Heart disease

The heart is a fist-sized muscle in your chest that pumps blood throughout the body. It’s divided into four chambers, consisting of two atria at the top half of the heart and two ventricles in the bottom half of the heart.

The heart is also the core of your circulatory system, which is the network of blood vessels (including capillaries, veins, and arteries) that performs several essential functions, including:

• Delivering oxygen- and nutrient-rich blood to vital organs
• Carrying carbon dioxide from the blood to the lungs to be exhaled (removed from the body through breathing)

Heart disease refers to multiple conditions that affect heart health. These conditions can disrupt various functions and parts of the heart, including:

• The heart muscle
• Heartbeat (pumping of the heart)
• Heart rate (the speed at which the heart pumps)
• Heart valves (flaps of tissue inside the heart that keep blood flowing in the correct direction)
• Blood vessels near the heart

Around 11 percent of adults in the U.S. have been diagnosed with heart disease, according to the National Heart, Lung, and Blood Institute (NHLBI). That’s more than one in every nine people.

Some types of heart disease are present at birth. This is called congenital heart disease. Others develop over time as a result of issues like hypertension (high blood pressure) and high cholesterol (elevated levels of a fatty, waxy substance that can build up in blood vessels).  

Heart disease can cause dangerous complications like heart attack and stroke, especially if it’s poorly managed or left untreated. You can lower your risk of heart disease by maintaining a healthy body weight, getting enough physical activity, and eating a heart-healthy diet.

Heart disease vs. cardiovascular disease

Heart disease and cardiovascular disease are terms that are often used interchangeably, but they’re not quite the same. Cardiovascular disease is an umbrella term that includes all types of conditions that affect the heart and blood vessels. (“Cardio” refers to the heart and “vascular” refers to blood vessels.) One in three deaths in the U.S. are linked to cardiovascular disease.

Heart disease is a type of cardiovascular disease that includes conditions that affect the heart muscle and its functions.

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The signs of heart disease vary according to the type and severity of the disease. In some cases, heart disease doesn’t cause any noticeable symptoms.

Heart disease symptoms may be subtle at first and slowly become more noticeable. Often, early signs of heart disease include chest pain, swelling in the lower body, shortness of breath, and fatigue.

Some people don’t experience any heart disease symptoms until a complication occurs, such as a heart attack or stroke.

There are several types of heart disease, including:  

Coronary artery disease

Also known as coronary heart disease (CHD), coronary artery disease is the most common form of heart disease. It occurs when arteries that supply the heart with blood become narrowed due to a buildup of plaque. (Arteries are blood vessels that carry oxygen-rich blood to the heart and other vital muscles and organs. Plaque is a waxy combination of cholesterol, fat, calcium, and other substances.) A buildup of plaque in arteries is known as atherosclerosis.

Atherosclerosis reduces blood flow to the heart, which can result in chest pain, blood clots, and heart attack. (Clots are jelly-like clumps of blood that can clog vessels.) Roughly 366,000 people in the U.S. die every year from coronary artery disease, according to the NHLBI.  

Symptoms of coronary artery disease

Coronary artery disease doesn’t usually cause symptoms in its initial stages. As the condition progresses and arteries narrow, symptoms may involve:

• Chest pain caused by a reduction in blood flow to the heart (also known as angina)
• Shortness of breath
• Swollen feet or hands
• Fatigue
• Heart palpitations (a racing, fluttering, or pounding heartbeat)

Arrhythmia

Arrhythmia is a heartbeat that’s unusually fast, slow, or that occurs at an inconsistent rhythm. While some arrhythmias are mild and don’t require treatment, more serious cases can lead to stroke or cause the heart to suddenly stop beating (a condition known as cardiac arrest). 

It’s normal for your heart to beat faster or slower at certain times. For example, your heart rate naturally goes up when you’re exercising or feeling anxious. It’s naturally slower when you’re relaxing or sleeping. But having a heartbeat that is consistently irregular could indicate an issue with the heart’s electrical system. It may also mean that your heart isn’t pumping enough blood, which can make you feel dizzy or weak.

Symptoms of arrhythmia 

Arrhythmia may not cause noticeable symptoms. When it does, symptoms may include: 

• Heart palpitations
• Shortness of breath
• Gasping for breath during sleep  
• Chest pain or tightness
• Anxiety or confusion
• Dizziness or lightheadedness
• Weakness
• Fainting or near-fainting

Cardiomyopathy   

Cardiomyopathy refers to several conditions that enlarge, thicken, thin out, or stiffen the heart muscle. Some cardiomyopathies are inherited (passed from parent to child).

