As we age, our blood vessels become less flexible, and fatty deposits, or plaque, can build up along artery walls. These changes can limit blood flow to the heart. According to the American Heart Association/American Stroke Association, heart disease is the number one cause of death in Americans.
Though aging is the top risk factor, other factors can contribute as well, most notably poor diet and exercise, uncontrolled high blood pressure, smoking, and diabetes. Fortunately, there are steps you can take to mitigate these risks.
Habits to reduce the risk of heart disease
When it comes to preventing cardiovascular problems, focus on four important areas: smoking, diet, exercise, and weight. Practicing healthy habits is the biggest key to reducing your risk now and in the future. Consider these lifestyle modifications:
If you smoke, quit. People who smoke are two to four times more likely to experience heart disease. Smoking can damage the lining of the arteries, leading to plaque buildup, or atherosclerosis. Atherosclerosis can occur in the heart (coronary heart disease) or legs (peripheral artery disease). Coronary heart disease can result in chest pain, heart attacks, heart failure, and arrhythmias.
Maintain a heart-healthy diet. Incorporate a variety of fruits and vegetables, whole grains, low-fat dairy, skinless poultry and fish, nuts and legumes, and healthy cooking oils — the Mediterranean diet is a good guide. Reduce your consumption of saturated fat, sodium, red meat (though leaner cuts are OK at times), and sweets.
Get at least 150 minutes of moderate physical activity per week. This could include brisk walking, water aerobics, and gardening. If you're pressed for time, shoot for 75 minutes of vigorous activity. Consider activities like running, swimming, cycling over 10 mph, and uphill hiking.
Maintain a healthy weight. Adhering to the three healthy lifestyle boosters above will help limit weight gain. Talk to your healthcare provider about other factors that may be affecting the numbers on the scale.
Additional lifestyle risks
Hypertension (high blood pressure) and diabetes are other major contributors to heart disease risk. The former makes your heart work harder by increasing the workload of the heart, which leads to smaller blood vessels and blockages in the arteries. The longer your heart has to work overtime, the larger your heart grows to keep up with demand. While this may sound positive, it actually means your heart becomes less efficient at pumping blood, meaning your body will have a harder time producing enough oxygen and nutrients.
With diabetes, high blood glucose can damage your blood vessels and nerves. The longer you have diabetes, the higher the risk you face for developing coronary disease.
Medications that can lower risk
"Bad" cholesterol, or low-density lipoprotein (LDL), is the main source of plaque buildup, which leads to atherosclerosis. Your ideal LDL level depends on your long-term risk for heart attack or stroke. Health care providers may calculate this using an online tool that accounts for cholesterol levels, age, race, sex, blood pressure, smoking habits, and history of diabetes. To get a sense of your estimated heart disease risk, you can use the American College of Cardiology's ASCVD Risk Estimator.
Most should keep their LDL number below 130. Those who have had a heart attack should aim for below 100. People considered very high risk should try for below 70.
Depending on your risk, you may be prescribed a statin to lower your cholesterol. These drugs stop the production of cholesterol by blocking an enzyme that creates it. They also help your body reabsorb existing cholesterol. They've been shown to reduce heart attack risk by 36% and death from a cardiac event by 31%.
If you've experienced any proven vascular event, such as a blockage, peripheral artery disease, heart attack, or stroke, or you have heart stents, then taking low-dose aspirin daily can help prevent another one. It can help blood clots from forming, which are a particular concern if you already have atherosclerosis. Just be sure to get the OK from your doctor first, since aspirin thins the blood and may be contraindicated for certain conditions.
See your doctor
Making an appointment to see your primary care physician regularly is an important way to prevent heart problems. Primary care doctors can help you manage blood pressure, diabetes, and weight loss, and quit smoking. Yours can always refer you to a cardiologist if needed.
Watch for symptoms
Know what to look for when it comes to identifying signs of coronary distress before you or a loved one experiences a cardiac event. Common signs of concern include chest, shoulder, or jaw pain or pressure related to an activity, such as walking up a flight of stairs or exercising; shortness of breath; heart palpitations or a faster heartbeat; dizziness or weakness; even indigestion. Again, your primary care provider should be your first call, unless you're having an emergency — then call 911.
The more proactive you are about addressing heart disease risk, the more likely you won't face a cardiac event down the road.
Find out more about the causes of heart attacks and steps you can take for prevention by visiting Kaiser Permanente’s Cardiac Care site.