Lowering Heart Disease

From the foods you savor to the steps you take, every choice influences the fate of your cardiovascular health and well-being. The impact isn’t always immediate, however. The choices you make as early as your teen years can have an effect on your heart health in the long run.

Heart disease is the leading cause of death in the United States, causing approximately 1 in every 5 deaths. Although not all risk factors for heart disease can be avoided, there are many steps you can take to lower your risk for heart disease and ensure you’re living a heart-healthy lifestyle.

What Is Heart Disease?

The term heart disease, also known as cardiovascular disease, encompasses several types of heart conditions that affect the heart and blood vessels, including coronary heart disease, heart attack and heart failure.

Heart disease conditions can range from issues that affect the heart muscle directly to problems with the surrounding blood vessels that supply the heart and other parts of the body.

Risk Factors for Heart Disease

Age

As your age increases, so does your risk for heart disease. People ages 65 and older are more likely to experience a heart attack, have a stroke or develop coronary heart disease and heart failure, according to the National Institute on Aging.

Age influences your risk for heart disease due to a number of factors, including cumulative effects of lifestyle choices and the natural aging of your body and the cardiovascular system. Importantly, the actions we take at a younger age can directly influence this risk as we get older.

Sex

Historically, women typically have a lower incidence of heart disease than men. However, heart disease is the leading cause of death for both men and women in the U.S., according to the Centers for Disease Control and Prevention.

Women are often underrepresented in studies for heart disease, and there’s a general lack of education and awareness surrounding heart disease and women, which may contribute to the discrepancies in diagnosis. Only about 56% of women in the U.S. recognize heart disease as their number one killer, according to a national survey from the American Heart Association.

Family history

Family history of heart disease plays a big role in your individual risk.

“If someone comes in saying, ‘My brother and father all had heart attacks at age 40,’” then that’s reason to be more concerned about early cardiovascular disease, says Dr. Jennifer Lee Wong, a cardiologist and medical director of non-invasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California.

According to Dr. Dmitriy Nevelev, the associate director of outpatient cardiology at Staten Island University Hospital in Staten Island, New York, you should be evaluated by a cardiologist if there’s a man in your family history who had heart disease diagnosed at younger than 55 years old or a woman in your family with heart disease diagnosed at 65 years old or younger. If a cardiologist isn’t available, then you should visit your primary care doctor to assess what risk factors you carry.

Underlying health conditions

Health conditions like hypertension, high cholesterol levels, autoimmune disorders and diabetes are major risk factors for cardiovascular disease.

Underlying health conditions can directly affect the structure and function of the heart and blood vessels, making your cardiovascular system more vulnerable to disease.

Smoking and excessive alcohol consumption

Overtime, excessive alcohol use can contribute to a slew of health problems, including high blood pressure and heart disease. Smoking is also a major contributor to heart disease. Smoking causes your blood vessels to become stiff and inflamed, which can narrow the blood vessels and lead to heart conditions.

Physical inactivity

Regular physical activity is crucial for maintaining heart health and preventing conditions that contribute to heart disease.

Being active helps strengthen the heart muscle, which makes it more efficient at pumping blood, whereas inactivity can lead to a weaker heart, causing difficulty delivering blood and oxygen to your heart and the rest of your body.

Low levels of exercise can also lead to weight gain and cause obesity, which is associated with an increased risk for heart disease due to factors like insulin resistance, inflammation in the body and excessive strain on the cardiovascular system.

Poor diet

A poor diet is a significant contributor to developing heart disease. Foods high in saturated and trans fats, like fried foods, full-fat dairy products and processed foods can raise your LDL, or “bad,” cholesterol levels, which is a major risk factor for heart disease.

Excessive sodium and sugar intake also increase your risk. Sugary beverages, foods rich in added sugars, processed foods and restaurant or fast food meals are all foods that can have a negative impact on your overall health.

Lacking intake of fruits and vegetables also may mean you’re missing out on essential nutrients, antioxidants and fiber that support your heart health and decrease your risk for heart disease.

Lack of sleep

You should regularly be getting seven to nine hours of good sleep per night.

Chronic fatigue or not sleeping well contributes to higher blood pressure and cardiovascular disease, Wong says.

“It’s not just about the quantity of sleep, but the quality,” Nevelev says. “If people are taking medicines to put them to sleep, it’s not necessarily the same quality of sleep that they would get with a natural eight hours of rest.”

High stress

Stress affects our bodies in a couple of ways.

“First, on the molecular and physiologic level, stress causes us to keep more weight – more difficulty losing weight, more propensity to gaining weight,” Nevelev says.

Carrying extra weight on your body increases your risk for heart disease.

Stress also increases the amount of inflammation in our body. Plus, it also prevents us from doing things that tend to reduce risk of heart disease.