The main forms of cardiomyopathy include: 

• Hypertrophic cardiomyopathy: This thickens the heart muscle and can cause sudden death in adolescents and young athletes.
• Dilated cardiomyopathy: This enlarges one of the heart’s lower chambers (called ventricles).
• Arrhythmic cardiomyopathy: This can cause arrhythmia.
• Restrictive cardiomyopathy: This can stiffen the heart muscle, cause scar tissue to form, or both.  

Symptoms of cardiomyopathy

Cardiomyopathy may never cause noticeable symptoms. In other cases, symptoms occur as the disease progresses. Possible cardiomyopathy symptoms include:

• Trouble breathing or shortness of breath
• Fatigue 
• Heart palpitations
• Swollen legs or ankles
• Fainting or near-fainting

Congenital heart disease

Congenital heart disease (a type of congenital birth defect) affects nearly 1 percent of babies born in the U.S. each year. It may involve being born with:

• A heart issue, such as a hole in the heart (also known as ventricular septal defect)
• A misshapen artery
• Missing parts of the heart (such as a missing valve)

Around one in four cases of congenital heart disease is considered severe. Surgery is sometimes necessary to correct congenital heart defects and improve heart function.  

Symptoms of congenital heart disease

The symptoms of congenital heart disease vary according to the type of issue. Some congenital heart diseases may not cause any noticeable changes. Others may cause one or more of the following symptoms in a baby or young child:

• Unusual tiredness
• Sleepiness when feeding
• Bluish lips or nails
• Troubled or rapid breathing

Valvular heart disease  

Valvular heart disease refers to an abnormality or disease in any of the heart’s four valves. These flaps of tissue located inside the heart open and close to keep blood flowing in the correct direction. Around 2.5 percent of people in the U.S. have valvular heart disease, according to the Centers for Disease Control and Prevention (CDC). The condition is most common in older adults.

Valvular heart disease (also called valve disease) can take several forms. Some cases involve “leaky” valves that don’t shut completely. In other cases, valves become stiff and can’t open fully. Death from valvular heart disease is most often linked to issues in the aortic valve, which feeds blood into the aorta. (The aorta is the body’s largest artery. It carries oxygen-rich blood from your heart to the rest of the body.)

Symptoms of valvular heart disease

Some valvular heart diseases develop slowly and don’t cause symptoms until the condition is advanced. Others may develop quickly and trigger symptoms such as:

• Irregular heartbeat
• Shortness of breath
• Lightheadedness or dizziness  
• Fainting
• Chest pain
• Fever
• Sudden weight gain
• Fatigue

Pericarditis   

The heart is surrounded by a thin envelope of tissue called the pericardium. Pericarditis occurs when this tissue becomes swollen or irritated. Possible causes of pericarditis include damage to the heart from heart attacks, chronic (long-term) conditions like kidney disease or rheumatoid arthritis, or injury to the chest area.

Early detection and treatment of pericarditis can prevent complications like fluid buildup around the heart (pericardial effusion) and scarring of the pericardium (constrictive pericarditis).  

Symptoms of pericarditis

The most common symptom of pericarditis is sharp chest pain around the left side of the chest. Some people with the condition experience chest pain that feels dull or achy. This chest pain may improve when sitting up and worsen when lying down.

Other possible symptoms of pericarditis include:

• Cough
• Weakness
• Swollen feet, legs, or belly
• Low-grade fever
• Shortness of breath that may occur or worsen when lying down
• Heart palpitations

Heart failure

Heart failure (also called congestive heart failure) affects around 6.2 million adults in the U.S., according to the CDC. It occurs when the heart can’t pump enough oxygen-rich blood to support the body’s organs. Heart failure doesn’t mean that the heart has stopped or can’t function, just that it’s not working effectively.

Treatment and healthy lifestyle changes for heart failure can help improve the heart’s ability to pump and can help ease heart failure symptoms. Still, heart failure usually worsens over time.  

Symptoms of heart failure

Heart failure symptoms can vary, but may include:

• Weakness and fatigue
• Shortness of breath during routine activities
• Difficulty breathing when lying down
• Swollen belly, legs, ankles, or feet

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Heart disease can disrupt cardiovascular function and lead to a wide range of life-threatening health complications. These may include but are not limited to: 

Heart attack

Known clinically as a myocardial infarction (MI), a heart attack occurs when a portion of the heart doesn’t receive enough blood. Coronary artery disease is the most common cause of heart attacks. According to the CDC, someone in the U.S. has a heart attack every 40 seconds.

A heart attack requires immediate medical attention. The more time that passes without emergency treatment to restore blood flow, the greater the risk of serious heart damage and death. Cardiogenic shock is the most common cause of death among people who experience heart attacks. This occurs when the heart suddenly can’t pump enough blood to sustain the body’s essential functions.

