The risk of heart disease and myocardial infarction depends on risk factors. Risk factors are a set of conditions that increase the likelihood of heart disease occurring and developing. Some risk factors such as smoking and physical inactivity can be changed; others such as hypertension, hypercholesterolemia and diabetes can be controlled. However, some risk factors cannot be modified, such as age, gender and genetics. Based on observations of different populations, the following risk factors other than hypercholesterolemia have been identified, including: 1. smoking 2. family history of positive premature heart disease (myocardial infarction or sudden cardiac death before the age of 55 for fathers or brothers, and 65 for mothers and sisters) 3. low HDL cholesterol levels (less than 40 mg/dL) 4. age (45 years or older for men and 55 years or older for women) 5. high blood pressure (blood pressure higher than 140/90mmHg or taking antihypertensive medication) If the risk factors can be changed and can be eliminated, they are called modifiable factors. For example, most people can successfully lower their total cholesterol and LDL levels by changing their diet, and/or taking medications that have been shown to be effective in lowering cholesterol. Healthy eating habits include eating foods with more soluble fiber (fruits and vegetables), avoiding saturated fats and hydrogenated fats (fried and hard-fat foods such as butter and margarine). Factors that cannot be changed, such as age and family history, are called unchangeable risk factors. It is important to know the risk factors. The more risk factors there are, the greater the likelihood of having a myocardial infarction. Once risk factors are identified, they can be changed and eliminated to reduce or eliminate the risk of myocardial infarction. Unfortunately, many people are not aware of their risk factors and myocardial infarction can be the first manifestation of the problem. Because myocardial infarction often leads to sudden death, knowing the risk factors and working to reduce and control them can save lives. Two important nomenclature terms: Familial cholesterolemia is characterized by abnormally elevated cholesterol levels. The patient is unable to properly manage LDL cholesterol in the body and is in an increased coronary risk state. Risk factors refer to an increased likelihood of developing the disease. Some risk factors such as smoking and physical inactivity can be modified; others such as hypertension, hypercholesterolemia and diabetes can be managed. However, some risk factors cannot be changed, such as age, gender and genetics.