February is National Heart Health Month, so there’s no better time than today to raise awareness about heart disease. In particular, the environmental risk factors of heart disease. 

Nearly half of all Americans are at risk of developing heart disease. While that number seems alarming, the good news is most of the risk factors are in your control. The even better news is that the risk factors that aren’t in your control can have minimal impact on your risk of developing heart disease.  

Environmental risk factors for heart disease are also part of the puzzle.  What do I mean by ”environmental risk factors for heart disease?” I’m going to tell you how where you live and your environment can be impacting your risk of developing heart disease. Don’t worry. You don’t have to pack your bags and move. By taking simple steps to address the factors in your control, such as your diet, lifestyle, and certain areas of your environment, you can lower the impact of the environmental risk factors for heart disease.  

Before I get into the environmental risk factors for heart disease, let’s talk about the common risks of heart disease and the difference between controllable and uncontrollable risk factors.  

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The Common Risk Factors for Heart Disease

Your heart is your body’s engine. It is responsible for pumping blood through a 60,000 mile (97,000 kilometers) network of blood vessels that carry nutrients, hormones, and oxygen throughout the body. If your heart is healthy, your body is able to get the oxygen, nutrients, and hormones it needs. 

Heart disease is caused by a combination of controllable and uncontrollable factors. The non-modifiable and modifiable risk factors of heart disease are similar in men and women, however, the signs of heart disease are not as recognizable in women as they are in men. 

It’s also important to understand that heart disease and cardiovascular disease are synonymous with each other, however they are very different. Heart disease is a catch-all phrase conventional medicine uses for a variety of conditions that affect the heart’s structure and function, such as a heart attack or heart failure. Whereas cardiovascular disease is a bigger umbrella used for all types of diseases that affect the cardiovascular system –the heart, arteries, veins and blood vessels – such as atherosclerotic cardiovascular disease or peripheral artery disease. 

Being able to identify the risk factors in your control can help you lower your risk of developing heart disease. 

Controllable Risk Factors of Heart Disease 

The more risk factors you have, the greater your chances are of developing heart disease. While you cannot change your age, race, sex or family history, there are several risk factors of heart disease that are in your control. Here are the risk factors that you can control: 


Smoking greatly increases your risk for heart disease, including coronary artery disease (CAD), peripheral artery disease, heart attack, heart failure, and stroke.  Smokers are not only two to four times as likely to develop heart disease but also more likely to die if they suffer a heart attack. 

High Blood Pressure

High blood pressure, also called hypertension, occurs when the force of your blood pushing against the walls of your blood vessels is too high. A normal blood pressure level is less than 120/80 mmHg. Adding more green vegetables to your diet is one way to lower your blood pressure. Other ways to lower your blood pressure are to exercise, lose weight, reduce sodium in your diet, lower your stress, and cut back on alcohol and caffeine

High LDL Cholesterol

Cholesterol is one of two types of lipids, along with triglycerides. The difference between triglycerides and cholesterol is that triglycerides are unused calories that provide your body with energy, while cholesterol is used to build cells and hormones. Cholesterol and triglycerides attach to lipoproteins. You can lower your cholesterol by changing your diet, losing weight, exercising, quit smoking, and lower your alcohol intake. 

Uncontrolled Diabetes

Uncontrolled diabetes contributes to a process called “glycation,” which is the result of insulin not properly metabolizing sugars. This excess sugar, which should be metabolized and used for energy, remains in your bloodstream and attaches to proteins and lipids (fats). These molecules then form harmful advanced glycation end products (literally AGE!) and become brittle as a result, and plaque forms in your arteries and blood vessels. This vascular damage can lead to heart attacks and strokes.1 If you are diabetic, controlling your blood glucose levels will lower your risk of heart disease. 

Physical Activity

Your heart is a muscle. Just like other muscles in your body, the more you work out your heart, the stronger it becomes. If you live a sedentary lifestyle, your heart is going to deteriorate like your muscles and become weak. Aerobic activity uses your heart and lungs for a long period of time. It also helps your heart use oxygen better and improves blood flow. Doing 30 minutes of aerobic exercise such as walking, swimming, light jogging, or biking can significantly lower your risk of heart disease. 

