When healthy, the heart is an efficient, hard-working pump that beats 100,000 times a day, delivering oxygen and nutrients throughout the body, says Amparo Villablanca, preventive cardiologist and director and founder of the UC Davis Health Women’s Cardiovascular Medicine Program. 

However, heart disease is the leading cause of death for both men and women in the U.S., accounting for about one million deaths per year, Richard Florio, MD, Physician in Chief at Kaiser Permanente Roseville Medical Center tells us. “The lifestyle choices you make can go a long way in preventing heart disease,” he says.

Since February is American Heart Month, we talked to local cardiologists and heart experts about risk factors, how to prevent heart disease, and what to ask your doctor to make sure you keep your ticker in tip-top shape.

Risky Business

Nancy Luo, MD, FACC, advanced heart failure and transplant cardiologist for Dignity Health Heart and Vascular Institute and Mercy Medical Group, says non-modifiable risk factors include your age, sex, and family history of premature heart disease. Modifiable risk factors are high cholesterol, diet, weight, exercise, hypertension, diabetes, and smoking.

Reetu Sharma, MD, cardiologist at Sutter Health Roseville and Go Red for Women Ambassador, says stress, depression, and lack of sleep are also risk factors. “You can change [your risk factors] with healthy dietary habits and regular exercise, but can’t change your age and family history,” she says. 

“The National Institutes of Health recommends at least two and a half hours of moderate activity each week (or 30 minutes, five days a week),” Dr. Villablanca says. “For additional benefits, your goal should be 60 minutes of moderate to vigorous activity on most days of the week. Managing stress is also very important for heart health. I recommend finding something that relaxes you—like meditation, yoga, or reading—and doing it at least once every day.”

Age is Not Just a Number

“Age is indeed a risk factor for heart disease; however, cardiologists are seeing [more] younger patients today than ever before. My youngest heart attack patient was 21,” Dr. Villablanca says. “Also, heart attack deaths are increasing in women under the age of 50. Every age is the right age to prioritize heart health.”

With that said, according to Dr. Florio, about four out of five people who die of coronary heart disease are 65 years of age or older. “An 80-year-old with no other risk factors is still at a higher risk than a 40-year-old smoker with high blood pressure,” says Stanley Henjum, MD, cardiologist at Marshall Cardiology.

Men are at increased risk of having heart disease starting at age 45, and women’s risk increases at 55 years old. “As we age, our heart and blood vessels undergo changes, such as the hardening of arteries, the build-up of fatty deposits in the arteries over many years, and the heart not being able to pump as fast while stressed or exercising,” says Brian Plante, ND, at Revolutions Naturopathic.

Healthy Habits

Dr. Sharma says it’s important to make healthy choices on a daily basis, lowering your risk for heart disease. “Avoid smoking and drinking heavily. Take time for yourself for activities that bring you happiness and a sense of freedom; work on better sleep hygiene; and avoid getting sick, as the flu, pneumonia, and other infections can take a toll on the heart,” she says.

Dr. Luo shares her motto to “sit less, move more,” as well as the benefits of the Mediterranean diet, which can reduce the risk of cardiovascular disease. “The Mediterranean diet features a wide variety of plant-based food including vegetables, fruits, whole grains, nuts, legumes, beans, herbs, spices, and olive oil. Foods eaten in moderation include fish, seafood, poultry, eggs, and dairy. Desserts and red meat are saved for special occasions.”

Any sort of movement will benefit you, Dr. Henjum shares. “Just taking several short walks is sufficient; [in fact], studies show that vigorous exercisers aren’t at any less risk than walkers and no one form of exercise is better than another. Consistency of effort is what counts.”

What’s Up Doc

Since more than 40% of Americans die from heart disease, it’s important to ask your doctor to evaluate your risk. Dr. Henjum says to ask about blood pressure and cholesterol and whether your physical fitness level is sufficient.

Dr. Luo suggests asking questions such as, “What is an appropriate diet and exercise regimen for me? Which foods help my blood pressure? Which diet helps me lose weight? Which diet is best to control diabetes? Are my blood pressure, cholesterol, and sugar levels at target range? And if I have diabetes, am I being treated with diabetic medications that will help prevent future cardiovascular disease and/or help me lose weight?”

George Fehrenbacher, MD, an interventional cardiologist with Sutter Roseville Medical Center, says if you think you might be at risk for heart issues, ask your doctor how to modify your risk factors. “If you’re having symptoms such as chest discomforts and shortness of breath, obtaining a physical examination, EKG, and bloodwork to look at the risk factors can be helpful,” he adds.

Prevention is the Best Medicine 

Dr. Sharma says she’s always surprised with the lack of awareness of cardiovascular disease, even though it’s the leading killer in developed countries. “There is awareness of breast cancer, HIV, colon cancer, MS, Alzheimer’s, and so many other diseases, but somehow heart disease is the one that’s left out of this awareness campaign, and it continues to kill more people than all of the others combined.” And prevention does save lives. “Early detection is your best chance at a good outcome and a long and happy rest of your life. But if you don’t see your MD, have appropriate risk factor evaluation, periodical screening tests, and begin prescriptions early when something is amiss, you won’t defeat this greatest threat to your longevity.”

Dr. Henjum says to pay attention to the ease or difficulty of normal everyday tasks, such as bringing in the groceries. “If it suddenly becomes difficult, speak with your doctor immediately. We get old in a decade, not overnight,” he says. 

Men and women should put their heart health first. “Women, in particular, tend to think of heart disease as a ‘man’s disease,’” Dr. Villablanca says. “This simply isn’t the case, as more women die of heart disease than all forms of cancer combined, and more women die of heart disease than men. The more we talk about heart health, the easier prevention becomes. We should all be having this conversation in our circles of friends and family, during National Heart Month in February and year-round.”