Symptoms of a heart attack

It’s important to call 911 if you experience possible symptoms of a heart attack. These can include:

• Chest pain or a sensation of chest tightness, fullness, aching, or squeezing
• Shortness of breath
• Discomfort or pain that travels to the jaw, neck, upper back, or one or both arms
• Cold sweats
• Nausea
• Sudden fatigue or dizziness
• Heartburn

Signs and symptoms of heart attack may vary between men and people assigned male at birth (AMAB) and women and people assigned female at birth (AFAB). For instance, women and people AFAB who are having a heart attack are more likely than men and people AMAB to experience shortness of breath, nausea, excessive fatigue, and pain or pressure in areas besides the chest. In general, though, chest pain is still the most common heart attack symptom for all people.  

Stroke

Also known as a “brain attack,” a stroke occurs when a part of the brain doesn’t receive enough blood from the heart. This can happen when a blood clot or plaque blocks blood flow in an artery that supplies the brain. It can also occur when a blood vessel in the brain bursts.

A stroke requires emergency treatment to restore blood flow to the brain. Even with treatment, a stroke can result in long-term brain damage, disability, or death.

Symptoms of a stroke

Signs and symptoms of a stroke tend to occur suddenly and may include:  

• Changes in vision
• Trouble speaking
• Numbness or weakness
• Impaired movement on one side of the body
• Confusion or difficulty understanding speech 
• Slurred speech or trouble speaking

Cardiac arrest

Cardiac arrest occurs when the heart suddenly stops beating. When this happens, blood can’t reach vital organs like the brain. Cardiac arrest is responsible for 300,000 to 450,000 deaths every year in the U.S., according to the NHLBI. Arrhythmias and other types of heart disease, including coronary artery disease and congenital heart disease, are the main risk factors for cardiac arrest.

Call 911 quickly if someone around you experiences signs of cardiac arrest, which typically includes sudden loss of consciousness. Performing cardiopulmonary resuscitation (CPR) or using an automated external defibrillator (AED) immediately after contacting emergency medical personnel increases the chances that a person may survive cardiac arrest.

AEDs are devices that send electric shocks to the heart to restore heart rhythm. They’re usually located in public places such as restaurants, gyms, entertainment venues, and schools. Instructions for use are available on AEDs or as part of their function, often in both written and audio form.

Aortic aneurysm 

An aortic aneurysm refers to a balloon-shaped bulge in the aorta, the artery that delivers blood from the heart to the chest and abdominal areas. An aneurysm can become deadly if it bursts (ruptures) and causes internal bleeding or if a weakened section of the artery wall splits into layers (a process known as dissection) and leaks blood.

Smoking is a major risk factor for aortic aneurysm, along with high blood pressure and high cholesterol.

Symptoms of aortic aneurysm

Call 911 if you or someone around you experiences possible symptoms of an aortic aneurysm. This may include:

• Sharp chest pain or upper back pain
• Throbbing pain in the side or back
• Shortness of breath
• Trouble swallowing or breathing
• Unexplained pain in the side, back, buttocks, or legs

Pulmonary hypertension

Pulmonary hypertension refers to high blood pressure in the pulmonary arteries, the blood vessels that deliver blood from the heart to the lungs. It’s a common complication of heart conditions such as valve disease and congenital heart disease. Treatment can help lower blood pressure in the pulmonary arteries and improve symptoms. 

Symptoms of pulmonary hypertension

In its early stages, pulmonary hypertension may cause shortness of breath during routine activities. As the condition progresses, symptoms may include:

• Chest pain or pressure
• Fatigue
• Dizziness
• Fainting
• Pain in the upper right corner of your abdomen
• Bluish lips or skin
• Swollen belly, legs, or ankles
• Loss of appetite

Seek immediate medical care if these symptoms occur.

Peripheral artery disease

Similar to coronary artery disease, peripheral artery disease (PAD) occurs when the peripheral arteries (located outside of the heart) become inflamed or clogged with plaque. PAD often reduces blood flow to the legs and feet. Prompt treatment of peripheral artery disease, which may include lifestyle changes and medication, can help improve blood flow to affected areas of the body and ease symptoms.

Symptoms of peripheral artery disease

Peripheral artery disease can cause a wide range of symptoms or no symptoms at all. When symptoms occur, they may include:

• Leg pain or cramping when walking or after exercise
• A sensation of coldness in a leg or foot
• Leg weakness or numbness
• Erectile dysfunction
• Changes in the color or texture of skin on the legs
• Slowed growth of toenails or leg hair
• Sores on the feet or legs that won’t heal

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Heart disease is associated with a wide range of symptoms that are commonly attributed to other conditions. Sometimes, there are no symptoms at all. That’s why visiting a healthcare provider (HCP) for regular preventive care is so important.