Obesity and Diet

Obesity is a common problem in the U.S. Nearly 1 in 3 Americans are considered obese. Obesity is linked to an increased risk of heart disease and is closely related to diet. However, it can be a bit misleading. If you have a body mass index (BMI) of 25 or higher, you are considered obese. What BMI doesn’t take into consideration is fat composition, age, bone structure, and gender. However, it is still used as a measurement of obesity because it is not always wrong. 

Obesity and being overweight are linked to several modifiable risk factors of heart disease including high cholesterol, high blood pressure, and type 2 diabetes. That’s why it’s important to eat a nutrient-dense diet and eliminate toxic and inflammatory foods and eat nutrient-dense foods

As I mentioned earlier, addressing the above risk factors of heart disease that are in your control will lessen the impact of those out of your control, such as age, race, sex, and genetics. Another factor out of your control are the environmental risk factors of heart disease. Let’s talk about how your environment impacts your health. 

How Your Environment Affects Your Health

More and more research is being done on how your environment influences your health, especially when it comes to exposure to toxins. Toxins are everywhere and can lead to oxidative stress.  We are exposed to toxins in our food and our water. We absorb them in our skin through our skincare products, cleaning supplies, and even our clothes. Toxins are even in the air we breathe.  

The Centers of Disease Control and Prevention released a study that found populations of Industrialized locations have a higher rate of heart disease than those in more rural areas.2

For example, areas with industry consisting of coal, oil, gas, steel, and textile manufacturing disturb the natural environment and release harmful particles into our air, soil, and water supply.

Toxins create free radicals in your body, which creates oxidative stress.  Free radicals are atoms that are in search of a spare electron to meet the requirement of having pairs of electrons. Antioxidants supply free radicals with the electron they need to prevent damage to healthy cells. 

Oxidative stress occurs when there’s an imbalance of antioxidants and free radicals. When you think of oxidative stress, picture jagged rusted particles (free radicals) floating around in your blood, bouncing against the vessel walls, tearing them up, and triggering a cascade of inflammation. When there are more free radicals than antioxidants, the free radicals can start doing damage to cells, proteins, and your DNA. This damage over a long period of time can lead to numerous diseases including heart disease.3

What are the Environmental Risk Factors of Heart Disease?

It is possible to limit exposure to environmental risk factors of heart disease such as air pollution, heavy metals, tobacco smoke, solvents, and pesticides. However, I understand that it isn’t always possible to completely avoid them. The good news is that it is possible to minimize adverse effects. Let’s talk about the environmental risk factors of heart disease and how you can limit your exposure.

Environmental Risk Factors for Heart Disease – Infographic – Amy Myers MD®Environmental Risk Factors for Heart Disease - Infographic - Amy Myers MD® https://content.amymyersmd.com/article/environmental-risk-factors-for-heart-disease/Environmental Risk Factors for Heart Disease – Infographic – Amy Myers MD®

Air Pollution and Heart Disease

The WHO has identified air pollution as the world’s largest single environmental risk factor of heart disease. In fact, 80% of deaths from heart disease can be attributed to outdoor air pollutants.4 You may not live in a heavy industrialized or high traffic area, yet small particles have the ability to travel hundreds to thousands of miles in the air affecting those far from the actual source. 

What you may not realize is that we are exposed to many forms of indoor air pollution as well through carbon monoxide, gas powered heaters, secondhand smoke, fumes from cleaning products, and mold.

While you cannot control the air outside, you can do something about the inside air pollution. Air purifying plants such as aloe vera, spider plans, and English ivy can absorb a number of toxins in your home. I also recommended getting a HEPA air filter, which I have in my office so that my team and I can breathe clean air all day and in my home in Santa Fe, New Mexico. 

My favorite air purifiers from AIRDoctor® are designed to remove even the tiniest particles from your air, including viruses, pet dander, dust mites, air pollution, and even cigarette smoke.

Heavy Metals

Metals such as lead, mercury, cadmium, and arsenic are in the top ten list of elements that increase the progression of heart disease, according to the WHO. Lead and arsenic are commonly found in drinking water as a result of old lead pipes.

Even though EPA standards greatly reduce these toxins in your water, elimination at 100% is challenging. However, if you have a private well or a small water system, you may be unaware of the amounts of harmful elements you’re ingesting daily. 

