How to Prevent Heart Disease

Healthy Lifestyle Can Prevent 99% of Heart Disease Cases

Alongside medication, lifestyle changes like limiting foods high in sodium can help reduce the risk of heart disease, experts said.
Before a heart attack, stroke or other cardiovascular disease hit, there are almost always warning signs, according to a new study.

Those warning signs are well-known cardiovascular disease risk factors, but more can still be done to reduce cases of heart disease, according to a study published Monday in the Journal of the American College of Cardiology.

Study on Lifestyle Prevention of Heart Attacks

• For this study, researchers analyzed data from two groups: more than 600,000 cases of cardiovascular disease in South Korea and another 1,000 cases in the United States.

• Researchers analyzed what percentage of those cases were preceded by traditional risk factors for cardiovascular disease, including blood pressure levels, blood sugar, cholesterol and smoking.

• In more than 99% of cases of cardiovascular disease, heart failure or stroke, the patient had at least one of the risk factors before the incident occurred, according to the data.

• “Even ‘mild’ elevations of these 4 factors should be addressed with lifestyle treatments or medications,” said Dr. Philip Greenland, one of the study’s lead authors, in an email. He is also a professor of preventive medicine and the Harry W. Dingman Professor of Cardiology at Northwestern University’s Feinberg School of Medicine in Chicago.

Beyond diagnoses

The new study is particularly important because it reinforces that doctors and patients can manage the risk factors for almost all cases of heart disease, said Dr. Susan Cheng, professor and vice chair of research affairs in the department of cardiology at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles. She did not participate in the research.

Some research suggests that a growing number of cardiovascular disease cases show no traditional indicators of risk beforehand. That trend could imply that although the health care profession has addressed controllable factors, other elements—still unclear to researchers—may play a role, leaving them without effective prevention strategies, Cheng added.

What differentiates this research, she said, is that scientists didn’t rely solely on diagnoses of diabetes or high blood pressure to determine if risk factors existed. Instead, they examined patients’ medical data directly.

Sometimes, just because a clinician hasn’t labeled someone as having high blood pressure or high blood sugar doesn’t mean their levels don’t indicate risk factors. By reviewing a broader scope of medical data, these researchers identified traditional, modifiable risks in almost all patient charts before cardiovascular disease developed, Cheng said.

So, if clinicians and patients want to reduce heart disease risk, the best course of action involves continuing to manage risk factors like blood sugar, blood pressure, cholesterol, and smoking, she said.

It’s not fighting aging. It’s improving longevity

The medical field has learned a lot about heart disease over the past century, and experts have consistently shared common knowledge on how to prevent it for many years, said Dr. Karen Joynt Maddox, professor of medicine in cardiology at Washington University Medical School in St. Louis, Missouri. She did not take part in the research.

But still, people struggle to implement those changes. Part of the problem often comes from the abstract nature of heart disease risk, Joynt Maddox said.

When a patient receives a diagnosis, it becomes easier to motivate change and start treatments to deal with the immediate problem, she said. But communicating the importance of acting on future disease risk poses a bigger challenge.

Another obstacle is that adding medications or new health protocols to manage heart disease risk often feels linked to aging, which some patients find scary or unappealing, said Dr. Ahmed Tawakol, a cardiologist at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School. He did not participate in the research.

Instead, he frames it as a move toward longevity. Managing blood pressure, blood sugar, and cholesterol doesn’t mean you’re losing something — it means you’re actively working to protect your lifespan and health span. You’re creating more years to feel young and to do the things that matter to you, he said.

Healthy lab results and healthy behaviors

While the risk factors for cardiovascular disease have remained consistent, the technology for managing them has evolved.

Managing high blood pressure is often a good place to start, and just getting a blood pressure cuff means you can get a sense of your levels at home, Joynt Maddox said. Then, work with your doctor to keep an eye on your risk factors and make a plan for management.

In addition to the clinical risk factors studied in the research, it is also important to improve your lifestyle risk factors, Tawakol said.

Maintaining good sleep, exercise, nutrition, a healthy weight and low levels of stress are key to lowering cardiovascular disease risk, he said.

“For example, stress and depression turn out to be as potent risk factors as smoking and diabetes,” Tawakol said.

“I’m hoping that the more we double down and show the efficacy of treating all these things together, that more people will combine these approaches and actually enjoy much longer health spans.”

To learn more about how to prevent heart disease, visit this detailed guide for expert tips and advice.

Have questions or need personalized support to protect your heart health?
Feel free to contact me anytime at Eberlorie@gmail.com — I’m here to help you live a longer, healthier life!