Preventive care involves having regular checkups and screenings that can help detect health issues before they cause more serious problems or become more difficult to treat. For instance, an HCP can screen for heart disease risk factors like high blood pressure and high cholesterol. They can also listen to your heartbeat with a stethoscope, which can reveal possible arrythmias and heart valve issues.

Generally speaking, most people ages 50 and older should visit an HCP for preventive care at least once a year. Adults who are younger than 50 and in good overall health should see an HCP at least once every three years. More frequent preventive care visits are recommended for people with chronic health conditions such as type 2 diabetes, chronic obstructive pulmonary disease (COPD), or heart disease.  

When to call 911

Some signs and symptoms of heart disease require emergency medical care. Call 911 immediately or go to the nearest hospital emergency department (ED) if you or someone around you experiences:

• Trouble breathing
• Chest pain (particularly if it occurs suddenly and is severe, persists for a few minutes without any explanation, or goes away and then comes back)  
• Loss of consciousness 
• Stomach pain that occurs suddenly and is severe
• Sudden changes in vision, numbness, weakness, or difficulty speaking

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A combination of medical, behavioral, lifestyle, and genetic factors can contribute to the development of heart disease. Different types of heart disease have different causes, and these causes can vary from person to person.

In general:

Coronary artery disease may be caused by atherosclerosis, which is linked to smoking, unhealthy diet, and obesity.  

Arrythmia may be caused by emotional or physical distress, high blood pressure, other heart diseases, diabetes, hormonal or fluid imbalances in the blood, smoking, excess caffeine or alcohol consumption, drug abuse, or the use of certain heart medications.

Cardiomyopathy is often inherited, although some cases of cardiomyopathy don’t have a known cause. 

Congenital heart disease occurs due to abnormalities in the development of a fetus’s heart during pregnancy. Genetic factors, certain medications, and medical conditions that affect the mother or birthing parent may contribute to congenital heart disease. In many cases, the cause of congenital heart disease is unknown.

Valvular heart disease may be caused by bacterial infection, endocarditis (an infection in the heart’s inner lining), other heart diseases, or autoimmune diseases like lupus. Some people are born with valve disease.

Pericarditis doesn’t always have a known cause. Some cases of pericarditis are linked to heart attacks, chest injuries, viral infections, heart surgery, rheumatoid arthritis, lupus, kidney failure, and cancer.  

Heart failure may be the result of other heart diseases, diabetes, and unhealthy behaviors like smoking.

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Risk factors increase your chances of developing a certain medical condition. Established risk factors for heart disease include:   

High blood pressure: High blood pressure, or hypertension, is a major risk factor for heart disease. It occurs when the force of blood pressing against the inside of blood vessel walls is consistently too high. Over time, high blood pressure can damage the heart, blood vessels, and other vital organs.

High blood pressure usually doesn’t cause obvious symptoms. Your HCP can measure your blood pressure, or you can take your own blood pressure with a machine at a pharmacy or with an at-home monitor.

High cholesterol: High cholesterol (also called lipidemia) refers to elevated levels of low-density lipoprotein (LDL) in the blood. Also known as “bad cholesterol,” LDL can accumulate inside the walls of arteries and reduce blood flow to the heart, brain, and other organs. 

The “good” type of cholesterol,-density lipoprotein (HDL), can lower a person’s risk of heart disease when it’s found in healthy levels. Your HCP can measure your HDL and LDL levels with a routine blood test called a lipid profile.

Tobacco use: Smoking cigarettes is closely linked to heart disease. Heart attacks are more common in people who smoke than in people who don’t smoke. People who are frequently exposed to secondhand smoke also have an increased risk of heart disease, even if they don’t smoke themselves.

Together with high blood pressure and high cholesterol, smoking is one of the three main risk factors for heart disease. Close to half of all people in the U.S. have at least one of these risk factors, according to the CDC.

Diabetes: Having diabetes increases a person’s risk of heart disease. Diabetes occurs when your body can’t properly use or produce enough insulin, a hormone that helps convert sugar into energy. This can cause sugar to accumulate in the blood. Adults with diabetes are more likely to die from heart disease than adults without diabetes.

Unhealthy diet: Maintaining a diet that’s high in cholesterol, saturated fats (found in many animal products like meat and dairy), and sodium (salt) is linked to atherosclerosis and high blood pressure, both of which can lead to heart disease.  

Lack of physical activity: Living an inactive lifestyle with lots of sitting can increase a person’s risk of heart disease and other conditions that can influence heart health, such as high blood pressure and diabetes.

