by HCA Midwest Health heart experts

You’re probably well aware that high cholesterol and high blood pressure raise your risk for heart attack, and that smoking isn’t good for your heart, either. You may even know that age, gender and family history can increase heart attack risk. But have you ever heard that flu, migraines or sleep apnea also can endanger your heart? Most people haven’t.

Heart problems don’t always begin in the heart. Many times your heart’s health is slowly compromised by conditions like diabetes, obesity or chronic stress.

To protect your heart, discuss your biggest risk factors with your healthcare provider. You also may want to ask about these five surprising heart attack risks:

1. Migraines. Having migraines doubles your risk of heart attack, according to a 2010 study in the journal Neurology. Migraine sufferers also are more likely to have risk factors such as diabetes, high blood pressure and high cholesterol. If you experience migraines, be sure to tell your doctor so you can be monitored for warning signs of heart disease.

2. Influenza. Having heart disease can make you more likely to contract the flu, and getting the flu virus can temporarily increase your risk of heart attack. Infections like the flu trigger inflammatory responses in the body, which can cause a heart attack. Your best strategy: get your flu vaccine at the beginning of flu season. A study released in October 2012 suggests a flu shot can dramatically decrease heart attacks and strokes. So if you haven’t already had your flu shot, get one!

3. Autoimmune disease. Certain autoimmune diseases and inflammatory syndromes like lupus and rheumatoid arthritis may ratchet up your chances of having a heart attack. The American College of Cardiology notes that several autoimmune disorders are linked to “heart block”—a problem with your heart’s electrical system. Some people may even need a pacemaker. Check with your doctor if you have an autoimmune disease and are experiencing erratic heartbeats.

4. Stopping aspirin therapy. Aspirin is a blood thinner that can prevent blood clots from forming. If you’ve been taking a daily aspirin as a preventive measure or because you’re a heart attack survivor, don’t suddenly stop taking it. That can boost your heart attack risk by triggering a blood clot (called the “rebound effect”). If you want to discontinue aspirin therapy, ask your healthcare provider how to wean yourself off of aspirin safely. One common method is to reduce how often you take an aspirin. Over several weeks you might go from daily to every other day to once or twice a week.

5. Sleep disorders. Sleep apnea, which disrupts a person’s breathing during sleep, not only affects sleep quality, it also increases the risk of heart attack, according to the National Sleep Foundation. Treatment for sleep apnea with a continuous positive airway pressure mask (CPAP) at night seems to reduce heart attack risk, perhaps because the therapy also reduces blood pressure, both at night and during the day. Lesson: don’t ignore sleep problems.

The best way to prevent heart attacks, of course, is to take care of yourself. Eating a healthy diet, getting plenty of sleep and exercising regularly helps keep your heart in tip-top shape.

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