In case of coronary artery disease or ischemic heart disease, surgeries are often needed to solve more severe problems with blood vessel clogging. However, cardiovascular stenosis or clogging does not just happen overnight but could be resulted from the long-term cumulation of many factors. The understanding of risk factors and changes in lifestyles are also the key for rehabilitation towards health.

Understanding risk factors of cardiovascular diseases

The risk factors of cardiovascular diseases are described below. There is a mutual relation among all risk factors, and chance of having cardiovascular diseases are higher as the number of risk factors increases.

• Age: Male ≧ 45 years old; Female ≧ 55 years old.
• Family History: Male immediate family before 55 years old or female immediate family before 65 years old having ischemic heart disease (myocardial infarction, coronary artery bypass surgery or sudden death).
• Smoking: Smoking still or was smoking up to 6 months ago, or exposure to a smoking environment.
• Sedentary Lifestyle: Lack of 30 minutes of moderate-intensity exercise at least 3 days per week, and at least for the last 3 months. 
• Obesity: Body Mass Index (BMI) ≧ 30 kg/m², male waist＞102 cm and female waist＞88 cm (Taiwan defines BMI ≧ 27 as obesity).
• High Blood Pressure: Take at least two measurement, systolic blood pressure ≧ 140mmHg and/or diastolic blood pressure ≧ 90 mmHg, or taking Anti-hypertensives.
• Dyslipidemia：LDL ≧ 130 mg/dL or HDL＜40mg/dL, or taking hypolipidemic agents (if only cholesterol data available, ≧ 200 mg/dL）。
• Prediabetes: Take at least two measurement, fasting plasma glucose ≧ 100 mg/dL and＜126 mg/dL, or after-meal plasma glucose ≧ 140 mg/dL, but＜200 mg/dL.

How to control risk factors of cardiovascular diseases

Risk factors can be divided into two types, one is irreversible (such as age and family history) and another type is the reversable risk factors. The most important part is the control over the reversable risk factors, which will prevent another coronary artery stenosis and thereby lower the recurrence rate of cardiovascular diseases.

• Smoking cessation: The objective is total smoking cessation, reducing the adverse impact of platelet aggregation and avoiding the declined function of pulmonary respiration due to smoking. 
• Dynamic lifestyle: Increase fitness activity and directly improve risk factors of non-exercise through cardiopulmonary rehabilitation. Ask professional to evaluate the risk and provide instructions on exercise formula. The patient is encouraged to engage in 30-60 minutes of aerobic exercises everyday or at least 3~4 times a week.
• Weight control: Body Mass Index (IBM) targeting at 18.5～23.9 kg/m²； male waist ＜90 cm, female waist ＜80 cm.
• Blood pressure control: Target ＜140 / 90 mmHg；Heart failure or renal dysfunction target ＜130 / 85 mmHg；Diabetes patients  target＜130 / 80 mmHg.
• Blood lipid control: Cholesterol＜200 mg/dL; Triglycerides＜200 mg/dL；low-density lipoprotein (LDL)＜150 mg/dL；High-density lipoprotein (HDL)＞35 mg/dL.
• Plasma glucose control: Glycated Hemoglobin＜7 ％.

Pulmonary rehabilitation exercises improve risk factors of cardiovascular diseases

Patients coming from the clinic room to the treatment room for cardiopulmonary rehabilitation will take some exercise trainings. Such patients will boost their cardiopulmonary endurance to directly improve inactivity-related risk factors. Moreover, they will effectively keep obesity under control, improve high blood lipids (cholesterol, triglycerides, lower LDL and higher HDL), and lower high blood pressure. In addition, the increase in insulin sensitivity or reduction in insulin resistance could boost glucose metabolism. The proportion of smoking can be lowed to reduce the risk factors of coronary artery diseases.

Do you have more understanding on the risk factors and the relation with you now? If you are still not sure about two or more factors of yourself, please consult with the medical staff before exercise. Let’s all try to benefit from exercises.