Obesity: Having obesity (excess body fat) can lead to heart disease. It’s also closely associated with high cholesterol, high blood pressure, and diabetes. Eating a high-calorie diet and not getting enough physical activity can contribute to obesity.

Excess alcohol consumption: Drinking too much alcohol can contribute to high blood pressure and raise levels of triglycerides (a fatty substance in the blood), both of which increase the risk of heart disease.

How much alcohol is too much? The CDC advises men and people AMAB to limit their alcohol consumption to two drinks per day, while women and people AFAB should have no more than one drink per day. A “drink” is defined as:

• 12 ounces of beer
• 8 ounces of malt liquor, including malt-based seltzers
• 5 ounces of wine
• 1.5 ounces (one shot) of distilled spirits such as vodka, whisky, rum, gin, and tequila

Chronic stress: Frequent, unrelieved stress can contribute to heart disease by raising levels of inflammation in the body, which can promote plaque accumulation in arteries. Stress also increases the production of hormones that can raise blood pressure and make the heart beat faster.

Gum disease: A growing amount of research links gum disease (periodontal disease) and poor oral health to cardiovascular disease. Bacteria can enter the bloodstream through swollen, inflamed gums and spread to the heart, which can contribute to atherosclerosis, endocarditis, and vasculitis (blood vessel inflammation).

Age: Heart disease can affect anyone at any age, but it’s more likely to occur as you get older. For instance, heart failure occurs 10 times more often in people older than 75 than in younger adults.

Family history and genetics: Having a close blood relative with heart disease (such as a parent or sibling) may mean you have a higher risk of heart disease. This is especially true if a female relative developed heart disease before age 65 or if a male relative experienced the condition before age 55. Genetics can sometimes play a role in the development of heart disease risk factors like high blood pressure

People who live or spend time together may also have similar diets and lifestyle habits, such as smoking or drinking too much alcohol, which may contribute to a higher risk of heart disease.

Sex assigned at birth: Heart disease is common among all people. That said, men and people AMAB have a higher risk of heart disease overall. Women and people AFAB are more likely to develop heart disease after menopause, which typically starts in a person’s late forties or early fifties.

Race and ethnicity: Heart disease is the leading cause of death for several racial and ethnic groups, including white people, Black people, and Native Americans. It’s more common among Black people, however—nearly half of Black people have been diagnosed with cardiovascular disease, compared to roughly 35 percent of white people. Heart disease risk factors such as high blood pressure and diabetes are also more common among minority groups.

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Diagnosing heart disease involves a thorough assessment of your heart health. Your HCP may begin by asking you questions about your lifestyle habits, such as how often you exercise and what you eat on a daily basis. They’ll likely discuss your family medical history and overall health, including what other conditions you may have, symptoms you’re experiencing, or medications you’re taking.

Your HCP will also perform a physical exam, during which they’ll check your blood pressure and listen to your heartbeat. From there, they may order one or more tests to learn more about your heart health and to screen for signs of heart disease. You may receive a diagnosis of heart disease based on the results of these tests.

Common tests for heart disease include: 

Blood test: Tests that measure levels of certain substances in the blood can help your HCP identify issues related to heart disease. These substances may include cholesterol, triglycerides, blood sugar, and proteins related to inflammation.

Stress test: Also called an exercise test, a stress test examines how your heart responds to physical activity. The test involves walking or running on a treadmill or pedaling on a stationary bicycle while an HCP monitors your heart. If you’re unable to exercise for the test, you may be given a medication that makes your heart pump faster or harder like it would during physical activity.

Electrocardiogram: An electrocardiogram (ECG or EKG) analyzes the timing and strength of the heart’s electrical signals. This can show if the heart is beating too quickly or slowly. An EKG may be performed in a medical setting or your HCP may ask you to wear a small, portable EKG device called a Holter monitor at home to record your heart rhythm for a day or more at a time.

Echocardiogram: An echocardiogram uses sound waves to create moving images of the heart as it pumps. It can show how blood travels through valves and if valves are damaged or working improperly.   

Imaging tests: Imaging tests like magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, and positron emission tomography (PET) scans are used to produce images of the heart and its blood vessels. Imaging tests can reveal damage to the heart muscle and areas of reduced blood flow.

Cardiac catheterization: A cardiac catheterization is a minimally invasive procedure that uses a contrast dye to reveal blockages in arteries. During the procedure, a thin, flexible tube called a catheter is gently inserted into a blood vessel (often in the neck, wrist, or groin) and directed to the heart. Dye is fed through the catheter to help highlight arteries on X-ray images, which are taken during the procedure.  

What questions should you ask your healthcare provider?

