Most people know what you can and can’t do to keep your heart healthy, but did you know that some risk factors matter more than others? When you make heart health a priority, you’ll want to know which factors drive the biggest changes so you can put your energy where it matters.
For example, both social interaction and blood pressure affect long-term heart health, but one matters far more than the other. When you know what to do, how to do it, and how much time and effort to put into certain changes, your heart will thank you for it.
There are four major impactors when it comes to heart health: blood pressure, lipids, nicotine use, and physical activity levels. Ranked in that order, their significance can make or break your heart health as you age. While the impact is smaller, dental care, flu vaccination, standing more, and more social connections can also support heart health.
21. Book the appointment
While you can check waist-to-hip ratio at home, a physician will need to investigate the other indicators through various tests. So, booking an appointment is the best place to start.
20. Measure your waist-to-hip ratio
Your waist-to-hip ratio is another way to assess heart health risk because weight alone doesn’t always tell the whole story. For women, an ideal ratio is 0.8 or lower; for men, 0.9 or lower.
19. Track your A1C
Blood sugar levels are measured in several ways, but one of the best ways to see how yours changes over time is to look at your long-term average, or A1C. It should sit below 5.7%.
18. Know your blood pressure targets
When looking at blood pressure, your target includes two numbers: systolic and diastolic. Your diastolic should be less than 80, whereas your systolic should be less than 120.
17. Know your cholesterol targets
For cholesterol, you want to aim for LDL below 100 mg/dL. HDL levels should be 60 mg/dL or greater, regardless of sex.
16. Keep your social ties strong
Social connections indirectly support heart health by helping manage physiological factors that can increase the risk of cardiovascular disease. Research shows that chronic stress, blood pressure, and inflammation can all be reduced through more meaningful social ties, which support a reduced risk of heart disease and stroke.
Interestingly, social isolation is also associated with an increased risk of cardiovascular disease that’s comparable to smoking. That said, the specific review that makes that comparison draws on a 1988 review, so more research is needed to determine if social isolation is as harmful as smoking.
15. Stand more
While standing alone won’t directly reduce your risk of heart disease, standing in situations where you would normally sit may modestly improve body fat mass, glycemic control, and cholesterol levels, helping your other efforts go a bit further toward optimal heart health.
14. Get your flu shot
Getting your flu vaccination helps prevent the flu and potential complications that can increase the risk of cardiovascular events. In rare cases, the flu can trigger blood clotting, abnormal dilation and constriction of blood vessels, and systemic inflammation that may increase heart disease risk.
13. Take care of your teeth and gums
Neglecting your oral health can lead to gum disease. When left untreated, gum disease increases the chance that bacteria can enter the bloodstream, which can contribute to blood clots, plaque buildup in the arteries, and heart inflammation.
12. Cut back on alcohol
While some older research suggests that having a small amount of alcohol can actually benefit heart health, the benefits may be negligible, and the more you drink, the more likely you are to actually increase your risk of cardiovascular disease.
One cohort study with 371,463 participants examined potential links between alcohol intake and cardiovascular disease and found that those who drink less were more likely to engage in other healthy lifestyle behaviors, leading to a lessened risk of heart disease.
However, those who drank more were at an increased risk of high blood pressure and coronary artery disease at rates of 1.3 times higher and 1.4 times higher, respectively. The consumption level studied was three or more drinks per day.
11. Get a handle on stress
Prolonged psychological stress strains the body, including the heart. A review article drawing on large-scale prospective epidemiological cohorts and clinical studies found that stress can keep blood pressure elevated by releasing stress hormones such as cortisol and adrenaline, increasing heart rate, and encouraging artery blockages through inflammation that accelerates plaque buildup and causes blood vessels to constrict and dilate improperly.
While this particular review doesn’t state exactly by how much stress can increase risk, data from a global cohort study on 118,706 participants found that generally high stress levels can increase the risk of a major cardiovascular event by 22%, with a 30% increased risk for stroke.
10. Sleep six to eight hours
In a broad review of medical literature, researchers pulled data from several small clinical trials and larger cohort studies to determine how sleep and cardiovascular disease risk were connected. They found that getting poor sleep or experiencing sleep disturbances regularly can lead to physiological changes that increase the risk of heart disease, such as inflammation, constriction of blood vessels, and elevated stress levels.
All three can speed up plaque buildup in arteries and blood vessels, increasing the risk of cardiovascular disease. While both sleeping too little and too much can both play a role, the researchers found that those who slept less than six hours per night experienced a 79% higher risk of cardiovascular disease. People who slept over eight hours per night were found to have a 35% increase in coronary artery disease.
9. Move for 150 to 300 minutes a week
Physical activity is next on the list, acting as a cardiovascular protector. According to the World Health Organization, getting 150 to 300 minutes of moderate-intensity exercise per week reduces the risk of heart disease by helping regulate blood pressure, lower blood lipids, and improve how well the body uses glucose for energy. Moderate-intensity exercise is rated as a 5 or 6 out of 10 on the effort scale.
