There is good news and bad news about heart disease—so, let’s get the bad news out of the way first. It’s the leading cause of death in the U.S. for both men and women, linked to one in every four deaths each year. And, while heart disorders typically do not develop until after age 65, recent research shows that heart attacks are on the rise in younger people, particularly women. The good news? According to the American Heart Association, a whopping 80% of heart problem cases can be prevented—meaning, your heart’s health is very often in your own hands. Want to live a longer, healthier life? Let’s talk how.
We went to some of the nation's top experts in heart disease to bring you the most up-to-date information possible.
Guy Mintz, M.D.Director of Cardiovascular Health & Lipidology
Michael Goyfman M.D., MPHDirector of Clinical Cardiology
Benjamin Hirsh, M.D.Director of Preventive Cardiology
Remind Me: What Is Heart Disease, Again?
Let’s not skip a beat—but instead begin with a quick overview. First thing to know? Heart disease is not just one disease. It’s an umbrella term for a range of conditions that can harm the heart. The most common type of heart disease is coronary artery disease, or CAD for short. (You might also hear your doc refer to it as coronary heart disease.)
CAD develops when your heart’s arteries stiffen and narrow due to a buildup of cholesterol, fat, and other substances (called plaque) on the walls of your arteries. Plaque inhibits the flow of blood, which prevents your heart from getting all of the life-giving oxygen it needs to function properly.
Other types of heart disease include:
Hypertension, also called high blood pressure (HBP), which makes your heart work harder, increasing your risk of heart failure and stroke.
Heart attack, which occurs when a blockage cuts off blood flow to the heart, starving your most important muscle of oxygen and other nutrients.
Heart failure, a.k.a. congestive heart failure, in which the heart becomes progressively less able to keep up with the body’s demand for oxygen-rich blood.
Heart valve disorders, which affect the parts of your heart that help regulate blood flow.
Arrhythmias, another umbrella term for various heart-rhythm disorders (like atrial fibrillation) that disrupt your ticker’s ability to beat properly, leading it to beat too fast, too slowly, or erratically.
Stroke, which is not technically a type of heart disease but is a common result of cardiovascular issues. When blood vessels are blocked, or when a blood clot in the heart is released and travels to the brain, the result is a sudden interruption of the blood and oxygen supply to the brain.
Heart disease has many causes and risk factors. Some you can’t do anything about. They include:
Your age. It’s just a fact of life that the older you get, the higher your risk of something going wrong with your ticker.
Your genetics. You inherit genes from your parents that may up your odds of heart disease.
Your biological sex. A lifetime of estrogen, which women have in greater amounts than men, may offer some protection against heart disease—at least until the menopausal years, when estrogen levels drop.
But let that knowledge encourage you to be even more vigilant about managing the risk factors you can control, like whether or not you smoke cigarettes or vape, how well you eat and sleep, and if you move your body enough. Keep in mind, too, that addressing one risk factor may also help you tackle one or more others at the same time. For example, if you exercise regularly, you’ll strengthen your heart, and you also may shed some weight, which has its own heart health benefits (we’ll get to that next).
Is Heart Disease Actually Preventable?
In the majority of cases, yes! (And isn’t that a relief to learn?) Only the factors listed above are totally uncontrollable. That means you get a big say when it comes to your ticker's overall well-being.
And, even if you do have a predisposition for a specific type of heart disease and its complications, there are often things you can do to halt its progression or even reverse the course of your disease after you’re diagnosed.
The first step toward prevention is to see your doctor and learn where your heart health stands. Right now you could be at high risk of heart disease and not even know it. Why? Because while we all wish bad stuff happening inside the body would announce itself with loud bells and whistles (or maybe just undeniable physical clues), some common health problems that can harm your heart can have no symptoms at all. Here are some of the heart-harming conditions your doctor will look for:
High Blood Pressure
High blood pressure is one of those sneaky conditions that fails to announce itself. Often called the “silent killer,” HBP gives no outward clues as it harms your heart and blood vessels, making you increasingly more prone to stroke, heart attack, and heart failure.
If you haven’t done so recently, get your blood pressure tested. According the American Stroke Association, normal blood pressure is 120/80 mm Hg or below. High blood pressure is a systolic pressure of 130 or higher, or a diastolic pressure of 80 or higher, that stays high over time. It should be noted that your BP is considered "elevated," the first signal that HBP could be a problem you'll need to deal with, when your systolic pressure measures up to 129 (even if your diastolic pressure is still safely at 80 or below).
If you do have HBP, there’s plenty you can do to get it under control before it does real damage to your ticker. This includes:
However, lifestyle adjustments alone may not be enough. Your doctor may advise you to take medication to lower your blood pressure. These drugs include:
Same goes for unhealthy cholesterol levels. You won't know you have it unless you get tested. There are two kinds: “good” HDL” and “bad” LDL cholesterol. If you’ve got too much LDL and not enough HDL you’re at higher risk for heart disease, because unhealthy cholesterol contributes to atherosclerosis, the plaque buildup that lead to coronary artery disease.
Diet and exercise can help you better manage your cholesterol levels, but your doctor may decide that you also need medication to keep it in check. These include:
Bile acid binding resins
Another huge tip-off to heart disease risk: high blood sugar, also known as blood glucose. Elevated blood sugar is a marker of type 2 diabetes, which not only boosts your odds of HBP and high cholesterol; it puts you squarely in the cross-hairs of heart disease.
Why? Because too much blood sugar damage your vessels along with the nerves that control them and your heart. People with diabetes have up to a four times greater risk of dying of heart disease than people who don’t have diabetes. Keeping your blood sugar in the normal range, or managing your diabetes if you already have the disease, will help you protect your heart. Preventing diabetes, like preventing heart disease, involves:
Eating a diet rich in fruits, vegetables, dark greens, fiber, and lean meat
Maintaining a healthy weight
A Family History
Ok, this isn't a condition, but it's crucial to discuss your family’s health history with your doctor. If your brother or father had heart disease before age 55 or your sister or mother before age 65, you may have a higher risk of heart disease yourself.
You’ll also want to discuss specific types of heart disease risk factors that run in your family, like HBP and high cholesterol. Why? The genes you’ve inherited from your parents can influence your future health.
For example, even if you’re a kale-loving yogi, your parents might have passed on to you a gene that causes familial hypercholesterolemia, a genetic disorder that causes high cholesterol that must be managed with medication. But keep in mind that genes are not always destiny. If you take excellent care of your heart, you may be able to avoid heart disease.
What Lifestyle Habits Help Prevent Heart Disease?
Below is a long list of all the things you can do to protect your body’s most important muscle. Depending on your current habits and lifestyle, it may be challenging. But the rewards for your heart health—and your health overall—can’t be overstated.
We know, many of you have tried to snuff out a smoking habit—more than once. Don’t give up! There are many smoking cessation methods out there, so if nicotine gum didn’t work for you, maybe the patch will. Or hypnosis. Or even the prescription drug Chantix.
The important thing is to keep fighting for your heart—and your life. If you slip up, let it go and try again with a fresh approach. You can do this. And if you need help, check out the American Heart Association’s support page to help you quit smoking.
How, exactly, does smoking hurt you heart? It:
raises your blood pressure
lowers your good HDL while raising your bad LDL cholesterol levels
damages your heart’s cells and blood vessels
contributes to plaque buildup, which you know can lead to a whole cascade of other problems, heart attack and stroke included
While the number of smokers in the U.S. has dropped over the years, nearly 1 in 6 American adults still lights up. Remember, there’s no safe amount of smoking. But what about e-cigarettes, you ask? The truth is, JUULs, vape pens, and mods haven’t been studied enough yet to fully understand the risks. However, many of the toxic chemicals you inhale when you vape have been linked to heart disease. Follow the AHA’s advice: Do everything in your power to quit vaping, too.
Eat a Heart-Healthy Diet
What you eat has a real impact on your heart, for better and for worse. An unhealthy diet can boost your blood pressure, blood sugar, and cholesterol, all while expanding your waistline. That’s a recipe for heart disease. Your best bet? Limit the following:
Foods rich in saturated fat, like fatty cuts of beef, lamb pork and other meat, as well as dairy products like butter and cheese
Trans fats, found in foods such as doughnuts, stick margarines and spreads, and baked goods like frozen pizza, pie crusts, cakes, cookies, and crackers.
High sodium foods, like processed foods and snacks, pizza, canned entrees, vegetables and soups.
Sugary foods, like sodas, desserts, fruit drinks, candy, and many breakfast cereals.
What, then, should you eat? You have lots of delicious options. One would be to follow what’s known as the Mediterranean diet, which emphasizes lean meats and fish, fiber-loaded whole grains, fruits and vegetables, beans, and other whole foods as well as healthy fats like olive oil. If HBP is a concern, talk to your doctor about the DASH (Dietary Approaches to Stop Hypertension) diet, which focuses on nutritious foods with low sodium.
Of course, eating right also means eating the right amount to prevent weight gain, or to lose weight if you’re carrying extra pounds. There’s no doubt that changing your eating habits will be challenging. For some of us, food is as much an addiction as smoking is to others.
Consider finding a registered dietitian/nutritionist who can help you develop a plan and plot healthy eating strategies to reach your goals. Working with a pro (if you can swing it) is 100% great, but if that’s not doable, take baby steps … don’t try to change everything overnight. If you’re a big soda drinker, for instance, set a goal to swap out one can for seltzer for a few days. When that gets easier, up the ante. You can do it—and your heart will thank you.
Exercise Regularly and Often
Working out strengthens your heart muscle, which allows it to work more efficiently. It also helps bring down unhealthy blood pressure, cholesterol, and blood sugar levels. And there’s more: Exercise can also assist you in your efforts to slim down, taking away some of the burden that excess weight puts on your heart. But if you’re like four out of five other Americans, you probably don’t work out for the recommended minimum of 150 heart protective minutes of moderate exercise per week.
We get it. Fitting 30 minutes of exercise into your busy schedule most days can be a challenge, but did you know that you don’t have to do all your exercise at once? Divide your time into three 10-minute chunks of sweat-inducing, heart-pumping aerobic moves. And you can do any exercise you like: brisk walking, bicycle rides, jogging, jumping jacks, or jumping rope. It all gets the job done. Also important: Get up from your desk or the couch and move around frequently. Extended periods of sitting on your butt have been tied to both heart disease and diabetes.
If you’re exercising and improving your diet, you’re already on your way to weight loss and a less-taxed heart muscle. Yay! You're also lowering your risk for type 2 diabetes. But what weight-loss goal should you set? Research shows that losing just 5% to 10% of your body weight can lead to big health benefits. If you’re not sure where your weight falls, we can help you figure it out with our DIY health calculators.
Other measures, like your waist size, are also important because excess abdominal fat has been linked to heart disease and even heart attack, according to a 2018 study in the Journal of the American Heart Association. Fat in your midsection causes chronic inflammation, leading to rises in your blood pressure and cholesterol. Guys, try to get your waist to 40 inches or less. Ladies, aim for 35 or less.
Prioritize Quality Sleep
If you regularly don’t get a good night’s sleep, the consequences could be much greater than feeling sluggish the next day. Over time, a lack of ZZZs contributes to obesity, HBP, and diabetes.
It also raises your risk of a heart attack, because long-standing sleep deprivation can up your heart rate, as well as lead to a spike in blood pressure and certain chemicals linked with inflammation, which may put extra strain on your heart.
This is particularly true if you have a condition called obstructive sleep apnea. Sleep apnea interrupts your breathing repeatedly throughout the night, though only for brief periods that usually don’t fully wake you up. For that reason, you may think you slept through the night despite feeling tired the next day.
