The 4 Risk Factors That Cause Virtually Every Heart Attack—and How to Fix Them
Even after decades of unhealthy habits, you can see rapid improvements with these expert tips
A new study that included over half a million people has uncovered evidence we think may surprise you: Just four heart attack risk factors are linked “to nearly every heart attack,” says Michelle Routhenstein, MS RD CDCES CDN, a preventive cardiology dietitian and certified diabetes educator.
The culprits? High blood pressure, high cholesterol, high blood sugar and tobacco use. A full 99 percent of patients experiencing cardiac events—which included heart attacks plus heart failure and stroke—had at least one of these conditions before being hospitalized, per findings in the Journal of the American College of Cardiology.
Given how common these issues are, should we be worried? Actually, in a sense, we should be relieved. Because they’re what experts call modifiable risks. In other words, “they’re all changeable,” says cardiologist Jack Wolfson, DO, founder of Natural Heart Doctor. “By making simple shifts in lifestyle, you can dramatically lower your chances of a heart attack or stroke. It’s incredibly good news.” Keep scrolling for easy advice to help eliminate heart attack risk factors and keep your ticker strong for years to come.
Woman's World Answers
What’s the best way to start protecting your heart?
“Heart disease isn’t about bad luck or bad genes, it is strongly linked to factors we can detect and optimize through science-based nutrition, lifestyle and medication as needed,” says Routhenstein. And the effort you put in doesn’t just improve your blood work. “Every small step adds up and moves you closer to a longer, healthier, and more vibrant life.”
So, where do you begin, especially if you have multiple risk factors? Dr. Wolfson says that, generally speaking, shifting from processed food to natural options, adding little walks throughout the day and going to bed earlier is an ideal starting point. It will help with all risk factors at once—including tobacco use, since healthy living reduces anxiety and can make you less inclined to light up.
That said, if you want a specific goal to focus on, “start with either blood pressure or blood sugar, whichever is most elevated. Improvements in these areas create a ripple effect that often improves cholesterol, lowers inflammation, boosts energy and enhances sleep. They are powerful starting points.”
4 simple ways to lower your heart attack risk, according to experts
Here’s what experts we spoke to recommend:
If you need to lower blood pressure…
“High blood pressure harms your heart because it constantly pushes against artery walls,” says Dr. Wolfson. “Imagine water running through a hose at double pressure. Over time, the hose stiffens and cracks. This same damage happens inside arteries, which increases the risk of heart attack and stroke.”
While that may sound scary, “blood pressure responds quickly to dietary and lifestyle changes,” says Routhenstein, who encourages folks to get a home monitoring device. “You can see improvements in real time, which motivates you and supports long-term success,” she says. (Read more about healthy blood pressure numbers based on your age here.)
Simple ways to make a big difference: “Cutting back on sodium matters because excess salt makes the body hold onto more water, increasing blood volume and raising the pressure inside the arteries,” says Routhenstein. You also want to emphasize foods rich in blood-vessel-relaxing potassium, magnesium and calcium, such as bananas, leafy greens, potatoes, beans and yogurt. And regular activity triggers blood vessels to relax and widen, making it easier for blood to flow.
Surprise blood-pressure-lowering hack: Beets! “A daily serving of beetroot powder or beet juice is a simple and powerful way to lower blood pressure because beets boost nitric oxide, which relaxes and opens your blood vessels,” says Dr. Wolfson. There’s growing research on the benefits of beets, including a study funded by the British Heart Foundation that found about a cup of beetroot juice daily helped hypertensive patients lower blood pressure by 7.7/2.4 mmHg in just four weeks. Don’t want to drink the juice straight? Hide it in a smoothie. “It is both safe and effective. I often recommend it for women looking to support healthy blood pressure naturally.”
