can decrease risk of heart disease, but cannot reverse the potential danger posed by risks such as high cholesterol or smoking.
Studies have shown that men who drink up to two alcohol drinks a day and women who drink up to one a day have a lower risk of heart disease. One drink is generally considered to be four to five ounces of wine, a 12-ounce beer, or 1 ounce of liquor.

Bigger Waist, Bigger Risk

Rather than relying on body mass index (BMI), the researchers took waist measurements. A waist circumference of more than 80 centimeters (32 inches) in women and more than 85 centimeters (34 inches) in men increased risk. Measuring the waist is a better predictor of heart attack risk because "it is a measure of abdominal fat, which is the type of fat that is most closely associated with heart attacks."

Diabetes

Some people believe that they need to have been born with diabetes for it to be a factor; but in fact, a person can get type two diabetes. Type two diabetes usually comes about when a person is very much overweight, particularly because of their diet. Too many people have a fondness for junk food, and junk food has a hefty amount of sugar in it. Eating too much sugar not only makes considerable weight increase, it also increases the level of sugar in the blood, which results in type two diabetes.
For people that have type two diabetes owing to years of eating junk food, heart disease is the next thing that typically happens. The fat from this food is absorbed into the blood flow, and over time the fatty substances build up in the arteries. Some people end up with arteries that are so blocked that they need bypass surgery.

Hypertension or high blood pressure

Hypertensive heart disease is on the whole a more serious and dangerous form of heart disease and it is normally caused by uncontrolled and extended elevation of blood pressure, as this can lead to various changes in the myocardial structure, coronary vasculature, and conduction system of the heart. 
Heart failure is a common complication of hypertensive heart disease, and it is often unrecognized, partly because of how at the time that heart failure develops, the dysfunction heart is unable to create the high blood pressure, which results in obscuring the etiology of the heart failure. 

Bigger Cholesterol Is Better

cholesterol size also plays a role in determining risks. Smaller, denser cholesterol molecules increase the risk of heart disease; these can more easily invade the artery wall causing inflammation and atherosclerosis plaque. The higher the amounts of smaller and denser particles, the higher the risks relative to larger cholesterol particles.
this factor alone may increase the risk of heart attacks by as much as 54%. Yet when a smoker has a bad lipid ratio (smaller to larger particles) "that combination accounts for two-thirds of heart disease."
In the study researchers measured particles which carry cholesterol in the blood called apoproteins. The ratio of apoliprotein B (which carries "bad" LDL cholesterol) and apoliprotein A-1 (which carries "good" HDL cholesterol) is a much simpler test.People at the highest risk for the ApoB/Apo A-1 ratio increased their risk of heart attack by 54%.

Risk Rises with One Cigarette

Second on the nine-item list is smoking which was associated with a 36% increased risk of heart attack which increases with the first cigarette. Smoking one to five cigarettes a day increases heart attack risk by 40% compared with nonsmokers. Smoking 20 cigarettes a day (one pack) is associated with a fourfold increased risk of heart attack and smoking two or more packs a day "is associated with a ninefold increased risk.
Moreover, while a daily low-dose aspirin can protect the heart, "smoking three cigarettes can wipe out the protective effect of aspirin and wipe out two-thirds of the protective effect of [cholesterol-lowering drugs]".

Stress Effect Stronger Than Thought

Stress is most dangerous when it is described as "permanent" and when stress is constant whether at home or at work. Moreover, people who say they have little control on the job or in the home are more likely to suffer stress-related heart disease.
Rounding out the list of risk factors were diabetes, high blood pressure, sedentary life style, and a diet that doesn't include generous servings of fruits and vegetables. On the positive side, a good diet, regular exercise, and moderate alcohol intake did reduce the risk of heart disease -- again the reduction was the same regardless of race or ethnicity.