Risk factors for heart disease


Key points about the risk factors for heart disease

  • Heart disease is the number one cause of death in Aotearoa New Zealand. It includes things like stroke, heart attack and other debilitating and life-threatening heart conditions.
  • Your risk of heart disease(mate manawa) is affected by many different factors, the more you have the greater your chance of having heart disease.
  • Some risk factors can’t be changed, but others can be reduced by making healthy lifestyle choices.
  • Doing a heart risk assessment will help you find out what your risk of heart disease is and what changes you need to make to reduce your risk.



Two young men laughing outdoors
Print this page

There are many different factors that shape your risk of getting heart disease. Some of these you can’t change, such as your age, sex and ethnicity. However, there are other factors you can change, such as whether you smoke, what you eat and drink and how much you exercise.

By making healthy choices every day, you reduce your risk of heart disease.

Learning about different risk factors can help you get a picture of your risk. Click on the risk factors in the table below to find out more.

To build your own heart risk profile based on factors such as these see our heart risk assessment page. 

Risk factors you can’t change:

Risk factors you can change:

  • Age
  • Sex
  • Ethnicity
  • Family history
  • Smoking
  • Blood glucose levels (with diabetes)
  • Blood pressure
  • Cholesterol levels
  • What you eat
  • Weight
  • Physical activity
  • Stress levels
  • Alcohol consumption

The following heart risk factors are things you can’t change. However, knowing that you have a certain risk factor helps you to know what your likelihood of having a heart-related event such as a heart attack or stroke is.

The more risk factors you have, the more important it is to make changes to the factors that you can influence. By making healthy choices every day, you can reduce your overall risk of heart disease.


  • Your chance of getting a heart attack increases with age.
  • Most people who die from a heart attack are 65 years or older.


  • Men have a greater risk of heart attack than women do, and they have attacks earlier in life.
  • At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks.
  • More women are presenting with symptoms suggesting heart disease or being admitted to hospital from the consequences of heart disease now than in the past.


  • In New Zealand, people of Māori, Pasifika and Indian subcontinent ethnicity are at greatest risk of heart disease. 

Family history

  • If an immediate male relative (your father or brother) had a heart attack or stroke before the age of 55, or if an immediate female relative (your mother or sister) had one before the age of 65, you are at greater risk of developing heart disease.
  • If both parents have had a heart attack or stroke before the age of 55, your risk of developing heart disease can rise to 50% compared to the general population.
  • However, having a family history of heart disease doesn't necessarily mean that you'll develop it. This is especially true if your family member smoked or had other risk factors that were not well treated.
  • Making lifestyle changes, and taking medicines to treat risk factors, can often lessen genetic (family history) influences and prevent or delay heart problems. 

The following heart risk factors are things that you can do something about. Learning how they increase your risk may help you feel more motivated to make the changes that are needed to reduce your risk of heart disease.

Being a smoker

  • The biggest single risk factor for heart attack is smoking.
  • A smoker’s risk of developing heart disease is much higher than that of a non-smoker. If you smoke, you are 2 to 4 times more likely than a non-smoker to have a heart attack.
  • Exposure to other people's smoke increases the risk of heart disease even for non-smokers.
  • Learn more about how and why to quit smoking.

Having poor blood glucose control (with diabetes)

  • Having diabetes hugely increases your risk of heart disease, especially if your blood glucose (sugar) levels are not controlled.
  • Heart disease is the leading cause of death for people aged 65 years of age or over with diabetes (68% die from heart disease).
  • If you have diabetes, it is important to work with your healthcare team to manage your blood glucose levels and control any other risk factors you can.
  • Learn more about diabetes – how to improve your blood glucose control if you already have diabetes or how to prevent getting diabetes.

Having high cholesterol

  • As your blood cholesterol rises, so does your risk of heart disease.
  • When you have other risk factors (such as high blood pressure and smoking), this risk increases even more.
  • Your cholesterol level is also affected by your age, sex, heredity (genes from your parents) and diet.
  • Learn more about high cholesterol and ways to reduce it.

Having high blood pressure

  • High blood pressure increases the workload placed on your heart. This makes the heart muscle thicker and stiffer, causing your heart to work poorly. A large heart is not a healthy one.
  • High blood pressure also increases your risk of stroke, heart attack, kidney failure and congestive heart failure.
  • If you also smoke or have obesity, high blood cholesterol levels or diabetes, your risk of heart attack or stroke increases even more.
  • Learn more about high blood pressure and ways to reduce it.

Having an unhealthy diet

  • What you eat affects risk factors such as your weight, cholesterol and blood glucose levels and blood pressure.
  • Following a heart-healthy eating plan will help to ensure you get all the nutrients you need to support your health.
  • This means eating plenty of vegetables and fruit, whole grains in place of refined grains, legumes, nuts, seeds, and other sources of healthy fats such as oily fish. You may also choose to include non-processed lean meats, poultry and/or dairy, while choosing vegetable-based oils.
  • Learn more about heart-healthy eating.

Being overweight

  • If you have excess body fat, especially a lot of fat around your waist, you are more likely to develop heart disease, even if you have no other risk factors.
  • Losing weight (a 3–5% loss of body weight) can significantly lower your risk of heart disease. It also reduces other risk factors such as high blood pressure, cholesterol and blood glucose.
  • Learn more about body size and health.

Not doing enough physical activity

  • An inactive lifestyle is a risk factor for heart disease.
  • Regular, moderate-to-vigorous physical activity helps reduce your risk of heart and blood vessel disease.
  • Even moderate-intensity activities help if done regularly and long term.
  • Walking is the easiest way to get some exercise: 3 kilometres 5 times a week is a useful way of keeping heart-healthy.
  • Physical activity can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people.
  • Learn more about the benefits of physical activity.

Being stressed

  • Stress may affect the risk factors that contribute to heart disease. For example, if you are stressed you may overeat, start smoking, or smoke or drink more than you otherwise would.
  • Learning healthier ways of managing stress is a way to reduce its effect on your heart health.
  • Learn more about stress and managing stress

Excess alcohol consumption

  • Drinking too much alcohol can increase your risk factors.
  • It can raise your blood pressure, increase a type of cholesterol (triglycerides) and increase your weight.
  • While it used to be thought that moderate alcohol intake was good for your heart, more recent research findings show that that, for most people, there will be little or no overall benefit.
  • If you drink, reduce your long-term health risks by drinking no more than:
    • 2 standard drinks a day for women and no more than 10 standard drinks a week
    • 3 standard drinks a day for men and no more than 15 standard drinks a week
    • with at least 2 alcohol-free days every week.
  • Read more about alcohol

Cardiovascular disease risk assessment and management 
See a summary of the CVD consensus(external link) on the NZ Heart Foundation website.
For more detail, see the Cardiovascular disease risk assessment and management for primary care(external link) Ministry of Health, NZ, 2018

See our page Heart failure for healthcare providers


heart check

Heart check

Heart Foundation, NZ

staying well with heart valve disease

Staying well with heart valve disease

Heart Foundation, NZ, 2020

eating for a healthy heart v2

Eating for a healthy heart

Heart Foundation, NZ, 2019

Need help now?

Healthline logo in supporters block

Need to talk logo

Healthpoint logo

Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Bryan Frost, FRNZCGP, Morrinsville

Last reviewed:

Page last updated: