How to Prevent Heart Disease

Heart disease is the leading cause of the death in the United States. It is also a major cause of disability. There are many things that can raise your risk for heart disease. They are called risk factors. Some of them you cannot control, but there are many that you can control. Learning about them can lower your risk of heart disease.

What are the heart disease risk factors that I cannot change?

Age. Your risk of heart disease increases as you get older. Men age 45 and older and women age 55 and older have a greater risk.

Some risk factors may affect heart disease risk differently in women than in men. For example, estrogen provides women some protection against heart disease, but diabetes raises the risk of heart disease more in women than in men.

Race or ethnicity. Certain groups have higher risks than others. African Americans are more likely than whites to have heart disease, while Hispanic Americans are less likely to have it. Some Asian groups, such as East Asians, have lower rates, but South Asians have higher rates.

Family history. You have a greater risk if you have a close family member who had heart disease at an early age.

What can I do to lower my risk of heart disease?

Fortunately, there are many things you can do to reduce your chances of getting heart disease:

Control your blood pressure. High blood pressure is a major risk factor for heart disease. It is important to get your blood pressure checked regularly - at least once a year for most adults, and more often if you have high blood pressure. Take steps, including lifestyle changes, to prevent or control high blood pressure.

Keep your cholesterol and triglyceride levels under control. High levels of cholesterol can clog your arteries and raise your risk of coronary artery disease and heart attack. Lifestyle changes and medicines (if needed) can lower your cholesterol. Triglycerides are another type of fat in the blood. High levels of triglycerides may also raise the risk of coronary artery disease, especially in women.

Stay at a healthy weight. Being overweight or having obesity can increase your risk for heart disease. This is mostly because they are linked to other heart disease risk factors, including high blood cholesterol and triglyceride levels, high blood pressure, and diabetes. Controlling your weight can lower these risks.

Eat a healthy diet. Try to limit saturated fats, foods high in sodium, and added sugars. Eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure and cholesterol, two things that can lower your risk of heart disease.

Get regular exercise. Exercise has many benefits, including strengthening your heart and improving your circulation. It can also help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can lower your risk of heart disease.

Limit alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain. Both of those raise your risk of heart disease. Men should have no more than two alcoholic drinks per day, and women should not have more than one.

Don't smoke. Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, quitting will lower your risk for heart disease. You can talk with your health care provider for help in finding the best way for you to quit.

Manage stress. Stress is linked to heart disease in many ways. It can raise your blood pressure. Extreme stress can be a "trigger" for a heart attack. Also, some common ways of coping with stress, such as overeating, heavy drinking, and smoking, are bad for your heart. Some ways to help manage your stress include exercise, listening to music, focusing on something calm or peaceful, and meditating.

Manage diabetes. Having diabetes doubles your risk of diabetic heart disease. That is because over time, high blood sugar from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. So, it is important to get tested for diabetes, and if you have it, to keep it under control.

Make sure that you get enough sleep. If you don't get enough sleep, you raise your risk of high blood pressure, obesity, and diabetes. Those three things can raise your risk for heart disease. Most adults need 7 to 9 hours of sleep per night. Make sure that you have good sleep habits. If you have frequent sleep problems, contact your health care provider. One problem, sleep apnea, causes people to briefly stop breathing many times during sleep. This interferes with your ability to get a good rest and can raise your risk of heart disease. If you think you might have it, ask your doctor about having a sleep study. And if you do have sleep apnea, make sure that you get treatment for it.

1. Don't smoke or use tobacco

One of the best things you can do for your heart is to stop smoking or using smokeless tobacco. Even if you're not a smoker, be sure to avoid secondhand smoke.

Chemicals in tobacco can damage the heart and blood vessels. Cigarette smoke reduces the oxygen in the blood, which increases blood pressure and heart rate because the heart has to work harder to supply enough oxygen to the body and brain.

There's good news, though. The risk of heart disease starts to drop in as little as a day after quitting. After a year without cigarettes, the risk of heart disease drops to about half that of a smoker. No matter how long or how much you smoked, you'll start reaping rewards as soon as you quit.

2. Get moving: Aim for at least 30 to 60 minutes of activity daily

Regular, daily physical activity can lower the risk of heart disease. Physical activity helps control your weight. It also reduces the chances of developing other conditions that may put a strain on the heart, such as high blood pressure, high cholesterol and type 2 diabetes.

