8 Ways to Prevent Heart Disease
Heart disease is a major cause of sickness and death in the U.S.
Heart disease includes many different conditions, but the most common one is coronary artery disease (CAD). CAD is a problem with the coronary arteries—the blood vessels that supply oxygen to the heart muscle. Your risk of heart disease and stroke can be reduced by lowering your chances of developing CAD.
You can have CAD and not know it. In its early stages, it doesn’t always cause symptoms. When there are symptoms, they can range from mild and subtle to sudden and devastating.
Most CAD is from atherosclerosis, or plaque buildup in the arteries, which can affect not only the arteries of the heart but any arteries in the body.
There are a number of known risk factors for heart disease, which means there are ways to reduce your risk.
Preventing heart disease starts with you. There are many different risk factors for developing heart disease that can be minimized through healthy habits. —Dr. Jay Patel
Tobacco use more than doubles your chance of developing CAD. And makes you up to six times more likely to have a heart attack. Smoking cigarettes, smokeless tobacco such as chewing tobacco, and secondhand smoke all increase your risk of developing heart disease.
Tobacco use can be directly linked to at least 20% of coronary artery disease deaths. Each cigarette you smoke raises your risk.
What to do
Quit smoking. Your risk decreases quickly after quitting. Within several years, it is almost similar to the risk for a nonsmoker. Even reducing the number of cigarettes you smoke daily will lower your risk—but not eliminate it altogether.
It can be difficult to quit smoking because you can be physically and psychologically dependent on it.
Quitting usually requires a combination of approaches including nicotine replacement therapy (patches, gums, lozenges, sprays), behavioral strategies, and psychosocial support, either from friends and family or experienced counselors.
It’s important to note that although some people use e-cigarettes to help them quit smoking, research is limited about their long-term effects. Experts do not consider them a reliable and safe way to quit smoking.
Cholesterol is a waxy substance that helps with the development of healthy cells throughout the body. Good cholesterol, like HDL, helps eliminate fat from the body. Bad cholesterol, like LDL, causes fat to be stored in the body—especially in your blood vessels. High levels of LDL causes atherosclerosis and increases your risk of CAD.
Cholesterol levels are affected by lifestyle, including diet and exercise patterns, and genetics.
All adults should have their cholesterol levels checked periodically to ensure that the levels are in a healthy range.
What to do
If you have high cholesterol, lower your risk of CAD significantly by reducing your bad cholesterol levels. To lower LDL:
- Eat a high-fiber, low-fat diet that limits foods from animal sources.
- Limit high-saturated fats like cheese, ice cream, and whole milk.
- Avoid processed food with trans fats, such as store-bought cookies or buttered popcorn.
- Exercise at least 150 minutes a week.
- You may need to take a cholesterol-reducing medication, such as a statin. They reduce cholesterol levels and also reduce your risk of having a heart attack or stroke.
High blood pressure
Blood pressure is a measure of the resistance to the flow of blood throughout the body. It can be measured using a cuff on your arm that inflates and deflates to calculate two numbers that make up the blood pressure.
The higher your blood pressure, the more force your heart needs to pump blood to the rest of the body. The force eventually causes blood vessels to stiffen, which then increases your risk of developing a stroke or CAD.
What to do
- Doctors typically check your blood pressure at every visit. If you go to the doctor regularly, your blood pressure is being monitored regularly. If you don’t go to the doctor regularly, check your blood pressure at least every 2 years—more often if you have a family history of high blood pressure. You can get your blood pressure checked at many drug stores and grocery stores for no cost, but they are not as reliable as going to the doctor.
- The ideal blood pressure is different for different people, depending on any underlying conditions. But in general everyone should aim to have a blood pressure of <120/<80.
- Follow a healthy diet that is high in fruits and vegetables, fiber, and potassium rich foods, and low in salt. If you have high blood pressure, follow the DASH diet (for Dietary Approaches to Stop Hypertension). It is high in whole grains, low-fat dairy products, vegetables, and fruits, and includes fish, poultry, beans, nuts, and healthy oils.
- Reduce alcohol intake as much as possible to lower blood pressure. Ideal is no more than 2 drinks a day for men and 1 drink a day for women.
- Quit tobacco use.
- Exercise at least 150 minutes a week.
- Lose weight if you’re overweight.
- Get more than 6 hours of sleep per night and try to maintain good sleep habits.
- If lifestyle changes do not lower your blood pressure, your doctor may prescribe a blood pressure medication. These include ACE inhibitors, diuretics (water pills), and calcium channel blockers.
Reducing risk factors for heart disease is hard work! It takes active effort to lead the healthy lifestyle that is required to accomplish this goal. In a world where delicious processed food and abundant home entertainment make it so easy to just kick back, relax, and order in, it is very challenging to make the choice to exercise and eat a healthy meal. —Dr. Patel
Regular exercise can decrease your risk of heart attack by a third to a half. About 50% of Americans are not meeting the exercise goals set by the American Heart Association (AHA) to help reduce risk of heart disease and stroke.
What to do
If you have been inactive for a long time, and are overweight and out of shape, talk to your doctor before starting an exercise program. The AHA recommends these exercise options to help reduce blood pressure and other risk factors:
- Aerobic exercise (running, biking, swimming).
- Dynamic resistance (resistance bands) or weight-training exercise.
- Do 150 minutes per week of moderate-intensity exercise (such as brisk walking, biking, and yoga) or 75 minutes per week of vigorous-intensity exercise (such as running or jogging, tennis, and swimming laps).
Being more than 20% over your ideal body weight increases other coronary artery disease risk factors, including high blood pressure, diabetes, high cholesterol, and a sedentary lifestyle.
You are considered obese if your body mass index (BMI) is 30 or greater (check this chart). You are overweight if your BMI is 25 to 29. BMI is an important screener for obesity, but it is not the only measure that is important. Excess stomach fat has been shown to increase risk of heart disease even when BMI is below 30.
What to do
The best approach to losing weight and maintaining a healthy weight is to use common sense rather than fad or extreme diets. To lose weight, you need to take in fewer calories than you burn off, so increase exercise and reduce calorie intake. Here’s how to do that:
- Do 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous-intensity exercise.
- Include a strength-training program to build muscle.
- Eat a heart-healthy diet that includes fruits, vegetables, and whole grains.
- If you are reducing your calorie intake, aim for 1,200 to 1,500 kcal/day for women and 1,500 to 1,800 kcal/day for men.
- Aim for slow weight loss (no more than 2 pounds per week).
Diabetes is when you have high levels of blood sugar. People with diabetes are 3 to 7 times more likely to die of cardiovascular disease. Type 2 diabetes affects about 45 million Americans. An aggressive approach to controlling diabetes and other risk factors may reduce your chances of heart complications.
What to do
- If you have diabetes, you must control your blood sugar levels (keeping them as close to normal as possible).
- Maintain a healthy weight or lose weight if you’re overweight.
- Eat a healthy high-fiber, low-fat, low-sugar diet.
- Do moderate-intensity exercise for at least 150 minutes per week.
- Your doctor may prescribe medications to help lower blood sugar levels. If you are taking medications, you should still follow all lifestyle recommendations.
People think that genetics are too strong to overcome. Several patients have told me that they feel they are fated to develop heart disease because their parents and grandparents suffered from heart attacks or heart failure. While genetics is certainly a significant component of your overall risk, it is still just that: a component. —Dr. Patel
Drinking too much alcohol can increase your risk of high blood pressure, obesity, high blood sugar, and poor sleep. All of these factors affect your risk for developing CAD.
What to do
Reduce your alcohol intake if you drink more than one (for women) or two (for men) alcoholic drinks per day. Keep in mind that a drink is one beer, one 5-ounce glass of wine, or 1.5 ounces of distilled spirits.
Talk to your doctor about whether moderate drinking (1 or 2 drinks daily) is safe for you.
Use of aspirin
A daily baby aspirin may protect you from developing heart disease, but it may also increase the risk of stomach bleeding. In certain people, the benefits outweigh the risks. Do not take a baby aspirin daily unless it is specifically recommended by your doctor.
Dr. Patel is a cardiology fellow at the University of California, Los Angeles. He received his undergraduate degrees in Mathematics and Psychology at the University of Illinois at Chicago, where he was a student in the Guaranteed Pre-Professional Admissions Program. After graduating summa cum laude with 2 degrees in 3 years, he matriculated to medical school at the University of Illinois. He completed his education in 2016. He did his residency in Internal Medicine at Stanford University and then moved to LA with his wife (and co-resident) to continue his training. While he loves almost every aspect of cardiology, he is most passionate about preventive cardiology in people of South Asian ancestry.