First, the bad news: Cardiovascular disease is the No. 1 cause of death in the U.S. for people of any gender.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
The good news: It’s preventable.
“It’s not inevitable that people will have a stroke or heart attack,” says cardiologist Luke Laffin, MD. “We can control it.”
It takes work and vigilance but, yes, it’s totally possible. To help get you on the right path, Dr. Laffin discusses four impactful changes that can help unlock the best preventative care for your heart.
What is heart disease?
The term “heart disease” covers many conditions that affect the heart. Most commonly, it refers to atherosclerotic cardiovascular disease. In this condition, you have plaque buildup in either the:
- Coronary arteries, which supply blood to the heart.
- Peripheral arteries, which supply blood to your limbs and brain.
This buildup can lead to a heart attack or stroke. But you can take steps to prevent it. “Other cardiovascular diseases — heart rhythm and heart valve problems or heart failure — may not be as preventable,” says Dr. Laffin.
Heart disease risk factors
According to a 2015 Annals of Internal Medicine study, about half the deaths from heart and vascular disease in the U.S. could be prevented. Reducing your risks for heart disease is the first step. These heart disease factors include:
- Obesity: A body mass index (BMI) above 30 puts you at risk for developing heart disease. Body fat distribution matters, too. “That central adiposity, also known as a spare tire, increases your risk,” notes Dr. Laffin. “Those fat cells may lead to future cardiovascular disease and problems such as high blood pressure and blood sugar.”
- High cholesterol and high blood pressure: Too much LDL (low-density lipoprotein) cholesterol can cause plaque to build up in your arteries, pinching off the flow of blood to your heart or brain. “Hypertension (high blood pressure) also increases risk for heart disease. It’s called ‘the silent killer’ because many people don’t know they have it,” says Dr. Laffin.
- Diabetes: “Making sure that diabetes is well controlled helps prevent plaque buildup and atherosclerosis (when plaque clogs your arteries),” notes Dr. Laffin. Plaque buildup restricts blood flow to your heart and other organs, which can lead to heart attack or stroke.
- Alcohol consumption: Dr. Laffin says that drinking too much alcohol increases the risk for heart disease. “If you have three or more drinks in one session, your blood pressure will be higher the following day. So it’s best for women to drink no more than one drink a day and men to stick to no more than two.”
How to prevent heart disease
To help prevent heart disease, Dr. Laffin recommends cultivating heart healthy habits in these four areas.
The Mediterranean diet continues to be the crème de la crème of the heart health world. It involves eating foods that are traditionally consumed in countries bordering the Mediterranean Sea. This translates into a diet loaded with:
- Whole grains.
- Healthy fats, such as olive oil.
“A 2018 New England Journal of Medicine study showed that this way of eating goes beyond improving your cholesterol and blood pressure. It also lowers your risk for stroke and heart attack,” Dr. Laffin notes.
Other diets, such as a whole food plant-based eating style, may also lower your risk. “But there’s less data suggesting they’re helpful in reducing the risk of strokes and heart attacks,” he adds. “A heart-healthy diet also has to be sustainable. Think 30-plus years into the future. It doesn’t help to go on a restrictive diet, and then two years later, go back to eating junk.”
2. Physical activity
“The heart is a muscle that needs exercise. Getting the heart rate in an aerobic training zone maintains that heart pumping, or systolic, function,” says Dr. Laffin. “But more importantly, regular physical activity can lead to lower blood pressure and weight stability.”
Dr. Laffin recommends at least 150 minutes of moderate intensity exercise each week. Moderate intensity means you can have a conversation while in action — so a brisk walk or light jog counts.
“And once you have made aerobic physical activity a habit, start adding in some resistance training using light weights or bands,” he says. “Even two to five times a week can help stave off heart disease.”
Don’t despair if a busy weekday schedule prevents you from reaching your fitness goals. Research suggests it’s more about quantity than time frame. “The so-called weekend warrior gets a similar cardiovascular benefit as individuals who exercise five times a week,” he points out.
Smoking is a major cause of atherosclerosis. The longer you smoke, the higher your risk of heart attack. But it’s never too late to quit. You can experience the benefits within months.
Your doctor can help you decide which smoking cessation method will work best for you. Quitting or avoiding the habit is an absolute must to protect your heart.
It’s not just lifestyle factors that affect heart disease risk. Genetics can also tip the scales in (or out of) your favor. “For example, if you adjust your lifestyle and get active and strict with what you eat, you can lower bad cholesterol by about 25% to 30%. But the rest is genetically driven,” explains Dr. Laffin. “And we can’t reverse risk factors such as genetics, family history and aging. At a certain point, you may need to take medications to prevent heart disease.”
To stay on top of heart disease factors you can’t change, talk to your healthcare provider regularly, says Dr. Laffin. You may also benefit from cholesterol-lowering drugs called statins, which can reduce stroke and heart attack risk.
“It’s also important to understand your blood pressure and cholesterol numbers because they help your physician make informed decisions about the best next steps in your care.”