Heart disease is a complex condition. Asking your HCP any questions you may have about heart disease can help you make confident, educated decisions as you work to improve your heart health.

Some basic questions about heart disease you might want to ask include:  

• What type of heart disease do I have?
• What do you think caused my heart disease? Is it genetic? 
• What is my prognosis (expected outcome)? Can my heart disease be reversed?
• What treatment options do you recommend? Can you explain the risks and benefits of each?
• What heart-healthy lifestyle changes should I make? Can you recommend an eating plan or exercise regimen?
• What things (such as foods, medications, or activities) should I avoid?
• How can I manage heart disease with other conditions I have? 
• How often should I see you? Do I need more frequent preventive care visits?
• Should I consider attending a heart disease support group?

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Heart disease is treated by a cardiologist. This is a medical doctor who specializes in cardiovascular health. Your primary care provider can also help you manage heart disease.

Heart disease usually isn’t reversible, but treatment can help improve your heart health and prevent complications. Your ideal course of heart disease treatment will depend on the type and severity of your condition.

Most heart disease treatment plans include a combination of healthy lifestyle changes and medication. Some people require surgery to improve heart function.

Healthy lifestyle changes

Maintaining a heart-healthy lifestyle is importantThis lifestyle requires you to:

Get enough physical activity. Regular exercise, such as taking brisk walks or riding a bike, can help you manage or reverse heart disease risk factors like high blood pressure, high cholesterol, diabetes, and obesity. Physical activity can also strengthen the heart muscle and reduce your risk of heart attack.

Certain types of high-intensity exercise (such as running or lifting heavy weights) may not be recommended for people with heart disease. Before starting a new exercise routine, speak with your HCP. They can suggest exercises that are appropriate for your health needs or they may refer you to an exercise physiologist for additional guidance. (An exercise physiologist is a medical professional who specializes in improving health through exercise.)

You don’t need to spend hours at the gym to reap the benefits of exercise. Simply taking more steps can have a positive impact on your heart health. A 2023 analysis of research published in the European Journal of Preventive Cardiology found that people who walked at least 4,000 steps (around two miles) every day had a lower risk of death from any cause. With each additional 1,000 steps, a person’s risk of death decreased another 15 percent.

The analysis also found that taking just 2,337 steps per day (equivalent to around one mile) lowered the risk of death from cardiovascular disease. Making small modifications to your daily routine—such as parking further away from the grocery store entrance or taking the stairs instead of the elevator—can help you get more steps each day. You can track your steps using a smartphone or a wearable fitness tracker.

Eat for a healthy heart. Incorporating more heart-healthy foods into your diet while limiting or avoiding others can help you manage heart disease and boost your overall health.

In general, heart-healthy foods include:

• Vegetables like broccoli and leafy greens such as spinach, kale, cabbage, and collard greens 
• Fruits like oranges, apples, grapes, bananas, blueberries, prunes, and avocadoes 
• Legumes like chickpeas (garbanzo beans), lima beans, lentils, kidney beans, and black-eyed peas
• Whole grains like brown rice, whole-grain breads and pastas, and oatmeal
• Lean proteins such as skinless poultry (chicken or turkey), fish (salmon, trout, or tuna), eggs, seeds, nuts, and soy products

Foods and beverages to limit or avoid include:

• Alcohol
• Items with added sugars, such as sodas, fruit drinks, sweetened tea and coffee, ice cream, cakes, cookies, pies, pastries, jams, doughnuts, syrups, and candies
• Items that are high in saturated fat, including fatty red meats, processed meats (like bacon and sausage), skin-on chicken, whole milk, butter, lard, coconut oil, and many fried foods
• Salty foods like processed meats, instant potatoes, canned soups, seasoning salts, soy sauce, many bottled dressings and condiments, frozen foods, pizza, and salty snacks like chips and crackers

The American Heart Association advises adults to limit their consumption of sodium to 2,300 milligrams daily. Ideally, most adults should consume no more than 1,500 milligrams a day.

Your HCP can provide you with advice about what foods to avoid or to include in your diet. They may recommend a flexible, heart-healthy eating plan to follow, such as the:

• Mediterranean diet
• Dietary Approaches to Stop Hypertension (DASH) diet 
• Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet

Achieve a healthy body weight. Moving more and eating a sensible diet can help you achieve and maintain a healthy body weight. This can relieve strain on your heart and improve your overall health. Ask your HCP about a healthy weight for you.

Quit smoking. Consider joining a smoking cessation program or asking your HCP for assistance with quitting smoking. If you don’t smoke, don’t start.

Manage stress. Incorporating stress management techniques into your daily routine can help you keep stress in check and reduce strain on your heart. Time-tested stress relievers include yoga, meditation, mindfulness, journaling, and deep breathing exercises. Make time for relaxation and say “no” to unnecessary obligations.