If you haven't been active for a while, you may need to slowly work your way up to these goals, but in general, you should do aim for at least:

150 minutes a week of moderate aerobic exercise, such as walking at a brisk pace.
75 minutes a week of vigorous aerobic activity, such as running.
Two or more strength training sessions a week

Even shorter bouts of activity offer heart benefits, so if you can't meet those guidelines, don't give up. Just five minutes of moving can help, and activities such as gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

3. Eat a heart-healthy diet

A healthy diet can help protect the heart, improve blood pressure and cholesterol, and reduce the risk of type 2 diabetes. A heart-healthy eating plan includes:

Vegetables and fruits.
Beans or other legumes.
Lean meats and fish.
Low-fat or fat-free dairy foods.
Whole grains.
Healthy fats, such as olive oil.

Two examples of heart-healthy food plans include the Dietary Approaches to Stop Hypertension (DASH) eating plan and the Mediterranean diet.

Limit intake of the following:

Salt.
Sugar.
Processed carbohydrates.
Alcohol.
Saturated fat (found in red meat and full-fat dairy products) and trans fat (found in fried fast food, chips, baked goods).

4. Maintain a healthy weight.

Being overweight — especially around the middle of the body — increases the risk of heart disease. Excess weight can lead to conditions that increase the chances of developing heart disease — including high blood pressure, high cholesterol and type 2 diabetes.

The body mass index (BMI) uses height and weight to determine whether a person is overweight or obese. A BMI of 25 or higher is considered overweight and is generally associated with higher cholesterol, higher blood pressure, and an increased risk of heart disease and stroke.

Waist circumference also can be a useful tool to measure how much belly fat you have. The risk of heart disease is higher if the waist measurement is greater than:

40 inches (101.6 centimeters, or cm) for men
35 inches (88.9 cm) for women

Even a small weight loss can be beneficial. Reducing weight by just 3% to 5% can help decrease certain fats in the blood (triglycerides), lower blood sugar (glucose) and reduce the risk of type 2 diabetes. Losing even more helps lower blood pressure and blood cholesterol level.

5. Get good quality sleep.

People who don't get enough sleep have a higher risk of obesity, high blood pressure, heart attack, diabetes and depression.

Most adults need at least seven hours of sleep each night. Make sleep a priority in your life. Set a sleep schedule and stick to it by going to bed and waking up at the same times each day. Keep your bedroom dark and quiet, so it's easier to sleep.

If you feel like you've been getting enough sleep but you're still tired throughout the day, ask your health care provider if you need to be evaluated for obstructive sleep apnea, a condition that can increase your risk of heart disease. Signs of obstructive sleep apnea include loud snoring, stopping breathing for short times during sleep and waking up gasping for air. Treatments for obstructive sleep apnea may include losing weight if you're overweight or using a continuous positive airway pressure (CPAP) device that keeps your airway open while you sleep.

6. Manage stress.

Some people cope with stress in unhealthy ways — such as overeating, drinking or smoking. Finding alternative ways to manage stress — such as physical activity, relaxation exercises or meditation — can help improve your health.

7. Get regular health screenings.

High blood pressure and high cholesterol can damage the heart and blood vessels. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.

Blood pressure. Regular blood pressure screenings usually start in childhood. Starting at age 18, blood pressure should be measured at least once every two years to screen for high blood pressure as a risk factor for heart disease and stroke.

If you're between 18 and 39 and have risk factors for high blood pressure, you'll likely be screened once a year. People age 40 and older also are given a blood pressure test yearly.

Cholesterol levels. Adults generally have their cholesterol measured at least once every four to six years. Cholesterol screening usually starts at age 20, though earlier testing may be recommended if you have other risk factors, such as a family history of early-onset heart disease.

Type 2 diabetes screening. Diabetes is a risk factor for heart disease. If you have risk factors for diabetes, such as being overweight or having a family history of diabetes, your health care provider may recommend early screening. If not, screening is recommended beginning at age 45, with retesting every three years.

If you have a condition such as high cholesterol, high blood pressure or diabetes, your health care provider may prescribe medications and recommend lifestyle changes. Make sure to take your medications as your health care provider prescribes and follow a healthy-lifestyle plan.