How to reduce your risk and prevent cardiovascular disease

We hope you take this news to heart.

Despite what the headlines might have you believe, the leading cause of death is not cancer, injuries or even diabetes, but heart disease. In the United States alone, someone dies from cardiovascular disease every 33 seconds, according to the Centers for Disease Control and Prevention. This represents 695,000 deaths in 2021.

Heart disease is an umbrella term that encompasses a number of serious illnesses, such as heart attacks, strokes and even high blood pressure, according to the National Institutes of Health.

And chances are you’ve already heard about the steps you can take to reduce your risks. Think: watch what you eat, increase your physical activity and manage your stress. But putting these steps into practice is easier said than done, especially when life is busy and, in some cases, the risk of heart disease can increase over time.

That’s why we spoke with Dr. Kinjan Parikh, a cardiologist at NYU Langone Heart, to get his best tips for maintaining a healthy heart, how to spot risk factors, prevention methods, and when to seek care.

What are the main risk factors for heart disease?

Everyone can have risk factors. Some we can control, and some we can’t control. Family history, age, gender and ethnicity are uncontrollable and can influence heart disease risk. The main controllable risk factors include cholesterol levels, blood pressure and, for people with diabetes, blood sugar levels.

How do genetics affect heart health and heart disease risk factors?

Heart disease is largely influenced by genetics. And while you can’t escape the genes you inherit, you can choose your lifestyle – what you eat, whether you exercise, when you see a doctor – and those lifestyle choices can change your life. Some people have higher blood pressure or cholesterol levels due to their genetics. Of course, optimizing certain lifestyles can often help you achieve a goal and prevent serious cardiac events.

Can you take steps to reduce your risks?

The foundation of heart disease prevention is a healthy lifestyle, including diet and exercise. The Mediterranean diet, rich in fruits, vegetables and healthy fats, is highly recommended. Reducing sodium intake, especially to control blood pressure, and minimizing sugar and processed foods are other important dietary steps. Regular physical activity, ideally 30 to 45 minutes of moderate intensity three to four times a week, is also essential. If lifestyle changes are not enough, medications such as blood pressure medications or statins may be needed to achieve optimal levels.

What is the link between cholesterol and heart disease? Can good cholesterol (HDL) compensate for the effects of bad cholesterol (LDL)?

There is a close relationship between cardiovascular disease and cholesterol levels. A lipid test – which shows the levels of “bad” cholesterol called LDL, “good” cholesterol called HDL, and triglycerides in your blood – assesses your risk of developing heart disease. High LDL levels can lead to plaque buildup, causing blockages that increase the risk of heart attacks and strokes. When we measure cholesterol levels in your blood, we look at a combination of what your body makes and what you eat. Although high HDL levels can help reduce risks by making it easier to remove LDL from the arteries, it does not completely negate the risks associated with high LDL levels. Both levels must be managed to maintain heart health.

What is the sign that something is wrong with your heart?

Classic symptoms include chest pain or pressure, which may also manifest as stomach discomfort. A notable sign is the inability to perform regular physical activities due to shortness of breath or chest pain. Regular exercise can serve as an early warning system for potential heart problems if symptoms change. There is a common misconception that heart disease primarily affects older men, but it can occur in anyone, regardless of age or gender. Women may be more likely to experience atypical symptoms such as abdominal pain, nausea, and/or sweating.

What should you ask your doctor about heart disease risk?

Heart health should be assessed at every annual exam. This includes checking blood pressure, cholesterol levels, blood sugar, and possibly EKG. People with increased risk factors may benefit from regular visits to a cardiologist for more specialized care. In summary, you need to know your key health numbers: blood pressure, cholesterol levels, or blood sugar levels for diabetes management. Understanding these numbers, their goals, and how to achieve them through lifestyle changes or medications is essential for proactive heart health management to significantly reduce the risk of heart disease.

Kinjan Parikh, MD, is a cardiologist at NYU Langone Heart and a clinical instructor at Department of MedicineTHE Leon H. Charney Division of Cardiology at NYU Grossman School of Medicine. His practice ranges from identifying cardiac risk factors to treating advanced heart disease. NYU Langone is among the nation’s top 5 hospitals for cardiology and heart surgery, according to U.S. News & World Report’s “Best Hospitals.” Make an appointment with one of our cardiologists Or cardiac surgeons.