One out of five people at risk of a heart attack don’t change their behaviors

A study conducted on more than 45,000 people published this week in the Journal of the American Heart Association found that almost 20% of those with at least five out of nine modifiable risk factors for heart disease, didn’t think they needed to make any healthy lifestyle changes.

Summary of the study is at:
Complete journal article:

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First of all, let’s clear up what a risk factor is. A risk factor is something that increases your chances, i.e. risk, of developing a disease. With all other things being equal, if you have heart disease risk factors, the chances of you developing heart disease or having a heart attack are greater than someone who doesn’t have them.


Heart disease risk factors are broken down into two categories, non-modifiable (not changeable) and modifiable (changeable).The non-modifiable ones are those things we can’t do anything about – our age, genetics/family history, gender, race.

Modifiable risk factors we can do something about. They are the ones related to our lifestyles and the ones in the research above. There are nine modifiable

  • smoking
  • high blood pressure
  • diabetes
  • abdominal obesity
  • high stress levels
  • less than five fruits and vegetables a day
  • more than four alcoholic drinks a week
  • physical inactivity
  • elevated lipoprotein levels


Making the lifestyle changes to address these risks can reduce your chances of a heart attack. It means taking responsibility for your health and doing all you can to prevent a heart attack in the first place rather than relying on a bypass or stent after the fact. It’s just like making sure you put gas in your car when it gets low. You don’t want to run out of gas and risk damaging the fuel pump. Yes, the fuel pump can be replaced, but at a cost much greater than simply filling up.

Albeit, putting gas in your car is a whole lot easier than changing the way you live!In fact, more than half of the study participants said lack of will power, work schedule, and family responsibilities stopped them from making the changes they knew they should make.

But, any step toward making those changes is better than no step at all. So, to reduce your heart attack risk:

  • Start with one behavior

Trying to change everything at once is overwhelming and leads to nothing changing
Choose something small for starters – maybe just adding a salad to dinner every night, or walking for 10 minutes after lunch.

  • Be specific and realistic about what you want to accomplish

I want to lose 20 pounds over the next 5 months (1-2 pounds a week) is specific and realistic.
I want to be a different size by the end of the week - is neither specific nor realistic.

  • Do some research into the different options for changing the behavior

If you want to quit smoking you can go cold turkey, use a nicotine patch, take medication and/or get hypnotized.

Increasing physical activity doesn’t only mean joining a gym, you could walk more for starters.

  • Make preparations for your change

If you’re going to increase fruit and vegetable intake, you need to buy fruits and vegetables.
If you’re going to try to reduce your stress, it might mean finding a yoga class that meets at a convenient time.

  • Write down one aim or goal for the first week

Make it something you can accomplish –

For example - My aim for this week is to:

  • not drink alcohol on Wednesday
  • have fruit during my coffee break
  • get my clothes ready the night before


  • Pick a change start date

Once you have everything in place, decide on when you’re going to start the change.

  • Get others around you on board to help

Don’t try to go it alone. You need all the help you can get from family and friends. Tell people you are quitting smoking, cutting back on drinking, walking more, etc.

  • Remember this is not a quick fix, this is a lifestyle change

It took you a long time to develop the unhealthy behaviors, it will take time to change them. Keep in mind that change is a process that doesn’t happen overnight. This is not a race, it’s more like a stroll in the park.

For more information see:

Harvard Health Publications

American Psychological Association

Centers for Disease Control – Diabetes Lifestyle Change


Note: Associates for Health Education and Behavior specializes in lifestyle behavior change for heart disease risk reduction. Working with each client as an ‘associate,’ together we develop a custom behavior change plan that reflects the unique life situation each person brings to the table.

Joanna Hayden, PhD, CHES is the principal of Associates for Health Education and Behavior, LLC, in Sparta, a practice focused on improving health through education. Her office offers individual and group health education, and individual health behavior change guidance.  For more information please see  To contact Dr. Hayden, email her

The opinions expressed herein are the writer's alone, and do not reflect the opinions of or anyone who works for is not responsible for the accuracy of any of the information supplied by the writer.

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