‘I’m in the Driver’s Seat’ – Modifiable Risk Factors

These are behaviours and characteristics that someone can willingly alter or ‘modify’ to minimize their risk of developing a cardiovascular disease. They are otherwise known as ‘lifestyle factors’ when it comes to describing the various aspects of managing cardiovascular disease. India has dramatically urbanized over the last few decades. Although urbanization has brought the country economic prosperity, it has been linked with a growing burden of cardiovascular diseases among Indians. This is because as more Indians are living in and moving to cities, they adopt drastic lifestyle changes. Some of the cardiovascular disease risk factors associated with these lifestyle changes are listed below:

Physical inactivity

Lack of physical activity is the culprit behind a host of health issues, but is a crucial risk factor for cardiovascular diseases. One of the defining characteristics of ‘city life’ in India is the overdependence on vehicles to get to places. This means that people are moving less and leading increasingly sedentary lifestyles. Moreover, as people get busier, they have less time to devote to physical activities. A study found that a large proportion of Indians are not exercising regularly, and physical inactivity was more common among females. There is ample scientific evidence showing a strong correlation between physical inactivity and the risk of developing several cardiovascular diseases. One study showed that people who exercise for at least 30 minutes have a 20%-30% lower risk of perishing from a cardiovascular-related illness than those who were insufficiently physically active. So, engaging in some form of physical activity can considerably reduce your risk of developing a cardiovascular disease.

Poor diet

A high calorie and high salt diet, a hallmark of the urban lifestyle, makes you more susceptible to a range of health problems, including cardiovascular diseases. You may have heard time and again that foods high in trans fats and saturated fats are bad for your heart. This is because these forms of fat increase the levels of ‘bad cholesterol’ in your blood vessels. ‘Bad’ cholesterol or ‘low-density lipoprotein’ can build up in the blood vessel walls and obstruct the flow of blood, leading to negative cardiovascular consequences. Street food, beloved by most Indians, is loaded with trans fats and saturated fats as they are frequently deep-fried. This may put regular street food eaters at a higher risk of cardiovascular diseases.

Consuming leafy green vegetables and fresh fruits have been shown to significantly reduce the risk of cardiovascular diseases. You may be surprised to know that despite India having the largest number of vegetarians in the world, Indians do not eat adequate quantities of fruits and vegetables. A well-balanced diet rich in fresh fruits and vegetables is vital to maintain a healthy heart.

High blood pressure

High blood pressure, or hypertension is a detrimental risk factor for cardiovascular disorders like coronary heart disease and stroke. The normal blood pressure is 120/80 mm Hg, and a blood pressure reading of more than 140/90 mm Hg is considered high or hypertensive. High blood pressure damages and narrows blood vessels, and can also excessively strain your heart, causing long-term damage to the cardiovascular system.

Hypertension has become a serious health concern, and it is the most common risk factor among Indians. One study showed that 20-40% of urban adults and 12-17% of rural adults have hypertension. The number hypertensive individuals in India is expected to rise to more than 213 million by 2025 (that’s around the population of Uttar Pradesh). This means that a large number of people will also have a higher chance of developing cardiovascular diseases in the future. Although there may be a genetic element to hypertension, it is also linked to lifestyle-associated factors like high salt diets, mental stress, and excess alcohol consumption. So, making healthier lifestyle choices critical in reducing your risk of becoming hypertensive.


We all know that smoking kills. This unhealthy habit is linked with a host of cancers and lung-related disorders. But smoking can also kill by increasing your risk of cardiovascular diseases. The toxic chemicals from burning tobacco have several harmful effects on the cardiovascular system, like damage to the lining of the  blood vessels and narrowing of the blood vessels.

Tobacco use is common in India. A 2016-17 survey found that around 29% of Indians use some form of tobacco, while another survey showed that 19% of youth engaged in tobacco and cigarette smoking. If you are a smoker, your risk of dying from a heart disease is almost two to three times higher than that of a non-smoker. Giving up smoking will not only benefit your heart, but also help you lead a healthy life with fewer health concerns overall.


Being diabetic is a major risk factor for developing cardiovascular diseases. Almost half a billion people in the world are living with diabetes, and India is home to the second-highest number of diabetics in the world. Many of us may know that diabetes is a disorder linked with the hormone insulin and the inability to regulate blood sugar levels. High blood sugar levels can negatively impact the heart’s performance and severely damage blood vessels. One study showed that the risk of dying from some form of heart disease or stroke is about 65% higher if you are diabetic. So, if you are diabetic, managing your diabetes will go hand-in-hand with managing your heart disease risk. And since type 2 diabetes is a lifestyle-associated disorder, making serious lifestyle changes can reduce your chances of developing a potentially fatal cardiovascular disease.


The knowledge that maintaining a healthy weight is important for our overall health and wellbeing is well established. Being obese puts us at a higher risk of problems like diabetes, hypertension, and atherosclerosis (the build up of cholesterol-containing plaque in the walls of blood vessels). These problems play a role in the development of cardiovascular illnesses like heart failure, coronary heart disease, and atrial fibrillation. Indians are getting heavier – more than 135 million people are now obese in India. And more alarmingly, the number of obese people in India is projected to triple between 2010 and 2040. This is a cause for great concern given the high risk of cardiovascular diseases in obese people. Although obesity may have complex biological causes, lifestyle factors like diet and fitness levels are important contributors to obesity. So maintaining a healthy weight is crucial to ensure your risk of heart diseases is low.

Remember, YOU are in charge

The number of modifiable risk factors for cardiovascular disease out there may be daunting, but controlling your risk factors is much easier than you think. Many of these  risk factors are linked, so making lifestyle changes to manage one risk factor can have ripple effects on the other risk factors. For example, changing to a diet with low salt, sugar and saturated fats can help manage your risk of other modifiable factors like hypertension, diabetes, and obesity.  This in turn reduces your risk of cardiovascular illnesses. Maintaining a healthy heart is achievable through simple and gradual lifestyle changes.


#1. Which of the following is not a risk factor for heart disease?