[Risk Factors for Heart Disease, Part 2]

Welcome back! In Part 1 of Risk Factors for Heart Disease, you learned about Family History, Gender, Age, Obesity, Smoking and how they relate to developing CAD. You also learned a little about me and my experience in the field of health, wellness and physiology.

If you have not read Part 1 yet, make sure you do that before continuing on with the rest of this educational journey as I will through the other 7 risk factors involved in keeping your heart and body as healthy as can be. Let’s jump right in.


Mindset toolkit: ask the right questions, and keep it simple. “What is stress? How does stress affect my health, and more specifically, my heart and arteries? How do I ultimately reduce stress? Pro tip when it comes to this topic: be gentle with yourself.

Let’s start with the first question, what is stress? You may think you have some ideas, but it can be very complicated. It comes from work, relationships, schedules, and other problems and/or catastrophic events that occur in your life that lead to stressful emotions. You also know that when you experience it, your heart beats faster, you feel nervous or anxious, sad or depressed, guilty for whatever legitimate or illegitimate reason, you have trouble sleeping, sleep too much, lose motivation... just to name a few.

But what about physiologically? It’s actually quite simple. Your brain sends electrical impulses between various neurons (thought) which instantaneously turns into emotion (nervousness, anxiety, etc) and with this stressor, your brain sends a signal for your body to release a “fight or flight” hormone called cortisol.

Now, there is some evidence in psychology and neuroscience that the emotional response comes before the thinking, but its so instantaneous it really doesn’t matter when it comes to your and my ability to train our brains. If we can do that, we are much better off.

Cortisol makes your heart race, arteries constrict and in turn restricts blood flow from other parts of your body so that it can mostly go to your super awesome and powerful brain to help it deal with the “stressful situation.”

The funniest part of this phenomenon is the fact that, more often than not, when you are stressed out, nothing catastrophically horrendous is actually happening to you in the moment. Usually, you are dwelling on something that is in the past, or something that hasn’t even happened yet and may never happen anyway.

You know exactly what I mean. For example, you just got home from work, it has been a very busy day. You sit on the couch because all you want to do is relax.

Then what happens? You remember you had an argument with your significant other the night before that didn’t end well, let alone come to any real “good” conclusion. This upsets you. You are dwelling in the past. In the very next moment you’re thinking about what your next interaction will be when they get home which makes you nervous and scared. You’re now worrying about the future.

All you want to do is relax and sit on the couch, when all you are physically doing in that stressful moment is, in fact, sitting on the couch. Only, you’re not relaxing, you’re freaking out.

THEN WHAT? You realize that you are freaking out and you start judging yourself for freaking out when all you have to do for the time being is relax and you aren’t relaxing! On top of that, you judge yourself again for, well, judging yourself. AAAHHHH!!

This is what I like to call the anxiety-snowball-effect from hell. The funniest part of it all, your significant other comes home and flat out tells you they were wrong and they love you and they are sorry. And to your surprise you see they have brought you your favorite...whatever your favorite whatever food or flower thing is. So what was the point of all that anxiety?

Nothing. And I know situations don’t always go like the one I just provided. Sometimes it really doesn’t turn out well. My point is… it’s ok. If it goes badly, all that worrying beforehand definitely made it worse.

REMEMBER YOUR MINDSET. Your brain is in charge of your mindset, and YOU are in charge of YOUR brain. In high stress situations your brain is trying to help itself by making your heart beat fast and give itself more oxygen. THIS IS A GOOD THING! Moderate levels of cortisol are healthy.

However, stress in the form of the anecdote above is too common in today’s society and happens numerous times every day. This is chronic stress. Over the course of a lifetime, it is extremely detrimental to the health of your arteries, heart, and leads to a more rapid deterioration of those telomeres in your DNA along with every cell in your body.

So what do we do?

Step one: Recognition of the stress. If you’re unable to admit that you are stressed out and try to block or hide it, you’re toast. I promise, the stress is still there and it’s not playing peek-a-boo.

