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9 Hidden Risk Factors for Heart Disease

By Amanda Gardner

Even doctors can miss subtle, early warning signs of heart disease. Be sure that you don’t.

Everyone knows that smoking and a steady diet of high-fat foods can do a real number on your heart, but few of us suspect that sleep habits and moods can play a role, too. Yet these seemingly unrelated issues may be early signs that heart trouble is just a beat away.
“Some risk factors have been under the radar,” says Nieca Goldberg, M.D., author of The Women’s Healthy Heart Program (Ballantine Books, 2006, $16). If a woman comes into Goldberg’s office with chest discomfort but without the other obvious risk factors, Goldberg asks about menstrual regularity and pregnancy complications, such as preeclampsia (high blood pressure) or gestational diabetes, because these also are strong risks. “Most women don’t make the connection between their reproductive organs and their heart, but estrogen is a key factor in cardiac health,” Goldberg says.
Even if pregnancy and periods are distant memories, they still can affect your heart disease risk. “All risk factors are important over a lifetime, because the damage is cumulative,” says C. Noel Bairey Merz, M.D., medical director of the Preventive and Rehabilitative Cardiac Center at Cedars-Sinai Medical Center in Los Angeles.
Scan the list on the following pages. If any of these scenarios apply to you, bring them up at your next doctor visit.

1. You sleep too little—or too much.
Screwed-up sleep patterns can hurt your heart. A 2003 analysis of more than 71,000 women, ages 45 to 65, in the Nurses’ Health Study found that sleeping five or fewer hours per night increased the risk for coronary disease by 45 percent. And those who regularly slept nine or more hours had a 38 percent greater risk than those who slept eight hours—even after taking into account risk factors such as snoring and smoking.

Why it’s a risk factor: “Too much or too little sleep can increase blood pressure and levels of stress hormones,” says Jennifer Mieres, M.D., a spokesperson for the American Heart Association. Over time, this causes wear on the heart. Try to sleep eight hours per night. If that’s difficult, talk to your doctor about medication and getting screened for a sleep disorder.

2. You have gum disease.
Recent research suggests that people with coronary artery disease are 38 percent more likely to also have periodontal disease than people without it. In fact, dental disease turned out to be a greater cardiac risk factor than smoking in some studies. “Right now it’s just an association, but studies are being done to see whether treating gum disease will reduce the risk of heart disease,” says periodontist Susan Karabin, D.D.S., vice president of the American Academy of Periodontology.

Why it’s a risk factor: While the link is not clear, it may be that the inflammation from gum disease allows bacteria to enter the mouth’s blood vessels, travel into the coronary artery vessels, and narrow the passages. This reduces blood flow. Treat your gum disease, but tell your doctor you’re seeing a periodontist so appropriate blood tests can be ordered.

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