If you don’t know the “Big Five” signs that you are at heightened risk for a heart attack, here is a refresher: Diabetes, smoking, family history, high cholesterol and high blood pressure.

“Those are powerful and very predictive. Each one by itself will double your risk, if not more, for coronary disease and events,” says Vincent Bufalino, MD, cardiologist. But those five are not the end of the story. Here are seven other heart disease indicators you should know about.

1. Eating on the run

If you are always just choking food down, you are missing out on the protective de-stressing factor that we all need which goes along with sitting down to enjoy and savor a meal. You are also probably eating unbalanced meals full of unhealthy processed foods loaded with sodium, sugar and fat that can lead to coronary heart disease.

2. Sexual dysfunction (men)

Early erectile problems are usually related inadequate blood flow to pelvic organs due to vascular disease. “That’s someone who should get a vascular workup because they also may have silent heart disease,” warns Dr. Bufalino.

3. Menopause

Postmenopausal women have a heightened risk for heart disease. Around 50% of American of women have high blood pressure by age 60, two-thirds by age 70. Dr. Bufalino reports that there is a spike in coronary heart disease-related deaths in women after menopause, with more women dying of the disease than men. “We don’t know what causes this but we do know that estrogen replacement doesn’t seem to alter the risk,” says Dr. Bufalino. All the more reason to keep exercising and eating right, no matter how old you are.

4. Sleep apnea

Pauses in breathing while sleeping, sleep apnea is frequently connected to atrial fibrillation (AF or A-fib), an irregular heartbeat. “If untreated, people with AF will develop a stroke over the course of five years.,” warns Dr. Bufalino. If you think you have sleep apnea, see a sleep medicine physician for assessment and treatment.

5. High triglycerides count

We tend to focus on LDL/HDL level when we check cholesterol. But triglycerides levels are also a key component in heart health. Triglycerides in your blood are positively linked to a atherosclerosis, heart disease and stoke. Lower the count by reducing your intake of carbohydrates (sugar and starches) and boost consumption of Omega IIIs (cold water fish, nuts, flax seed, spinach, brussel sprouts.

6. Low good HDL

Speaking of cholesterol, we strive for a low overall number. HDL (high-density lipoproteins), however, actually takes out cholesterol from your system and brings it to your liver, which breaks it down. Increasing HDL is beneficial — it’s like having a protective oil covering your arteries. You can boost it with the usual: exercise, avoid foods with saturated fats, quit smoking, drink alcohol moderately, eat more fiber and Omega IIIs, and reduce to a healthy weight.

7. Earlobe creases

And here’s the strangest one of all: If you have a diagonal crease on your earlobes, there is a soft correlation to increased heart attack risk. The hypothesis is that the creases are signs of premature aging, and people who look older early in life are more likely to present with coronary heart disease. Dr. Bufalino says, “It sounds odd but there are enough reports that it’s hard to deny that one.”