“People who have increased stress tend to have less time and less motivation to exercise or eat more healthfully,” Nevelev says.

Screening for Heart Disease 

Doctors use a combination of measures to screen for heart disease and assess their patient’s cardiovascular health. Your doctor will typically start by taking your medical history and conducting a physical examination.

Whenever assessing someone’s baseline risk of developing heart disease, there are modifiable and nonmodifiable risk factors that your doctor evaluates, Nevelev says.

Modifiable risk factors for heart disease are those that you can change or control through lifestyle modifications or medical interventions. Not all risk factors are modifiable, such as age, sex and family history, but others can be addressed to significantly reduce your risk of developing heart disease.

“We are doing a lot more testing these days on patients who have a strong family history to check for certain biomarkers,” Nevelev says.

For example, your doctor will likely check your lipoprotein (a), which is a form of low-density lipoprotein, because there’s a strong established correlation with a lifelong risk of developing heart disease. Blood tests are also used to measure cholesterol levels and triglycerides. Coronary artery calcium scans can help predict coronary heart disease risk.

Depending on your individual risk level or symptoms that have surfaced, your doctor may order imaging tests or other tests like an electrocardiogram, which records electrical activity of the heart and can detect irregularities in heart rhythm, signs of a heart attack or other abnormalities.

Steps to Lower Your Risk for Heart Disease

Interventions that target modifiable risk factors are key to managing heart disease risk. Actionable steps you can take to reduce your risk for heart disease include:

Eat a heart-healthy diet.

“I often recommend the DASH diet, or dietary approaches to stop hypertension,” Wong says.

The DASH diet emphasizes consuming fruits and vegetables, whole grains, lean protein and low-fat dairy and avoiding saturated fats, especially red meats that are high in saturated fats, and minimizing sweets intake.

“These diets have been well documented to decrease your risk of cardiovascular disease,” Wong says – both for those who are prone to heart disease as well as those who don’t have underlying genetic tendencies.

Nevelev’s go-to is the Mediterranean diet. He tells his patients to focus on three principles when sticking with a heart-healthy diet:

Increase your physical activity levels.

The American Heart Association promotes 150 minutes of moderate intensity exercise per week.

“Start with little changes,” Wong says. “You don’t have to suddenly jump up to 150 minutes a week. Even five minutes a day – it can make a difference.”

Nevelev adds that anything is better than nothing, and more is always better than less.

“Even if all you can muster up is just walking around the block a few times a day, that’s significantly better than doing absolutely nothing,” he points out.

Increasing your activity levels and sticking to a well-balanced, heart-healthy diet will also help keep your weight in check, as higher body weight is shown to increase your risk for heart disease.

Improve sleep hygiene.

Practicing good sleep habits is essential for getting the recommended seven to nine hours of sleep per night. Some tips for proper sleep hygiene include:

Manage stress levels.

Stress is extremely prominent this day and age, from financial stress to medical or physical issues to putting up with stress at work.

“It’s hard to find a patient who doesn’t have a significant stress in life,” Nevelev says.

But too much stress without reprieve for long periods of time is problematic and not sustainable for your mind or body. Maintaining a well-balanced diet, increasing your physical activity levels and getting better sleep not only contribute to better heart health, but also reduce your stress levels.

Additional strategies to reduce stress may include mindfulness exercises, daily journaling practices and, in some cases, getting additional support from a mental health practitioner.

Reduce alcohol consumption.

The Dietary Guidelines for Americans recommends that adults of the legal drinking age limit alcohol intake to two drinks or less per day for men and one drink or less per day for women.

Next time you’re out with friends, try swapping your drink order for one of many mocktails that have hit bar menus in recent years.

Quit smoking.

Not only is keeping up with a smoking habit expensive, but it’s detrimental to your health in more ways than one. Quitting smoking isn’t easy, but many resources exist to help you.

Ask your doctor about smoking cessation programs. There are also several organizations that offer free cessation resources, such as the American Lung Association’s Freedom from Smoking course or the CDC’s 1-800-QUIT-NOW quitline that provides free over-the-phone coaching.

Visit Your Doctor Regularly

Keeping up with routine doctor’s appointments is key to identifying and managing risk factors for heart disease in its early stages, allowing for timely intervention.

“A lot of people ignore elevated blood pressure because it’s not something that they can feel,” Wong says. “They may not realize the long-term consequences because, in the short term – even the first few years of it – nothing happens.”

She adds, “But we’re trying to prevent problems often decades away.”

Based on factors of your lifestyle, personal health conditions and family history, your doctor will work together with you to create an individualized plan of action to manage and reduce your risk for heart disease.

“It’s hard to convince patients in their early 20s that what you’re doing today is going to be a big factor in what happens to you decades from now,” she says.