Just about everyone knows that genetics, weight and diet play a critical role in heart disease. But now research has pinpointed new risk factors that can affect our heart health.

Dr. Beth Abramson, director of the Cardiac Prevention Centre at St. Michael's Hospital, says there are well-known risk factors for heart disease which still apply, including:

• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• A family history of heart disease -- if you have had a close female relative (such as a parent or sibling) diagnosed with heart disease before she was 65, or a close male relative diagnosed before he turned 55, you could be at risk.

New Risk Factors

Waist circumference
"We know that when you have increased weight across the belly, your metabolism is slightly different, it makes the blood pressure a little higher, it gives you a tendency to diabetes -- we call that metabolic syndrome," Abramson says. "The truth is that lifestyle, in addition to diet and exercise, can improve all these increased risk factors that we now know to be so important."

The body processes belly fat differently, she says. A slim person with a little beer belly (apple shaped) is at greater risk than many women who put on weight across the hips (pear shaped). She warns that being a large pear shape with plenty of weight across the belly area is still a danger.

C-reactive protein (CRP)
Heart disease develops for many reasons, including inflammation in the body and the blood vessels. The catch, she said, is that we can reduce that inflammation, or C-reactive protein, by losing weight, exercising, cutting down on some of the fat in our diet and not smoking.

To assess your risk for heart disease, visit your healthcare provider. By checking all the  factors, such as age, blood pressure and cholesterol, your healthcare provider can  determine your level of risk.

Diabetes
Diabetes is what is called a 'risk equivalent'. Weather you've had a heart attack or you have diabetes but have not had a heart attack, your risk of heart disease is the same. It's as if you had heart disease, Abramson says. There are some very important medications, in addition to lifestyle and diet considerations, that diabetics and people with heart disease should consider.

Blood pressure
People and doctors need to be retrained, she says, because what we though was a normal blood pressure many years ago is now actually considered a higher normal blood pressure.

"We actually have to start thinking that the lower the blood pressure, the better," Abramson said. "You can't have too low a blood pressure if you're feeling well, if you're not dizzy, not fainting or light-headed."