Heart Disease Heart disease occurs when blockages build up in the arteries supplying blood to the heart. These blockages slowly build up over time due to risk factors. The major risk factors for heart disease are: Risk factors, which cannot be modified: Age: Men, older than 45 years and women older than 55 years are at a higher risk. Family history: Your risk increases if a close family member (parents and siblings) has had heart disease. Risk factors, which can be modified: Blood Pressure: High blood pressure, which is defined as greater than 140/90 mmHg. Your ideal blood pressure should be 120/80 or below. Diabetes: You have diabetes, if your fasting blood sugar is greater than 126 mg/dl on more than one occasion Cholesterol: to keep your risk level low your total cholesterol should be below 200 mg/dl and your HDL cholesterol (the ‘good’ cholesterol) should be above 40 mg/dl Smoking: Any amount of smoking or tobacco chewing is a major risk factor for heart disease and cancer. A normal ECG or stress test does not mean you will not have disease in the future. To effectively halt this progression you need to aggressively modify your risk factors over a lifetime, and the only way to do that is through lifestyle modification.