Have you ever made a new year’s resolution, started strong and then slipped back into old habits by February?  Maybe you’ve said that you’ll go for morning walks again? But not until things settle at work, probably next month. Then you realise it’s been 6 months, and you still haven’t started. Before you know it, 5 years have passed, you’ve only exercised a handful of times and you’ve gained 5 kilos. But that’s not too bad – it’s only a kilo a year and it’s normal for a bloke in his 40s or 50s to gain weight, right? Middle age spread!   

Your wife is on your back about your blood pressure and cholesterol levels, which were high on your last GP visit. You’ve said you’ll start eating healthy and exercising again, but not until the holidays because work is high stress right now. Next thing, the lift at work is out of order. You take the 5 flights of stairs. At the 3rd flight, you’re out of breath and there’s a slight pain in your shoulder and neck, but you keep going. By the time you reach the office, you’re sweating profusely, dizzy and can hardly breathe. You insist to co-workers that you’re fine, you’re just unfit. But thankfully, a colleague calls an ambulance which arrives within 10 minutes, only to inform you that you’re having a heart attack. This quick call saves your life.    

It is often a scary event like this that finally prompts us to make major changes to our health habits. And unfortunately, a lot of the damage is already done. So why not start now? Know your heart attack risk factors and address them, before it’s too late.   

Firstly, what is a heart attack?  

A heart attack occurs when blood to the heart is restricted or completely cut off, usually in the coronary artery supplying the heart. The heart muscle needs oxygen, nutrients, and blood to pump so the longer that blood flow is blocked, the more damage to the heart and cardiovascular system.   

What causes a heart attack?   

Over time, fatty deposits of cholesterol and other waste products form plaque on our artery walls, generally at sites of injury or damage to the blood vessel. *


This plaque can break off and form clots in the bloodstream, which get stuck and restrict blood flow. If this happens in the small arteries of the heart, a heart attack occurs due to partial or complete restriction of blood (Ojha, 2021). 

Text box containing signs & symptoms of a heart attack
Text box containing details about what to do if you think you or someone else are having a heart attack

What are the risk factors?   

We have broken these into modifiable and non-modifiable factors. Non-modifiable we cannot change – age, sex, family history and race (Hajar, 2017).  

So, let’s focus on modifiable – risk factors we can influence daily by changing our behaviours. These account for more than 90% of acute heart attacks across all ages, sexes, and ethnic groups (Anand et al., 2008).   

The 9 Modifiable Risk Factors:   

  1. Lack of physical activity  

Physical activity has consistently proven to be preventative in developing many diseases and conditions, including coronary heart disease (CHD). CHD is characterised by plaque accumulation on the coronary artery walls, which in the early stages leads to chest pain, and later – heart attacks.    

Inadequate physical activity almost doubles your risk of dying from CHD (Hajar, 2017).   

1. Unhealthy diet  

A diet high in fruit and vegetables lowers your risk of CHD, as well as the risk of developing diabetes, high blood pressure, high cholesterol, and obesity.   

2. Excessive weight or obesity  

Being overweight or obese is an independent risk factor for “all-cause mortality”, or in other words – your risk of dying from any cause. Having a high BMI in childhood is also associated with increased risk of CHD later in life (Hajar, 2017).   

However, it’s important where your excess fat is stored! Studies have shown that high abdominal obesity is a stronger predictor of heart attack risk than BMI alone (Anand et al., 2008).   

3. Stress & Psychological factors   

A relationship has been found between psychological stress and CHD. Life events contributing could be financial stress, job loss, family conflict, separation/divorce etc (Hajar, 2017). It’s important to manage stress and seek professional help when necessary.   

4. Smoking:  

Smokers under 50 years old are 10 times more likely to develop CHD than non-smokers (Hajar, 2017).  Luckily, stopping smoking immediately reduces risk of non-fatal and fatal heart attacks so it’s never too late to stop!   

5. Diabetes:  

Type 2 diabetes increases risk of CHD and stroke, in conjunction with other underlying conditions (hypertension, smoking, high cholesterol, and a sedentary lifestyle). In fact, adults with diabetes are 2-4 times more likely to die from CHD than those without (Hajar, 2017).   

6. High blood pressure/hypertension  

High blood pressure makes it harder for your heart to pump blood around the body, increasing your risk of a heart attack. This can be managed with medication, stress reduction, diet, and exercise (Hajar, 2017).   

7. High blood cholesterol levels  

High levels of low-density lipoproteins (LDLs), often termed “bad cholesterol,” and low levels of high-density lipoproteins (HDLs, or “good cholesterol”), contribute to plaque formation in the arteries, hence increasing your risk of heart attack.   

8. Alcohol consumption  

Too much alcohol can elevate blood pressure, stress, and increase overweight or obesity risk, consequently increasing the risk of developing CHD.   

Why are men in their 40s, 50s and 60s particularly high risk?   

As we age, our risk of CHD increases. For those with CHD, the underlying pathology has developed over time so that when the symptoms first appear (~45 years old), the disease is usually advanced (Hajar, 2017).     

Text box detailing the incidence rates of heart attacks in the US

Men are at higher risk than women, with the average onset 10 years earlier in men (Anand et al., 2008; Hajar, 2017). This is largely due to higher engagement in modifiable risk factors in men under 60, compared to women of the same age. For example, compare to men, women under 60 tend to have lower rates of smoking, abnormal blood lipids, and alcohol use.   

Interestingly, these modifiable risk factors have a stronger association with heart attacks in those under the age of 60, compared to over (Anand et al., 2008). This highlights how important it is to improve our health behaviours in our 40s and 50s, to reduce our heart attack risk.  

Take action & reduce your risk now.   

While there are heart attack risk factors we cannot change, many of the risks are modifiable and associated with our day-to-day lifestyle.   

PREVENTION IS KEY!  Here are our top tips:   

  • Quit smoking. It’s never too late.    
  • Move your body daily! Whether this is a 30-minute walk, 20 minutes of housework or 15 minutes of gardening, get moving!    
  • Eat plenty of fruits, vegetables, wholegrains, lean meats, and unprocessed foods. Limit salt, sugar, and saturated fats.   
  • Get your blood pressure, cholesterol and lipids checked. Discuss your options with your GP if these are abnormal or elevated.   
  • Manage and minimise stress. Take time for activities that relax you and help you recover. Seek professional help if necessary.   
  • Reduce alcohol consumption. Limit to 2 standards drinks/day for men, and 1 for women.  
  • Reduce risk of Type 2 Diabetes. By doing the above.