One little trick that works for me is, when I recognize that I’m thinking about all the horrible things that “might” happen, or I’m dwelling on something that I can’t change, I have a choice to bring present moment awareness to what is happening in my mind and say to myself, “this is delusion” or “I’m thinking.” I look at the feeling and experience for what it is, just my own brain messing with me. This puts me in control. I want to be in control. It’s my brain dude. I am in control.

Step two: Now that I’m in control of my thoughts, I literally come to my senses. Meaning I redirect my attention toward whatever physical senses I choose to bring awareness to. And you can use any 7 of them. That’s right, we have 7 senses: sight, touch, taste, smell, hearing, kinesthetic and, what mindfulness meditation practitioners call, the “mind sense.”

The mind sense is in fact what we already talked about, the activity of your brain or the thoughts in your mind. When you can bring non judgemental awareness to what’s going on up there, you are a mere observer and will not get caught or stuck on your emotions, and ultimately deal and cope in a wiser, calmer more definitive manner.

This type of brain control isn’t easy. It takes practice. If you practice meditation, you probably know what I mean. Some people are just naturally gifted at this type of control without practicing for whatever reason. Good for you. I’m definitely not one of them, but I can say it has helped me in multiple facets of life and will always be a journey of growth, acceptance and heightened awareness of the present moment. Which is what I’m looking for because you have to be IN your life in order to enjoy it. When your mind is wandering, YOU aren’t really THERE.

If you don’t practice meditation and aren’t afraid to give it a try, I recommend you just do it and see what happens. Try 5 or 10 minutes a day. Everyone has that amount of time. If you aren’t ready to sit in silence for a few minutes a day and just focus on your breathing, or feel like it's absurd or a waste of time, don’t do it.

What else decreases stress? Healthy eating, exercise, doing things that give you joy, being with people that you like spending time with, prayer, meditation, singing, dancing, sports, reading the list goes on and on and I’m sure you can fill in more and get creative, so long as it is healthy. And when it comes to health, moderation is key. I can’t stress that enough. Pun intended.

By the way, this was a lot of info and much of this will leave you hanging a bit. But remember, every risk factor I talk about in Part 1 and 2 is a very brief introductory course to give you an overview so you may start bringing more awareness to all the aspects of your health. So take notes and ask questions. You can determine future learning modules.


If you have high blood pressure (140/90 mmHg or greater), you are at higher risk for heart disease. Why? Think of your arteries as an elastic garden hose. There is a constant, beating stream of water (blood) flowing through those hoses by a pump (your heart) that pushes the water through the pump about every second.

With each pulsation of the pump, the hose stretches a bit and then relaxes. Just the right amount and fluctuation of pressure maintains the elasticity and efficiency of the hose over time. Too much constant pressure and the hose will start to stiffen, causing the water to not move as well. When that happens, your hose may even develop calcium deposits inside because the water is stagnant in some areas and certain molecules in the water have a better chance to stick to it. This significantly blocks the water's ability to move freely. The biggest problem though, there is no return policy or warranty on the hose so if you don’t know how to maintain it well, your garden will not flourish.

I’m sure you understand the metaphor by now.

Mindset: what can I do to maintain the elasticity of my arteries? What else causes my blood pressure to be high?

Question number one: EXERCISE is THE BEST way to maintain the elasticity of your arteries and a healthy blood pressure. When you exercise, your heart beats faster and raises your blood pressure for a short period of time. When you are finished exercising your blood pressure is generally lower overall than it was before exercise. Consistency in essential.

Eating the right foods also maintains your arteries. Too much salt (sodium) in your habitual diet will keep your blood pressure at unsafe levels. Why? Your blood is mostly water, that is why it is important to stay hydrated. However, sodium absorbs and holds onto water. If you eat too much salt daily (AHA recommends 1,500 mmg as the healthy maximum amount) you are adding more volume to your blood in the form of combined sodium and water.