I highly recommend getting a water filtration system for your home. There are multiple filtration methods in addition to contaminants to filter. There are pitcher filters, under-sink filtration systems, and whole-house filters such as those available from Aquasana. There’s also my personal favorite: The gravity filtration system. In a gravity filtration system, you have to manually fill the upper chamber. I find it’s worth the effort because the filters provided with this system remove a wide range of bacteria, viruses, chlorine, pesticides, herbicides, and other harmful toxins. 

Tobacco Smoke

I mentioned smoking earlier as a controllable risk factor of heart disease. You can quit smoking if you are a smoker. However, even if you are not a smoker, exposure to cigarette smoke via secondhand smoke can increase your risk of heart disease. 

Exposure to secondhand smoke has immediate adverse effects on your cardiovascular system.5

Secondhand smoke increases the risk of heart disease and developing lung cancer. When you are exposed to secondhand smoke, it causes your blood to get stickier, increases LDL cholesterol, and can cause damage to your blood vessels. 

If you’re around smokers, you can ask them to not smoke around you or encourage them to quit. If you have guests that are smokers, ask them to smoke outside in an open area. 


A solvent is any substance used to dissolve a chemical. The most common solvent is water, however, gas and solids can also be used as a solvent. The most common place solvents are used in your clothing is at the dry cleaner. Dry cleaning does not involve a full-water bath for your clothes. Instead, they use hydrocarbon-based chemicals as solvents to remove stains. 

When your clothing returns home with that distinctive dry-cleaned smell, it is not a good thing. That means that there is chemical residue on your clothes that will come in contact with your skin. A good way to avoid these toxic chemicals is to find a dry cleaner that uses non-toxic cleaners such as silicone. 

Solvents are also used in the dyeing process to serve as water and stain repellents. They can also inhibit bacteria growth in your clothing, act as flame retardants, and play the role of plasticizers to help designs adhere to fabric.6


Pesticides and herbicides are toxic by their very nature. Unfortunately your diet can chronically expose you to these dangerous poisons. The National Research Council claims that in children especially, dietary intake of pesticides accounts for most of their pesticide exposure. Pesticides are ubiquitous in our food supply. They are commonly found in baby formula, cereals, frozen foods, meats, soft drinks, soupes, fruit juices, tofu, and vegetable oils. 

GMO crops were developed to allow farmers to use more herbicides without killing the crops themselves. This is problematic because continuous exposure to toxins, including pesticides, is one of the key environmental risk factors of heart disease. 

The best way to avoid pesticides is to buy organic foods. I’ve always advocated for eating an organic diet as much as possible. Foods labeled 100% USDA organic cannot lawfully contain GMOs. Buying 100% organic ensures not only that your food is non-GMO, but that it is free from dangerous pesticides, hormones, and other chemicals.7 I understand that sometimes it’s difficult to buy all organic foods. At the very least you should buy organic grass-fed beef, free-range chicken, and wild-caught seafood. 

How to Lower Your Risk of Heart Disease

It’s never too late to take care of your heart and lower your risk of developing heart disease. Lifestyle changes such as exercising 30 minutes every day, changing your diet to eliminate fatty foods and eating a nutrient-dense diet, losing weight, and reducing stress can lower the impact of uncontrollable risk factors of heart disease. 

Taking the steps I mentioned above, such as using water filters, air purifiers, and reducing exposure to solvents, pesticides, and tobacco smoke can lower the effects of environmental risk factors of heart disease.  

You don’t have to move to address the environmental risk factors of heart disease, however, you can address them as well as your controllable risk factors. Don’t wait! While you cannot do anything to change your age, sex, genetics, or family history, you can limit their effect by lowering the number of controllable risk factors of heart disease. 

Article Sources

  1. What is Glycation?. Share Care. 2020.
  2. Growing Epidemic of Coronary Heart Disease in Low- and Middle-Income Countries. Thomas A. Gaziano, MD, MSc, et al. Current problems in cardiology, vol 35. 2010.
  3. Everything You Should Know About Oxidative Stress. Megan Dix, RN, BSN. Healthline. 2018.
  4. Cardiovascular diseases (CVDs) Facts. World Health Organization. 2021.
  5. Secondhand Smoke (SHS) Facts. Centers of Disease Control and Prevention. 2021.
  6. Chemical Solvents and Supplies. Apparel Search. 2021.
  7. What is a Bioengineered Food?. U.S. Department of Agriculture. 2021.