If you have family members with cardiovascular diseases, then you have an increased risk of developing heart diseases, regardless if you maintain a healthy lifestyle and diet. Those with extremely high cholesterol are at risk as well because it can't be lowered even by lifestyle and diet changes alone. Medications are needed in order to lower cholesterol levels. Other key risk factors that make a person more vulnerable to heart diseases are hypertension, high blood sugar, diabetes, obesity, smoking, and poor lifestyle.