Back to the hose metaphor. What happens if you have, say, 5 liters of water constantly circulating through your hose. Add just another 0.5 liters of water volume to that hose. You didn’t add any more hose, so with a little physics we can deduce that you just significantly increased the amount of pressure that hose has to endure. The hose only likes short bursts of increased pressure, not whole days and weeks.

Here’s the kicker, read your labels, sodium is literally EVERYWHERE! Shop on the outside of the grocery store where all the whole foods are. Avoid the middle isles. Anything in a bag or a box is riddled with sodium, AND SUGAR.

What else causes high blood pressure? Stress (cortisol), lack of exercise Various types of foods that contain high amounts of sugar and saturated fat. Which leads me to the next risk factor.


There are two types of cholesterol. Low density lipoprotein (LDL) and high density lipoprotein (HDL).  LDL is bad cholesterol, HDL is good cholesterol. So you want your HDL to be as high as possible. If HDL is greater than 60 mg/dL that’s actually a negative risk factor for heart disease which is good. That means you can negate one of your positive risk factors. LDL you want to keep at low levels. Why? It clogs your arteries which leads to heart disease.

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So how do we change or affect our cholesterol levels? C’mon do I even have to say it? Exercise and what you eat. Let's break down the foods real quick in the simplest way possible.

High LDL foods (try to limit): Anything that walks on 4 legs or comes/made from an animal that walks on 4 legs. Also, coconuts and most shellfish and crustaceans are fairly high in LDL or saturated fat. Simple enough?

But wait there’s more! Sugar (carbohydrates), if not utilized immediately upon consumption, will convert into fat tissue and raise your LDL cholesterol. That’s also why exercise is so key here. It not only uses up the sugar in your system but also the free cholesterol molecules floating around in bloodstream trying to clog your arteries AND fat tissue. Exercise is magic people.

Foods to increase your HDL (Keep a healthy amount in your diet): Anything that contains monounsaturated or polyunsaturated fat. Key word: UNsaturated. So, anything that lives in the water that has gills and a tail and some fins. The best kind though? Fatty fish like salmon, mackerel, tuna, sardines and trout.

What else? Olive oil, vegetable oil, tree nuts and their oil (almonds, pistachios, peanuts, Brazil nuts and others), avocados, whole grains, beans/legumes, high fiber fruit, flax, chia, soy, red wine (in moderation), not smoking, exercising, and even reduced stress.

Lastly, taking cholesterol medication as your doctor prescribes.


Yes, diabetes is a positive risk factor for heart disease. Most especially if it is not well controlled. The fluctuation in blood sugar levels over time deteriorates coronary and peripheral arteries.

But there’s great news for you. You have already made huge steps and will continue on with your learning journey while keeping up the fight! More good news, every risk factor that we can change has had a huge trend in that they are all affected by exercising, eating well, reducing stress and cultivating an effective mindset toward being healthier.

I have worked with hundreds of people with diabetes. I have seen folks completely get off insulin. Doctors have taken their patients off medications. People have felt better, reduced their stress, lost weight, increased lean muscle mass, increased strength and endurance, improved their lives, the list goes on and on. All of it is due to lifestyle behavior changes.

All these risk factors that you have learned to improve apply to not only to heart disease, but also diabetes, cancer, stroke, peripheral artery disease and so many other health problems I couldn’t possibly list them all.


At minimum, the AHA recommends 150 minutes of moderate aerobic exercise per week supplemented with 2 to 3 days of whole body strength training for decreased risk of heart disease. Easy peasy. Like I’ve said. You are in a great spot with lots of like minded individuals and professionals to help you along.

I love the Nike slogan. JUST DO IT!

David Zetts

Certified Exercise Physiologist


We offer a variety of services specifically for Diabetics which include but are not limited to: Health and wellness coaching, nutrition coaching, diabetic education, fitness training, mindset training, supportive online community of like-minded diabetics, and so much more! Want more info? Check us out here: 


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