Heart disease is the number one killer for both men and women in America, causing one in three deaths each year (that's one person each minute!), according to the Centers for Disease Control and Prevention (CDC). It's not just a concern of older adults, either: Heart disease can affect people at any age.
That's why it's important to stay on top of things like your blood pressure, cholesterol and weight, as well as embrace a heart-healthy lifestyle that includes eating a healthy diet and getting regular exercise and plenty of sleep.
But it can be hard to remember to do everything you need to protect your ticker. Let this checklist be your guide as to what to do to stay on top of your heart health.
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Eat Your Fruits and Veggies
Aim to get at least 4 servings of fruit and 5 servings of veggies a day, per recommendations from the American Heart Association (AHA). Folks who munch on around 8 servings of fruits and veggies a day have a significantly lower risk of developing and dying from heart disease than those who get less than five, according to a June 2017 study in the International Journal of Epidemiology.
Ideally, you'll want to mix it up so that the fruits and veggies are different colors, adds Johanna Contreras, MD, a cardiologist at Mount Sinai Hospital in New York City, as they all have different antioxidants and other nutrients key to heart health.
Get Some Exercise
In the United States, only about one in five adults gets the recommended amount of physical activity (both aerobic and strength training), according to the CDC. But breaking a sweat is key to reducing your risk for heart disease and stroke, says Suzanne Steinbaum, MD, a cardiologist in New York City and an AHA spokesperson.
Exercising has been shown to improve risk factors for heart disease such as high blood pressure and cholesterol, and lowers your risk of heart disease, per the U.S. National Library of Medicine.
Get moving with these three types of workouts:
Cardio: Both the AHA and the U.S. Department of Health and Human Services' Physical Activity Guidelines for Americans recommend that adults get at least 150 minutes per week of moderate activity or 75 minutes of vigorous activity (or a combination).
Strength training: In an analysis of nearly 13,000 adults, spending up to an hour a week on resistance training reduced the risk for heart attack or stroke by 40 to 70 percent, per a March 2019 study published in Medicine & Science in Sports & Exercise.
Spending more than an hour didn't lead to additional risk reduction. That is, you don't have to devote tons of time to resistance workouts to reap the heart health benefits: One set of 8 to 12 strength-training reps that works your muscles to fatigue is usually enough for each muscle group. Aim to fit strength training into your schedule twice a week, with at least two days of rest between workouts, per the AHA.
Yoga: Doing Downward Facing Dog may reduce risk of heart disease as much as aerobic exercise like brisk walking, according to a December 2014 review in the European Journal of Preventive Cardiology. People in randomized controlled trials examining yoga's effects on heart health lost an average of 5 pounds, lowered their blood pressure by five points and slashed their levels of bad LDL cholesterol by 12.
This is probably because yoga helps strengthen muscles, while also incorporating mindfulness techniques that can relieve stress, says Nieca Goldberg, MD, director of the Joan H. Tisch Center for Women's Health at NYU Langone Health in NYC. Try making time for yoga once a week (or more!).
Do 3 to 5 Minutes of Deep Breathing
Mindfulness practices like deep breathing appear to help reduce your risk of heart disease, according to a September 2017 scientific statement in the Journal of the American Heart Association. When experts reviewed dozens of studies published over the last two decades, they found that meditation helped lower blood pressure, improved blood flow to the heart and lowered blood glucose levels.
"Mindfulness lowers levels of stress hormones, which can raise blood pressure and inflammation in the body linked to heart disease," Dr. Goldberg says.
New to Meditation and Breathing Exercises?
Get 7 to 8 Hours of Sleep
Getting enough shut-eye may be as important to your heart health as other lifestyle factors such as eating right and exercising, Dr. Goldberg says.
For example, one study examined the sleep habits of more than 400,000 people in the United Kingdom and found that sleeping fewer than six hours a night raised the risk of a first heart attack by 20 percent compared to those who clocked between six and nine hours, per September 2019 findings published in the Journal of the American College of Cardiology.
Try to set a consistent bedtime and wake-up time: Doing so makes it easier to get your needed zzzs, and will also keep your body clock in balance, which is also important for heart health.
Get better shut-eye by avoiding these 10 common habits that ruin sleep.
Hang Out With Your Friends
"Our social settings can play just as big of a role in affecting health as medications and physical lifestyle changes," Dr. Steinbaum says. "Social isolation can have adverse effects on our hearts and can encourage behaviors that increase your risk for heart disease, such as eating a poor diet, physical inactivity and excessive smoking or drinking alcohol."
Not having strong social relationships is associated with an increased risk for stroke or heart disease, per a May 2016 study in Heart. So, consider spending time with friends, family and loved ones a priority — not something to push to the back burner. At least a couple of times a week, reach out and connect with friends.
Have Fish for Dinner at Least Twice
Put fish on the menu at least twice a week, per the AHA. Aim for two 3.5-ounce servings of fatty fish (a serving size is slightly bigger than a checkbook) such as salmon, mackerel, herring, lake trout, sardines and albacore tuna. These are all rich in omega-3 fatty acids, which are thought to help reduce some of the inflammation that may contribute to heart disease, Dr. Goldberg says.
These fatty fish also reduce triglycerides, a type of fat in your blood, slow the buildup of plaque in your arteries and slightly lower your blood pressure.
Try These Fish Dishes
Snack on Nuts
Munching on an ounce of nuts at least five times a week is associated with a 20 percent lower risk of developing heart disease, according to a November 2017 study in the Journal of the American College of Cardiology.
