Heart disease is a head-scratcher. We know it exists. We know it's lethal. And a lot of us know that it's elbowed out every type of cancer to become the leading cause of death in the U.S. About half of all adults have at least one of the key risk factors, like high blood pressure and cholesterol levels. Still, many of us put finger to nose and declare "Not it!" when we think about our own odds of the disease. We want to change that.
"Everyone needs to start paying attention," says Nisha B. Jhalani, M.D., director of inpatient clinical services for the Center for Interventional Vascular Therapy at New York-Presbyterian Hospital/Columbia University Medical Center. "The risk factors for heart disease can be entirely asymptomatic for a very long time. And many people who stand to develop it look completely healthy." The upshot, she says, is that you actually have a lot of control over your heart health. "A few simple changes can prevent the disease even among folks who are most at-risk," notes Jhalani. Here are some proven ways to find your path to a healthier heart. You're it!
"Primary care physicians and ob-gyns are at the front line for screening patients for heart disease—and a lot of them aren't having the conversation," says Jhalani. It's not on purpose, of course. It's just that it isn't always front-of-mind during standard office visits. "That's why I tell everyone I know: Bring it up yourself!" she adds. And ask early. Heart screening should start in your 20s, not 40s. That cardiac once-over should include family history and vitals like blood pressure, cholesterol and glucose levels.
Hitting these numbers will help keep your ticker in top shape, according to Nisha B. Jhalani, M.D., director of inpatient clinical services for the Center for Interventional Vascular Therapy at New York-Presbyterian Hospital/Columbia University Medical Center. If yours are higher in any of these categories, talk to your doc about how you can get them down to a healthier level.
Even though most of us think of cardio as The Exercise for heart health, incorporating strength training actually does a better job at lowering blood pressure—and keeping it down—than aerobic workouts alone, according to a study published in the Journal of Strength and Conditioning Research. Add about 20 minutes of weight training to your regular cardio routine three to four days a week to get the B.P. benefits. For the record, the American Heart Association recommends getting a total of 150 minutes of moderate activity (like walking or a not-super-strenuous strength session) or 75 minutes of vigorous exercise (running) per week.
If you smoke, stop. As in: right now. Abruptly quitting (with the help of a nicotine patch or other support) is more effective—in both the short- and long-term than tapering your habit, according to a randomized controlled study published in the Annals of Internal Medicine. One possible reason is that gradual cessation requires structure and step-by-step goals that may be hard to follow. Need more motivation? Know that you can slash your risk of heart disease in half within one year of quitting, according to the World Health Organization.
People who sleep for 5 hours or less a night have hearts that are about 1.5 years older than those who get an adequate 7 hours of shut-eye, according to a new study published in the journal Sleep Health. "Sleep is so incredibly important that no matter how well you eat or how much you exercise, if you're not getting enough rest, the benefits of those healthy lifestyle choices are substantially diminished," says study co-author Julia Durmer, a sleep medicine and public health researcher at Emory University in Atlanta.
We love a good steak or a gooey cheeseburger. But keeping it occasional is key. A study published in the journal Circulation linked higher intakes of red meat with an increased risk of coronary heart disease—and found that swapping out one daily serving for a healthier protein source, like nuts, fish or poultry, can lower your odds of developing the condition by 30, 24 and 19 percent, respectively. You don't have to be a hardcore carnivore to reap the benefits, either. The researchers note that everyone who cut back decreased their risk.
There's something to that old eat-breakfast-like-a-king advice. A recent study published in the journal Cell Metabolism found that consuming all of your daily calories before 3 p.m. can lower blood pressure by 10 to 11 mmHg in a mere five weeks. "Your body is simply better able to rid itself of too much sodium when you eat earlier in the day," says study author Courtney M. Peterson, Ph.D., assistant professor of nutrition sciences at the University of Alabama at Birmingham. "It's connected to your natural circadian rhythms." Cramming in a day's worth of food before the workday is over isn't exactly practical, but she says even getting most of your calories by midday—and having a modest evening meal—is still heart-smart.
Bypass the Halloween bargain bin variety and head straight for the dark stuff—containing at least 60 percent cacao. "People who eat about three 1-ounce servings a week have a significantly lower risk of cardiovascular and other heart-related diseases," says Monique Tello, M.D., a clinical instructor at Harvard Medical School and author of Healthy Habits for Your Heart. It's likely because of chocolate's flavonoids, which dilate blood vessels and help prevent arterial stiffness and plaque buildup.
Coffee has been extensively studied and the results are remarkably consistent: "Drinking three to five 8-ounce cups a day is associated with a lower risk of developing cardiovascular disease and of heart disease-related death," says Frank Hu, M.D., Ph.D., chair of the Department of Nutrition at the Harvard T.H. Chan School of Public Health. Why? "It's likely the mix of antioxidants, polyphenols and other compounds," says Hu. And while steering clear of sugar-bomb brews is a good idea in general (sorry, whipped caramel mocha), research shows that even those who like their java a little sweet and creamy saw positive heart results.
Less than a half hour of listening to Mozart can notably lower blood pressure and heart rate, according to a study at Ruhr University Bochum in Germany. (The soothing, slow-tempo tunes likely tamp down levels of cortisol, a stress hormone that contributes to high blood pressure.) Not a classical fan? Take heart: the researchers note that as long as the music you're listening to is lyric-free and you find it pleasant, it'll likely positively impact your heart too.
Cats are great and all, but dogs are your best friend for guarding against heart disease. Single people who have one or more pups are 36 percent less likely to die from cardiovascular disease than those without a furry friend, notes a recent Swedish study of more than 3.4 million adults. "While we found a risk reduction in all types of households, singles had the biggest heart improvements," says study author Tove Fall, Ph.D., an associate professor of epidemiology at Uppsala University. "It's likely connected to the social aspects of being a dog owner, like going for walks in the park and having a companion to curl up with."
"No matter how often you go out to eat, try cutting back. And that includes everything from dinner at a restaurant with friends to grabbing a muffin at Starbucks," says Jessica Crandall Snyder, R.D.N., owner of Vital RD, where she specializes in cardiac diet modification. "It'll likely decrease your -sodium intake more than twofold." According to Center for Science in the Public Interest stats, the majority of fast-food meals contain more than 1,500 mg of sodium, and it's easy to find entrees at some restaurant chains with 2,000, 3,000 or even 4,000 mg—way saltier than the 700 to 800 mg Crandall Snyder recommends. (We aim for our heart-healthy meals to come in at 600 mg of sodium or less.)