8. Try the Mediterranean diet
When it comes to specific diets, the Mediterranean diet has been shown to reign supreme. A review of several cohort studies, controlled trials, and systematic reviews examined the Mediterranean diet and found that following this dietary pattern can reduce your cardiovascular disease risk by up to 58%.
7. Build your plate around plants
A higher intake of plant-based foods, such as vegetables, fruits, and whole grains, is also shown to consistently lower cardiovascular disease risk, whereas processed and red meats, foods high in sodium, and foods high in added sugars do the opposite.
6. Swap saturated fats for unsaturated ones
Your diet can affect heart disease risk because it influences risk factors mentioned above, such as blood pressure, cholesterol and lipids, and glycemic control. A review article and educational overview published in BMJ found that several dietary nutrients can either help or hurt heart health over time.
For example, fats are often thought of as bad, but only certain fats are. Saturated fatty acids increase the risk of heart disease, whereas eating ‘healthy’ fats, such as polyunsaturated fats, can reduce your risk.
5. Get to a healthy weight
Obesity is a known risk factor for developing cardiovascular disease. According to the CDC, obesity or having excess body fat can drive up other risk factors, such as causing bad cholesterol to go higher, lowering good cholesterol levels, increasing blood pressure, and driving the development of diabetes, all of which can increase the risk of developing cardiovascular disease in the future.
The Framingham Heart Study also examined obesity and its effects on cardiovascular disease risk and found that people living with obesity under 50 were twice as likely to develop coronary heart disease compared to those who were at a healthy weight.
4. Know your cholesterol, and bring LDL down
Lipids, fat-like substances such as cholesterol, are the second-most important risk factor to monitor. While they are found in the blood and body tissues and used for energy, levels that reach dangerously high levels can end up forming dangerous plaques that block blood flow, triggering heart attacks and strokes, as evidenced by the large-scale Framingham Heart Study.
The study, which originally enrolled 5,209 participants between 30 and 62, looked at several aspects of health starting in 1948 and continuing to today. Over time, researchers added the participants’ children, spouses, and grandchildren. The study determined that cholesterol plays a significant role in heart disease risk.
Two fats matter: high-density lipoprotein (HDL) and low-density lipoprotein (LDL), with HDL protective and LDL problematic. A systematic review and meta-analysis found that high LDL cholesterol can increase the risk of cardiovascular death by 21%.
3. Keep your blood sugar under control
Researchers have also found that glycemic control plays a major role in cardiovascular disease risk. A systematic review and meta-analysis of 71 studies looked at glycemic control in people with and without diabetes and found that poor blood sugar control, even in people without diabetes, increased the risk of plaque buildup in arteries. The more poorly controlled blood sugar was, the more it could also be used to predict future cardiovascular events in people who already have coronary disease as well.
Diabetes is, in and of itself, a comorbidity of heart disease and can increase your risk of cardiovascular disease by about double. So, it’s important not only to stay on top of your blood glucose levels to avoid diabetes, but also to reduce your cardiovascular risk.
2. Quit nicotine
Nicotine use is another significant risk factor. It has a bit more of an indirect association because smoking drives up fat in the blood, reduces HDL cholesterol, increases the buildup of plaque in blood vessels and narrows blood vessels. According to the Centers for Disease Control and Prevention (CDC), cigarette smokers have a two- to four-times higher risk of developing heart disease or having a stroke compared to non-smokers.
1. Get your blood pressure checked, and get it down
High blood pressure, often referred to as the ‘silent killer’ because it often presents without symptoms, is the number one global risk factor for cardiovascular disease, according to an epidemiological observational study that examined data on hundreds of millions of people for the Global Burden of Disease, Injuries, and Risk Factors Study. According to research, high blood pressure is associated with a 2.5-fold increase in the risk of cardiovascular disease.
Get your blood pressure checked regularly, and if you have high blood pressure, make it a top priority to talk with a physician about lowering it through lifestyle changes and/or medication.
The Bottom Line
Because there are so many things you can focus on for heart health, making all these changes at once can feel overwhelming. The good news is that you don’t have to overhaul your entire life overnight. It’s best to pick the risk factor that’s most significant and work your way through any others your physician finds over time.
Since high blood pressure is the leading cause of cardiovascular disease, getting yours checked and under control before you do anything else is a great place to start. In some cases, your high blood pressure could be attributed to one or more other factors on this list as well, so addressing one will also deal with the others.
Taking care of your heart is one of the best things you can do to improve your quality of life and longevity. So, if you start today, you’ll be one day closer to optimal heart health.
Angelica Bottaro is a medical writer and researcher with a background in psychology and journalism.
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