Heart disease is the leading cause of death in the US, and research shows people with specific blood types are at higher risk of heart attack and heart failure—in certain cases, up to 51% more likely to experience serious health conditions. Blood types A, B, and AB have an 8% higher chance of heart attack, 10% increased risk of heart failure, 51% increased chance of deep vein thrombosis, and 47% more likely to develop a pulmonary embolism. But why is this the case? Dr. Douglas Guggenheim, a hematologist with Penn Medicine, believes this increased risk can be explained by the proteins in blood types A, B, or AB, which cause inflammation and more blockages/thickening in veins and arteries.
Meanwhile, people with blood type O have a lower risk of blood clots but a higher risk of bleeding disorders. “Determining someone’s blood group is relatively easy, low in cost and widely used,” says Hilde Groot, MD. “General practitioners might use this information in the prevention and treatment of cardiovascular disease, and medical professionals can consider including blood group information in future trials for risk and treatment approaches.”
Dr. Guggenheim makes it clear that having type O blood does not mean there is no risk at all of heart issues. “A well-balanced, heart-healthy diet in general is going to be what any physician is going to recommend, and I would say that ABO doesn’t change that,” he says. “I don’t think there’s a protective benefit from just having type O blood that contributes to being scot-free.” So how can you protect your heart? Here are five factors—aside from blood type—that can increase your risk of heart disease, according to experts.
High blood pressure is a major risk for heart disease, and is often called the silent killer due to lack of symptoms. “It means that we don’t know we have it, and it leads to cardiovascular morbidity and mortality, so strokes and heart attacks,” says preventive cardiologist Luke Laffin, MD. “The vast majority of people with hypertension don’t have any symptoms whatsoever. And it’s because, at least for the majority of people, blood pressure doesn’t tend to rise acutely. It becomes elevated over many years, and the body can adapt to high blood pressures for long periods of time. But then there’s maladaptive features. For example, the heart muscle gets thick, called left ventricular hypertrophy. That’s no good. That’s a surrogate marker for end organ damage. So, the body doesn’t like it for decades on end seeing these high blood pressures, and that’s why it’s called the silent killer.
“So the big four are strokes, heart attacks, heart failure and kidney disease — and there’s overwhelming amounts of data to show that uncontrolled hypertension leads to these outcomes,” Dr. Laffin says. “And again, these happen over many years, but there’s clearly risks associated with them. So, probably the most sensitive to blood pressure reductions is a reduction in stroke. So, if you reduce your blood pressure, that’s going to give you the biggest benefit in terms of reducing your risk of stroke in the future.”
High cholesterol is linked to heart disease and stroke, doctors say. “Dyslipidemia… is one of those big, need-your-dictionary words. But it’s linked to something many of us are familiar with: heart disease and stroke, the No. 1 and No. 3 killers in the United States,” says cardiologist Andrew Calvin, M.D. “Dyslipidemia means abnormal cholesterol and triglyceride levels. While these fat substances are necessary for your body to function normally, too much of the bad kind or not enough of the good kind increases your risk of heart disease, stroke or narrowed arteries in your arms or legs.”
There are three different types of cholesterol: HDL, LDL, and triglycerides. LDL is the problematic cholesterol, while HDL is the beneficial type that helps lower LDL. “Low-density lipoprotein (LDL) cholesterol,” says Dr. Calvin. “Sometimes called ‘bad’ cholesterol, too much of it in your blood causes the buildup of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaques sometimes rupture and can lead to a heart attack or stroke.”
Smoking is terrible for your heart—studies show smokers have an increased risk of heart attack or stroke even with no previous warnings of cardiovascular issues. “There is often more awareness and concern about cancer as a result of smoking than heart disease, so we wanted to better define the risks of smoking related to different types of cardiovascular disease and, most importantly, to cardiovascular death,” says Dr. Sadiya S. Khan, an assistant professor of medicine in the division of cardiology at Northwestern University’s Feinberg School of Medicine in Chicago. “In our analysis, even after adjusting for deaths not related to the heart, such as due to lung cancer, we found that fatal or non-fatal events related to cardiovascular disease are more likely to occur among people who smoke.”
Heart attacks are the first sign of heart disease for people of all ages, while stroke is most common in younger smokers. “People who smoke may not realize the harm cigarettes are causing their body until it’s too late,” Dr. Khan says. “Another notable finding among people who smoked was the early onset of CVD, and among those who developed CVD, how much younger they were. There’s not a lot of research on young adults who smoke, particularly among young men.”
Studies show that more than two thirds of heart disease deaths worldwide are linked to poor dietary choices, and 6 million deaths could have been avoided through healthier diets. “A way of looking at it is thinking about food as medicine,” says Kate Patton, MEd, RD, CCSD, LD. “The right food can really improve your health and decrease your risk of developing these chronic diseases.”
So what diet is good for heart health? The Mediterranean diet has been proven to have heart-healthy benefits. “The Mediterranean diet is more than a ‘diet.’ It’s a heart-healthy eating plan. For most people, what is good for your heart is good for your brain and the rest of your body, too,” says cardiology nurse practitioner Teresa Scanlan. “The Mediterranean diet is a way of eating based on the traditional cuisine of countries bordering the Mediterranean Sea. While there is no single definition of the Mediterranean diet, it is typically high in vegetables, fruits, whole grains, beans, nuts and seeds, and olive oil.”
Research shows 35% of coronary heart disease mortality is linked to lack of exercise. “It’s common to not move much throughout the day, and then try to make up for that sedentary behavior with 45 minutes of exercise. I’m guilty of it too,” says Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. “But that small period of exercise can’t compensate for a lack of activity all day long. We need both exercise and activity. Exercising and frequently moving throughout the day are good for everyone, no matter what weight you’re at. Regular activity is a crucial element of maintaining good heart health.”
Getting five minutes of movement every hour, 30 minutes of moderate to vigorous exercise three to five times a week, and 10,000 steps a day is a good amount of exercise. “Although I’m a big fan of the 10,000-steps-a-day goal, your goal shouldn’t necessarily be to do those steps all at one time,” Dr. Blaha says. “It’s better to spread your activity out during the day and get steps in every hour to meet your goal. Ideally, you should both exercise and have a high daily activity level. Research indicates that doing one or the other doesn’t provide the same level of heart-protecting benefits as doing both.”