Prioritize sleep. Most adults need 7 to 9 hours of sleep daily. If you struggle to fall or stay asleep, taking relatively simple steps to improve your sleep quality (such as skipping late-afternoon caffeine and sticking to a consistent bedtime schedule) may help.

If getting reliable sleep is an ongoing issue for you, talk to your HCP for more help. They may want to evaluate you for a sleep condition, such as sleep apnea.

Cardiac rehabilitation

Cardiac rehabilitation is recommended for many people with heart disease, especially after a heart attack or heart surgery. This HCP-supervised program helps strengthen the heart and prevent future issues through healthy lifestyle practices. Research shows that cardiac rehabilitation can help lower the risk of hospitalization and death.

During cardiac rehabilitation, you may receive care from exercise and nutrition specialists, physical therapists, and licensed mental health providers, along with your regular HCP or cardiologist. Programs generally include:

• Exercises that strengthen the heart
• Counseling to help manage stress and mental health concerns
• Education regarding medication, healthy eating, smoking cessation, and other health topics

Most cardiac rehabilitation programs last between two and eight months. Programs may be provided in a hospital, at a rehabilitation center, or in your home.

Medications

Medications can help ease heart disease symptoms, improve heart function, or help prevent complications of heart disease. The medication you may need will depend on what type of heart disease you have and your overall health.

In general, medications for heart disease include:

• Medicines that lower blood pressure: These include calcium channel blockers, diuretics, alpha blockers, beta blockers, vasodilators, angiotensin-converting enzyme (ACE) inhibitors, and others.
• Medicines that relieve chest pain (angina): These include aspirin, statins, beta blockers, ranolazine, nitroglycerine, and others.
• Medicines that regulate heartbeat: These include sodium channel blockers, beta blockers, and potassium channel blockers.
• Medicines that lower cholesterol: These include statins and non-statin options like alirocumab, bempedoic acid, evolocumab, and ezetimibe.
• Medicines that control blood sugar: These include metformin, empagliflozin, and canagliflozin.

If you have obesity or overweight, your HCP may also recommend taking a weight-loss medication such as semaglutide, liraglutide, or orlistat to help you reach a healthy weight. Keep in mind that these medications must be combined with a healthy diet and regular exercise to provide long-term results.

Certain vitamins and supplements may also help lower levels blood triglycerides. These include omega 3 fatty acids, niacin, and fibrates. 

Take all medications and supplements as directed by your HCP. Never stop a medication without first speaking with your HCP and promptly let them know if you experience any unexpected side effects.

Surgery

More severe forms of heart disease may require surgical treatment. For instance, someone may receive heart surgery to address a blocked artery, repair an aneurysm, or implant a device that can correct an abnormal heart rhythm.

There are several procedures that can be used to address heart disease, including but not limited to:

• Heart valve surgery to repair or replace a damaged heart valve
• Catheter ablation to regulate heart rhythm by destroying arrythmia-causing tissue with hot or cold energy
• Maze procedure to strategically create scar tissue in certain parts of the heart to improve a serious type of arrythmia called atrial fibrillation (AFib)
• Coronary artery bypass grafting (also known as bypass surgery) to create a new path for blood to “bypass” blocked arteries and reach the heart
• Percutaneous coronary intervention to break up stuck plaque and open clogged or narrowed arteries  
• Septal myectomy to remove a small portion of thickened heart tissue and improve blood flow in someone with cardiomyopathy  
• Cardiac device procedures that involve implanting a device to improve heart function. These may include a pacemaker (to regulate heart rate), a left ventricular assist device (to help the heart pump more efficiently), or an artificial heart has become diseased or unable to function properly until a patient can receive a heart transplant)
• Heart transplant surgery to replace a failing heart with a healthy heart from a deceased donor (this surgery is uncommon)

Heart surgery is performed by cardiac surgeons. Some heart procedures are minimally invasive, meaning they’re performed with special instruments through one or a few small incisions. Open heart surgery involves opening the chest wall and accessing the heart directly.

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You can lower your risk of many types of heart disease by following a healthy lifestyle and managing other conditions you may have, such as hypertension or diabetes. Other heart diseases, such as congenital heart disease (which is present at birth), aren’t preventable.

