Risk factors for a second heart attack

People who have a heart attack are at increased risk of another one

People who have a heart attack are at higher risk of another one. Know your risk factors and adopt a healthy lifestyle to prevent a second heart attack.


You may have had a procedure and medication to restore blood and oxygen supply to the heart muscle. Even if this resolved your symptoms the affected blood vessel could narrow or occlude again. Also, the same factors that led to your first heart attack may already be damaging other blood vessels in your body. If these blood vessels supply the heart it could lead to another heart attack. If they supply the brain, it could lead to a stroke. Blocked vessels in the legs can cause peripheral arterial disease.

The risk of a second heart attack or another cardiovascular event is not the same for everyone. It depends on numerous factors, of which some can be influenced and others cannot. The most relevant risk factors are:

Unmodifiable risk factors:

  • Age
  • Sex
  • Number and type of previous cardiovascular events
  • Remaining pumping capacity of your heart
  • Presence of atrial fibrillation (a form of rhythm disorder)
  • Kidney dysfunction

Modifiable risk factors:

Identifying your risk factors determines the behaviour changes and medications needed to prevent new cardiovascular events. In addition, these factors can be combined to estimate your probability of a cardiovascular event in the next 10 years (see ‘The SMART risk score’). This forecast will help your doctor decide whether you need standard or more intensive preventive treatment. Whatever your risk level, a healthy lifestyle is crucial to prevent a second heart attack.

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