If you always feel tired during the day or your partner complains of your snoring, talk to your doctor about sleep apnea, because it boosts your chances of heart failure, arrhythmia, and stroke. Then ask about doing a sleep study to monitor your breathing in a hospital setting, and about CPAP (continuous positive airway pressure) therapy, which can keep you breathing easy—and protect your heart.
Chronic insomnia—difficulty falling asleep, staying asleep, or both—can also harm your heart. In addition, when you don’t sleep well you tend to make poor food choices and lose your motivation to exercise the next day. If you're struggling with insomnia, bring it up to your doctor. While there are medications that can help, you may also be a good candidate for cognitive-behavioral therapy, which has been shown to be an effective (and drug-free!) treatment.
Limit Alcoholic Beverages
Look, if you enjoy having a beer or cocktail at the end of a long week, keep on imbibing (if you’re otherwise feeling good)! Drinking a single drink per day if you’re a woman and two if you’re a man (because men metabolize alcohol differently than women) is usually perfectly fine. But remember not to pour too generously: One drink equals 12 ounces of beer, five ounces of wine, or 1.5 ounces of hard liquor, like gin or bourbon. When drinking is done in true moderation, we say “Cheers!” to that.
It’s when you overdo it that drinking can harm your heart, directly and indirectly. It can lead to spikes in blood pressure, plus ups your odds for heart failure, stroke, and atrial fibrillation, too. Excessive booze also boosts your triglycerides, a type of fat found in your blood that’s been linked to heart disease. And alcohol is full of empty calories, which can pack on unwanted pounds, strain your ticker, and make it work harder.
Let Yourself Relax (Like, Really Relax)
Many of us feel guilty for seeking some downtime to decompress—but regularly unwinding, body and soul, is every bit as essential as other preventive measures when it comes to heart disease. So, take those time-outs!
Experts can’t fully explain why stress and your heart don’t play well together, but there are some pretty strong connections. After all, stress influences many things that are known to be heart disease risk factors. It can trigger inflammation, raise your blood pressure, and affect your cholesterol levels.
Stress also encourages behavior that compromises your heart health. For example, when you’re under too much pressure, you may eat too much, overindulge in alcohol, or light up a cigarette. Your goal: Find ways to curb stress if it’s a constant in your life. Regular exercise, which we talked about above, can help—yoga’s especially good in this regard. You should also try meditation, deep breathing, improving your sleep, and hanging out with friends.
Like we said, there’s a lot you can do to prevent heart disease from happening in the first place—and even if you do develop some form of it, you can implement many of these prevention tips to help keep it from getting worse. Your heart is the engine of your body. Keep it in tune and it will help you keep stepping to the beat for years to come.
At what age do I need to start thinking about heart disease?
It’s never too soon. Heart disease can start when you’re still young, but typically it develops after age 65. Still, heart disease doesn’t happen overnight. It most often develops over many years, as habits like smoking, eating poorly, and otherwise neglecting your health, take their slow toll. The earlier you embrace heart-healthy habits, the better your chances of preventing heart disease.
How do I get my spouse/partner to take heart health more seriously?
Partners have a big influence on each other. If one eats poorly, for example, nine times out of 10, the other will, too. In addition to discussing your concerns, start modeling the lifestyle changes you want to see in your spouse. For example, research has shown that if you start to exercise regularly, the couch potato you love so much will move along with you.
Is there a quick fix to prevent heart disease?
Sadly, no. But your heart’s health is well worth the effort. Keep in mind that many changes that seem hard at first can become habits over time. Don’t be surprised if you enjoy working out or refraining from alcohol. Still, it’s true that some people will always struggle with weight maintenance, healthy eating, or snuffing out smoking. Ask your doctor for advice and maybe a referral to a specialist who can help guide your efforts. The most important thing? Just keep trying.
Is it too late if I already have heart disease?
No! All the things you do to prevent heart disease in the first place, like eating well and exercising, will also help you live a longer and healthier life even if you have some form of heart disease. Of course, medications and surgery may be necessary, too, but the most important thing you can do is to take care of your heart every day.
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