• Balance calorie intake and physical activity to achieve or maintain a healthy body weight.
• Consume a diet rich in a variety of vegetables and fruits.
• Choose whole-grain, high-fiber foods. These include fruits, vegetables, and legumes (beans). Good whole grain choices include whole wheat, oats/oatmeal, rye, barley, brown rice, buckwheat, bulgur, millet, and quinoa.
• Consume fish, especially oily fish, at least twice a week (about 8 ounces/week). Oily fish such as salmon, mackerel, and sardines are rich in the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Consumption of these fatty acids is linked to reduced risk of sudden death and death from coronary artery disease. People with existing heart disease should consider taking daily fish oil supplements of 850 - 1,000 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DPA).
• Limit daily intake of saturated fat (found mostly in animal products) to less than 7% of total calories, trans fat (found in hydrogenated fats, commercially baked products, and many fast foods) to less than 1% of total calories, and cholesterol (found in eggs, dairy products, meat, poultry, fish, and shellfish) to fewer than 300 mg per day. Choose lean meats and vegetable alternatives (such as soy). Select fat-free and low-fat dairy products. Grill, bake, or broil fish, meat, and skinless poultry.
• Use little or no sodium (salt) in your foods. Reducing sodium can lower blood pressure and decrease the risk of heart disease and heart failure.
• Cut down on beverages and foods that contain added sugars (corn syrups, sucrose, glucose, fructose, maltrose, dextrose, concentrated fruit juice, and honey.)
• If you drink alcohol, do so in moderation. The AHA recommends limiting alcohol to no more than 2 drinks per day for men and 1 drink per day for women.

[For more information on diet, see In-Depth Report #43: Heart-healthy diet.]

Weight Reduction

People should aim for a BMI index of 18.5 - 24.9. Weight reduction is recommended for obese patients who have high blood pressure, high cholesterol levels, metabolic syndrome, or diabetes.

Some obese patients with coronary artery disease may consider having bariatric surgery (stomach bypass) to lose excess weight. The weight lost after surgery can help improve blood pressure, cholesterol, blood sugar and other factors associated with CAD.

Exercise and Cardiac Rehabilitation

Everyone in normal health should do at least moderate physical activity for a minimum of 30 - 60 minutes on most, if not all, days of the week

Even low amounts of moderate or high intensity exercise (walking or jogging 12 miles a week) can help produce beneficial changes in cholesterol and lipid levels. However, more prolonged exercise is required to significantly change cholesterol levels, notably by increasing HDL ("good cholesterol"). Resistance (weight) training has also been associated with heart protection.

Click the icon to see an image about angina.

Sudden strenuous exercise (especially snow shoveling) puts many people at risk for angina and heart attack. Patients with angina should never exercise shortly after eating. People with risk factors for heart disease should seek medical clearance and a detailed exercise prescription. And all people, including healthy individuals, should listen carefully to their bodies for signs of distress as they exercise. [For more information, see In-Depth Report #29: Exercise.]

Influenza Vaccination (Flu Shot)

Patients with CAD are considered at high risk for complications from influenza. People with CAD should get an annual flu shot.

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Review Date: 05/05/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)