Many of the same lifestyle changes used to manage heart disease can also help prevent it. For example:

• Don’t smoke. If you do smoke, quitting will lower your risk of heart disease.
• Eat healthfully. Enjoy heart-healthy foods like vegetables, fruits, lean proteins, and whole grains. Limit alcohol, added sugars, and foods that are high in saturated fat and sodium.
• Maintain a healthy weight. A sensible diet and regular physical activity can help you avoid obesity and overweight. For help with weight loss, reach out to your HCP.
• Keep tabs on your blood pressure and cholesterol levels. How often you need your blood pressure and cholesterol levels checked will depend on your overall health and heart disease risk factors.
• Manage diabetes. If you have diabetes, controlling your blood sugar levels will help lower your risk of heart disease.
• Stay physically active. Regular exercise reduces the risk of heart disease risk factors like diabetes, obesity, high blood pressure, and high cholesterol.

The CDC advises most healthy adults to get at least 150 minutes of moderate-intensity aerobic exercise every week (or 30 minutes of exercise, five days per week). Examples of moderate-intensity exercises include brisk walking, water aerobics, riding a bike, or even pushing a lawn mower. If you prefer a faster pace, you can opt for 75 minutes of vigorous-intensity aerobic exercises per week, such as running, swimming laps, or playing basketball.

It’s also beneficial to incorporate muscle-strengthening activities into your exercise routine at least twice a week. These activities can include lifting light weights, using resistance bands, practicing certain types of yoga, or doing body weight exercises such as planks and push-ups. 

Keep in mind that some exercise is much better than none. If 30 minutes of exercise at a time seems daunting, start with an easy walk and gradually work your way up. Your HCP may also be able to recommend an exercise plan that’s suited to your needs.

Be sure to consult with your HCP before starting a workout routine or modifying one that you already follow. If you have heart disease or heart disease risk factors, you may need to make tweaks to your exercise program to boost your health without placing unnecessary strain on your heart.

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Heart disease is the leading cause of death for women and people AFAB, men and people AMAB, and most ethnic and racial groups in the U.S. It can shorten life span and hinder general well-being.

A 2022 study published in the European Journal of Heart Failure found that heart failure reduced life expectancy by 7.3 years, on average. According to statistics from the American Heart Association, heart attacks result in more than 16 years of lost life, on average.

There is positive news, though. People in the 21st century are developing cardiovascular disease 8 to 10 years later in life than people did between 1960 and 1979, which may translate into more healthy years and an increase in lifespan. That’s according to a 2022 analysis published in Circulation that drew on data from the decades-long Framingham Heart Study. The later onset of heart disease is likely due to lower rates of smoking, expanded access to health care, and improved treatments for high cholesterol and high blood pressure.

Overall, many people with heart disease can prolong and improve their lives by following a heart-healthy lifestyle and adhering to their HCP’s treatment guidance. It is possible to live a full, healthy life with heart disease.

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Staying on top of your health is essential if you live with heart disease. Visit your HCP regularly for preventive care and attend all medical appointments recommended by your HCP. Promptly let them know if you experience new or unusual symptoms. If you have questions regarding treatment or medications, don’t hesitate to ask.

Heart disease and mental health

Practicing a heart-healthy lifestyle that emphasizes nutritious foods, regular physical activity, stress management, and good-quality sleep is important if you have heart disease—and not just for your physical health. A growing body of research indicates a two-way relationship between heart disease and various mental health conditions, including:

• Major depression
• Bipolar disorder
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)
• Chronic stress

Frequent anxiety, depression, stress binge eating, and smoking can contribute to poor heart health. One 2023 study, published in the Journal of the American Heart Association, found that young adults with depression had an increased risk of poor cardiovascular health and cardiovascular disease.  

Research also shows that cardiac events like heart attack, heart failure, and stroke are linked to anxiety, depression, and PTSD. Such health scares can lead to financial strain, a fear of disability or death, or anxiety over the possibility of a future health crisis. This can, in turn, place additional strain on the heart. 

It’s important to take steps to protect your mental well-being, especially if you have a mental health condition, heart disease, or both. If you struggle with your mental health, it may feel easier to isolate yourself from others. But socializing with family or friends can help improve your mood.

Sharing your feelings with a trusted loved one or a mental health provider can help you navigate difficult emotions or situations. Many people also find it beneficial to connect with others facing heart disease or mental health issues in online or in-person support groups.  

Your HCP can direct you to a support group or help you find a mental health provider for your needs. For immediate assistance with feelings of severe depression or anxiety, call or text 988 to reach the 988 Suicide & Crisis Lifeline. This service is free, confidential, and available 24/7.

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Reach out to your HCP to learn more about heart disease, including its signs and symptoms, prevention strategies, and treatment options. People with heart disease and their caregivers can also find helpful resources from organizations like the CDC’s Million Hearts initiative or the American Heart Association. 

• Women’s Hearts vs. Men’s Hearts
• Subtle Heart Attack Signs in Women
• Too Young to Have a Heart Attack? Think Again