Guidelines

Guideline on Heart Disease Prevention (2019)

Heart disease is the leading cause of death for both men and women. It accounts for almost 1 in every 3 deaths worldwide each year. In the U.S., nearly half of adults already have some form of heart disease. But many people don’t know that most of the time healthy habits can prevent it.

The American College of Cardiology and American Heart Association published new recommendations about how to stop heart disease before it starts. Here are key points that you should know about the 2019 guideline.

About Heart Disease
Heart disease includes a range of conditions that affect the heart. The most common type occurs when plaque — made up of cholesterol, fat and other substances — builds up in the arteries. Clogged arteries can limit blood flow and cause chest pain, heart attack, stroke or even death.

What Increases Your Risk

Many factors  increase your chance of developing heart disease such as: 

  • Your age
  • Gender
  • Race
  • Cholesterol
  • Blood pressure 
  • If you smoke
  • If you have diabetes

While you cannot change some of these factors, many you can change. In fact, healthy habits throughout life – such as eating heart-healthy, moving more, maintaining a healthy weight and not smoking or quitting smoking – are the most important steps you can take to prevent cardiovascular disease.  

Those healthy habits help control your blood pressure, cholesterol and blood sugar levels. Together, they help you build the foundation of a healthy heart. More than 80% of heart disease is preventable. Even when you have a family history or genes that put you at a greater risk of heart disease, a heart-healthy lifestyle can lower your risk.

Screening for Heart Disease

You can use tools to help gauge the likelihood that you might have a heart attack or stroke – or die from one – over the short- and long-term.

If you haven’t had a heart attack, stroke or related procedure and you’re between 40 and 75 years old, ask your health care professional about your 10-year risk score. They can record certain information about your health to generate your risk score. This score, given as a percentage, estimates the chance that you will have a heart attack or stroke, or die from one of these events in the next 10 years.

Your score will identify you as low, borderline, intermediate or high risk for heart disease. The information can help you and your health care professional decide whether you need to step up prevention efforts or if you might need more tests. 

For example, if you have a low risk – or chance – of developing heart disease, your health care professional may advise you to simply continue heart-healthy habits and regular checkups. 

However, if you have high likelihood of developing heart disease, your health care professional may recommend more tests to assess your health or prescribe medicines to help lower your risk. 

Heart-Healthy Lifestyle

Adopting heart-healthy habits throughout life is the best way to prevent heart disease, according to the experts. So, when they urge healthy living, what does that mean? The recommendations offer some guidance.

❱❱ Eat Heart-Healthy

In general, follow a diet rich in fruits, vegetables, nuts, whole grains, fish or lean meats. 

Also, limit eating processed meats – which include deli meat, sausages, or bacon – refined carbohydrates and sugar-sweetened beverages. You should avoid trans fats.

❱❱ Move More

Adults should get at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise each week to promote good health. To reach that goal, you could try walking briskly for 30 minutes five times in one week. Activities such as running or biking count as vigorous exercise. 

Intensity of Activity
Examples
Light Walking slowly, cooking, light housework
Moderate Brisk walking (2.4 mph-4 mph), biking (5 mph-9 mph), ballroom dancing, active yoga, recreational swimming
Vigorous Jogging or running, biking (≥10 mph), singles tennis, swimming laps

❱❱ Maintain a Healthy Weight

Being overweight or obese increases your chance of developing heart disease and other health problems. You can find out if you are considered obese by calculating your body mass index (BMI), a measurement based on your height and weight. A BMI of 25-29 means you are overweight, and a BMI of 30 or higher means you are obese. 

Steps you can take to lose weight include eating fewer calories and exercising more. If you are trying to reach a healthy weight and need support, ask your health care team about weight-loss programs that can help.

❱❱ Don’t Smoke 

Smoking is the leading preventable cause of death in the United States. It greatly increases the likelihood you will develop heart disease, have a heart attack or stroke. 

If you smoke, ask for advice and help to quit. Your health care professional can offer support – including counseling, nicotine replacement therapy or medicines that can assist you to quit – to help you kick the habit. Even so-called social smoking, which is smoking sometimes with friends or during social gatherings, increases your chance of a heart attack or stroke.

Breathing in secondhand smoke also increases your chance of heart disease. It’s important for everyone to avoid secondhand smoke.

Manage Risk Factors

If you have diabetes, high blood pressure or high cholesterol, you need to watch the conditions closely to help lower the chance you develop heart disease. Health care professionals always recommend you practice healthy habits to help control these conditions. 

However, medication may also be recommended when lifestyle changes aren’t enough, or when patients are at high risk of heart events. The most common medications include metformin for diabetes, statins for high cholesterol, and a variety of drugs to lower blood pressure. 

What about Aspirin?

Aspirin is often an important part of treatment for people who have had a heart attack or stroke and for those living with heart disease. But for most people without disease, there’s not enough evidence to support its benefit.  

An aspirin a day should be used rarely to prevent a heart attack or stroke in people without heart or blood vessel disease. That’s because you can take other steps to lower your chance of heart disease that can be more effective and have fewer side effects.  

Healthy habits and watching certain factors can help you prevent heart disease. While we now have treatments that improve survival and quality of life for patients with heart disease, prevention is still the best medicine.

Go to CardioSmart.org/Prevention to learn more about the building blocks of a healthy heart.