Just don't eat much more than that (it's about the size of a small handful), as nuts are also high in calories.
Perform a Small Act of Kindness
Take some time during your busy day to do something small to help another — whether it's letting someone cut in front of you in the grocery checkout line or bringing soup to a sick neighbor.
People who frequently perform these altruistic acts report a greater sense of purpose and meaning in their lives, according to a June 2015 study in the Journal of Positive Psychology. These positive feelings reduce stress, which in turn may improve heart health, Dr. Contreras notes.
In fact, instead of waiting for situations to pop up so you can be helpful, make an active effort to pursue volunteering. People who volunteer at least 200 hours a year are 40 percent less likely to develop high blood pressure than those who don't, according to a June 2013 study in Psychology and Aging. That shakes out to less than four hours a week, or about 17 hours a month.
Every 6 Months
Take a Vacation
Even a short weekend trip can do your heart good. Each vacation taken during the year was linked with a 24 percent reduction with risk of developing metabolic syndrome (a cluster of symptoms that include high blood pressure, cholesterol, insulin levels and obesity), per a June 2019 study in the journal Psychology and Health. Just make sure you don't stray too far from your regular healthy eating and workout habits while on vacation, since that would undercut the benefits of time away.
Make Sure You're Maintaining a Healthy Weight
Weight matters when it comes to heart health. Being overweight increases the risk for heart disease (and many other chronic conditions), according to an August 2019 study in the International Journal of Epidemiology.
You can weigh yourself to make sure you're maintaining a healthy weight. But stepping on the scale isn't the only way to track weight gains (or losses): You can also take heed if clothes fit you differently or scroll back in your social media to see if there visible differences in your weight.
See Your Dentist
Your dental health may be linked to your heart health: For example, people who had lost teeth due to untreated gum disease were at higher risk of heart attack and stroke, per a study presented in October 2019 at the annual meeting of the American College of Cardiology.
It's thought that gum inflammation may trigger inflammation in your arteries, Dr. Goldberg explains.
Get Your Blood Pressure Checked
After age 40 — and earlier if you have a high risk of high blood pressure — get your blood pressure checked once a year, per the U.S. Department of Health and Human Services. Between the ages of 18 and 40, aim to get it checked every 3 to 5 years.
"It's one of the most important screenings because high blood pressure usually has no symptoms, so it can't be detected without being measured," Dr. Contreras says.
In fact, nearly half of all Americans now have high blood pressure, according to the AHA, which published new guidelines in 2017 recommending everyone aim for a blood pressure less than 120/80 millimeters of mercury (mmHg). What do those numbers mean? The top number measures the pressure of blood as the heart beats, while the bottom number reveals the pressure of blood between beats, per the AHA.
"We know now that people whose blood pressure level is between 130 to 139 over 80 to 89 have double the risk of heart attack or stroke as those whose blood pressure is under 120/80," Dr. Contreras says.
If your blood pressure reading is above 120/80, your doctor will recommend checking it more frequently — and may want to discuss treatment options to lower it.
Every 4 to 6 Years
Check Your Cholesterol
Starting at age 20, everyone should get a blood test that measures your total cholesterol, LDL (bad) cholesterol and HDL (good) cholesterol, per the AHA recommendations.
But you may need to get tested more frequently if you're at increased risk for heart disease — for example, if you are overweight or already have high blood pressure. Your total cholesterol should be under 200 milligrams per deciliter (mg/dL), with your bad cholesterol under 100 and your good cholesterol at least 50.
Is This an Emergency?
- American Heart Association: "Facts About Heart Disease in Women"
- American Heart Association: "Fruits and Vegetables Serving Size Infographic"
- International Journal of Epidemiology: "Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies"
- CDC: "Exercise or Physical Activity"
- US Department of Health & Human Services: "2018 Physical Activity Guidelines"
- Journal of the American Heart Association: "Meditation and Cardiovascular Risk Reduction"
- Journal of the American College of Cardiology: "Sleep Duration and Myocardial Infarction"
- Medicine & Science in Sports & Exercise: "Associations of Resistance Exercise with Cardiovascular Disease Morbidity and Mortality"
- American Heart Association: "Strength & Resistance Training Exercises"
- Annals of Behavioral Medicine: "Social integration prospectively predicts changes in heart rate variability among individuals undergoing migration stress"
- American Heart Association: "Fish & Omega-3 Fatty Acid"
- Journal of the American College of Cardiology: "Nut Consumption and Risk of Cardiovascular Disease"
- Journal of Positive Psychology: "Prosociality enhances meaning in life"
- European Journal of Preventative Cardiology: "The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials"
- Psychology & Health: "Vacation frequency is associated with metabolic syndrome and symptoms"
- American College of Cardiology: "Tooth loss associated with higher risk of heart disease: Adults missing one or more teeth from nontraumatic events more prone to heart attack, stroke."
- American Heart Association: "More than 100 million Americans have high blood pressure, AHA says"
- American Heart Association: "How to get Your Cholesterol Tested"
- Centers for Disease Control and Prevention: "Heart Disease Facts"
- Psychology and Aging: "A prospective study of volunteerism and hypertension risk in older adults."
- AHA: "Understanding Blood Pressure Readings"
- Heart: "Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies"
- U.S. Department of Health and Human Services: "Get Your Blood Pressure Checked"
- International Journal of Epidemiology: "Is the long-term decline in cardiovascular-disease mortality in high-income countries over? Evidence from national vital statistics"
- U.S. National Library of Medicine: "Benefits of Exercise"