Updated on March 13, 2024.
Every year in the United States more than 750,000 people have a heart attack. There are things you can do to protect your heart health and reduce your risk. The first step is to learn about the risk factors that make certain people more likely to have a heart attack. These risk factors include:
- Smoking and other tobacco use
- Unhealthy diet high in salt, saturated fat which is solid at room temperature, and trans fats often found in processed and junk foods
- Drinking too much alcohol
- Obesity or being overweight
- Being inactive or not getting regular exercise
- High blood pressure
- Unhealthy cholesterol levels (a fat-like substance in the blood)
- Diabetes (high blood sugar levels)
- Older age
- Family history of heart disease
Age and family history are two risk factors you can’t control. But others—like smoking, obesity, and inactivity—can be changed.
“It’s hard to say a percentage, but I would say about half of all heart attacks are preventable as long as risk factors are identified,” says Vivek Sailam, MD, a cardiologist with Virtua Our Lady of Lourdes Medical Center in Camden, New Jersey.
But research suggests that many people are not making the lifestyle changes that could help reduce their risk for heart problems, including heart attack. A 2017 study published in International Journal of Cardiology compared the characteristics of the average person experiencing a heart attack in 2014 versus 1995. In 2014, the average person who had a heart attack was younger, more obese, and had more risk factors than the average person who had a heart attack victim about 10 years earlier.
Heart attacks are occurring at younger ages
That 2017 study found that the average age for people to have the most serious kind of heart attack—known as ST-elevation myocardial infarction, or STEMI—at Cleveland Clinic dropped from 64 at the beginning of the study period to 60 by the end. The percentage of people with diabetes increased from 24 percent to 31 percent. In 2014, more than 75 percent of those studied had high blood pressure, compared to only 55 percent in 1995. And even though smoking rates among U.S. adults have fallen since the 1960s, the hospital saw an increase in smoking rates among heart attack patients, from 28 percent to 46 percent.
These findings are similar to what Dr. Sailam's own observations. “Unfortunately, in the past 10 years or so I’ve been seeing a steady increase in patients younger than 50 who have significant risk factors: morbid [extreme] obesity, diabetes, high cholesterol, high blood pressure, and tobacco use,” he says.
The researchers also found that rates of diabetes, high blood pressure, smoking, and obesity were higher in people with low income levels. These differences could be related in part to difficulties in getting quality medical care. Lack of health insurance or more difficulties seeing a healthcare provider and paying for care may play a role as well.
If you live in an area where it's hard to find or buy fresh fruits and vegetables, it can also affect your health. Those with lower incomes are also more likely to smoke or have more trouble quitting. One possible reason why: if you are not able to find or use programs to help you stop smoking, it may be harder for you to quit.
Many risks are preventable
The increase in heart attack risk factors is, in part, due to unhealthy lifestyle choices: smoking, eating too much, eating the wrong kinds of foods, and not exercising, Sailam says. “It’s absolutely lifestyle-mediated,” he explains. “Consumption of food from chain restaurants has increased dramatically, and portion sizes are up exponentially. Patients are sedentary, not exercising.”
Diet and exercise changes can reduce the risk of heart attack, as well as helping you manage obesity, high blood pressure, high blood sugar, and high cholesterol.
“If you have risk factors, you want to get them evaluated and treated. You don’t want to wait until something happens,” Sailam says. “Be proactive. A lot of folks ignore risk factors, and I meet them in the ER while they’re having a heart attack.”
Lifestyle management
Good places to start? Reduce food portions and try to get more exercise, as you are able.
Be mindful about how much you eat at mealtimes, or your food portion sizes. Sailam estimates many of his patients may eat 4,000 calories ore more each day. That’s well above even the highest of the United States Department of Agriculture’s (USDA) daily estimates; most people need between 1,600 and 3,000 calories per day.
Try to move more each day, or avoid sitting for long periods of time. The Centers for Disease Control and Prevention (CDC) recommends 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous exercise. Walking 30 minutes a day is an excellent way to get your daily dose of moderate exercise. This can be done in smaller amounts of activity. For example, you can take three 10-minute walks a day instead of one 30-minute walk. In addition, you should try to include strength training two times each week, such as sit-ups or push-ups.
