How to prevent heart disease: proven ways to reduce risk

Heart disease (also known as coronary artery disease) is scary. The number one cause of death in the United States, it's the malady every man fears—but too many of us don't do enough to prevent. And that's the good news: Heart disease can often be prevented with some simple lifestyle changes.

Heart disease occurs when plaque builds up on the walls of the arteries and blood vessels that feed into the heart, a condition called atherosclerosis. Plaque consists of fat, cholesterol, calcium, and other substances found in the blood. Over time, that buildup narrows the arteries, lessening blood flow. If the flow is blocked completely, or if a blood clot forms, that can cause a heart attack or stroke.

The good news is that an estimated 80% of cases of heart disease can be prevented, the American Heart Association says. It may even be possible for certain types of heart disease to be reversed by developing healthy habits that reduce the buildup of those artery-clogging plaques (Harvard Health Publishing, 2019).

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According to the Centers for Disease Control and Prevention, almost half of Americans (47%) have at least one of three risk factors for heart disease: High blood pressure, high cholesterol and being a smoker. Heart disease prevention begins with slashing those risks, and others, with simple lifestyle changes. These are some of the most effective ways to prevent or reverse heart disease.

Quit smoking or don’t start

Not smoking, and avoiding secondhand smoke, is one of the most important things you can do to maintain heart health. Tobacco smoke contains more than 4,000 toxins which can harm blood cells and damage artery walls and blood vessels. It can also lower "good" cholesterol, raise triglycerides (a type of fat in the blood), cause blood vessels to narrow, and make blood more sticky and susceptible to clotting. All of this increases your risk of atherosclerosis and heart disease.

Secondhand smoke also risks the heart health of those around you: It lowers "good" cholesterol, raises blood pressure, and damages heart tissue, according to the National Institutes of Health (NHLBI, n.d.). In fact, nonsmokers who breathe secondhand smoke have a 25 to 30% higher risk of developing heart disease than people who aren't exposed to secondhand smoke (CDC, 2020).

Eat a heart-healthy diet

A heart-healthy diet is one that's low in sodium, saturated fat, and processed foods. It emphasizes fruits and vegetables, whole grains, lean protein, and "good" unsaturated fats like the kinds found in fatty fish and olive oil. Each week, include two servings of fatty fish such as salmon in your eating plan; they're rich in omega-3 fatty acids, which can lower cholesterol and help prevent heart disease.

Healthy eating involves lowering your intake of sodium; consuming too much of it can exacerbate high blood pressure, raising your risk of heart attack and stroke. The American Heart Association recommends consuming no more than 2,300 milligrams of sodium—about one teaspoon of salt—daily. (And 6 in 10 Americans should have no more than 1,500 milligrams daily.) According to the CDC, 90% of Americans eat more salt than those dietary guidelines recommend, including 98% of men. Most of us take in 3,400 mg of sodium every day.

And consuming too much saturated fat can increase levels of blood cholesterol and triglycerides, which can contribute to the clogging of arteries. Read more about the basics of a heart-healthy diet here.

Exercise regularly and maintain a healthy weight

Frequent physical activity is key to a healthy heart. The American Heart Association recommends that all adults get at least 150 minutes of moderate aerobic exercise (such as brisk walking) or 75 minutes of vigorous exercise (such as running, swimming, or rowing) every week. Aim for 30 to 60 minutes of exercise most days of the week. Even if you can't commit that much time, get up and get moving—a little physical activity is better for your heart than none at all.

Know the healthy weight range for your age and stay within it. If you're overweight, talk with your healthcare provider about how weight loss can reduce your risk of heart disease and other potential life-threatening conditions.

Keep your blood pressure in a healthy range

Over time, high blood pressure (or hypertension) can weaken the walls of blood vessels, increasing your risk of stroke, heart attack, and dementia. Think you're out of the woods? You might not be anymore: In 2018, the American Heart Association lowered the guidelines for healthy blood pressure from 140/90 to 130/80 for some adults. According to Harvard Medical School, that means 70 to 79 percent of men over 55 technically have high blood pressure (Harvard Health Publishing, 2019).

If you have high blood pressure or diabetes, following your doctor's advice about diet and lifestyle changes, and complying with any medications you're prescribed, will lower your risk of heart disease. If you don't have those conditions, make healthy lifestyle choices to avoid developing them.

Get enough quality sleep

"People who don't sleep enough are at higher risk for cardiovascular disease and coronary heart disease—regardless of age, weight, smoking and exercise habits," says the National Sleep Foundation (Suni, 2020). Scientists believe that not getting enough rest impairs glucose metabolism, raises blood pressure, and increases inflammation—all risk factors for heart issues.

Not getting enough shut-eye can increase stress, which is a heart disease risk factor in itself. According to Harvard Medical School, sleep-deprived people have higher blood levels of stress hormones and inflammation, key contributors to heart disease; just one night of inadequate sleep can disrupt your system.

Even if you're getting enough sleep, make sure you're managing stress by getting enough exercise, maintaining social connections, and consulting your healthcare provider if you start to feel overwhelmed.

Get regular check-ups

Get regular check-ups, have your blood pressure tested regularly, and discuss what your family history might mean for your risk of heart disease.

If you don't have heart disease, you can make moves to prevent it. Even if you've been diagnosed with heart disease, you can take steps to slow its progression. Follow all the tips above, make them healthy habits, and continue to take any prescribed medication regularly.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

November 03, 2019

Written by

Michael Martin

Fact checked by

Mike Bohl, MD, MPH, ALM

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About the medical reviewer

Mike Bohl, MD, MPH, ALM

Dr. Mike is a licensed physician and a former Director, Medical Content & Education at Ro.