If you need to lower cholesterol…
“Cholesterol itself is not the enemy,” says Dr. Wolfson. The real issue is cholesterol that has been damaged or “oxidized” by factors like processed foods, toxins or inflammation. Oxidized cholesterol irritates the artery lining, contributes to artery-clogging plaque buildup and generally makes it hard for blood to flow freely. “So the goal is not lowering cholesterol at all costs, but preventing it from becoming damaged.” (Read more about healthy cholesterol numbers based on your age here.)
Simple ways to make a big difference: Steer away from foods that oxidize cholesterol—namely sugar and processed food, advises Dr. Wolfson. Instead, load up on whole, anti-inflammatory foods such as produce and high-quality protein. Routhenstein says you’ll also want to limit saturated fats from red meat and dairy, instead opting for healthy unsaturated fats (such as olive and avocado oil) and foods rich in omega-3 fatty acids (such as walnuts and salmon). Eating plenty of soluble and insoluble fiber also helps “support cholesterol clearance from the body,” she adds.
Surprise cholesterol-lowering hack: Breakfast! “Skipping breakfast prompts the liver to produce more LDL cholesterol and disrupts hormones that regulate hunger and insulin, which makes it harder for the body to clear cholesterol efficiently,” says Routhenstein. “Studies show that people who skip breakfast may see their LDL rise by around 9 to 10 mg/dL on average.”
If you need to lower blood sugar…
What does blood sugar have to do with your heart? “Excess glucose acts like tiny shards of glass, irritating and inflaming the artery walls,” Dr. Wolfson explains. Adds Routhenstein: “Even mildly high blood sugar damages blood vessels and makes blood more likely to clot, accelerating plaque growth and rupture.“ (Read more about healthy blood sugar numbers based on your age here.)
Simple ways to make a big difference: Once again, walking is key—especially after meals, since moving muscles for as little as ten minutes triggers them to burn more sugar for fuel. Avoid sugar bombs, especially sugary drinks. It’s also smart to eat protein and healthy fats with carbs, says Routhenstein. Protein and fat help slow the rate at which any carbs you eat become blood sugar; avoiding blood sugar surges helps prevent cell damage that worsens blood sugar control.
Surprise blood-sugar-lowering hack: Sleep! Our bodies need us to snooze long enough each night (typically 7-8 hours per night) to essentially recalibrate hormones and keep them at optimal levels. A famous Harvard study showed that even one week of lousy sleep messes with the hormone insulin and leaves our bodies 40 percent worse at clearing sugar from our blood. “Women often see dramatic improvements in blood sugar levels simply by prioritizing early sleep,” says Dr. Wolfson.
If you need to quit smoking…
“Tobacco damages the heart even faster than it harms the lungs,” cautions Dr. Wolfson. “It stiffens arteries, increases clotting, raises inflammation and reduces the amount of oxygen in your blood. All of these factors dramatically increase cardiovascular risk.” Most of us who’ve tried to kick the habit know it can be tough, but there are more options than ever before. And it’s so worth it.
Simple ways to make a big difference: “Remove cigarettes from your home and car, and replace the ritual rather than relying on willpower alone,” suggests Dr. Wolfson. For example, sipping tea or taking a short walk during times you would normally smoke can be very effective.
Adds Routhenstein: “Using nicotine replacement therapy, such as patches, gum, or lozenges, or prescription medications can greatly improve your chances of quitting.”
Surprise smoking-cessation hack: Aromatherapy! For a study in the Journal of Alternative and Complementary Medicine, smokers were instructed to dab different essential oils on a tissue and inhale for two minutes when craving nicotine. “Aromatherapy can help calm the nervous system,” explains Dr. Wolfson. “Many patients have shared with me that certain essential oils—especially black pepper and lavender—help reduce cravings and ease the tension associated with quitting. It’s certainly a useful addition to a tobacco cessation plan.”
The bottom line: It’s never too late to start protecting your heart
“Your heart is incredibly forgiving,” says Dr. Wolfson. “Even after decades of unhealthy patterns, you often experience rapid improvements once you make small, consistent changes. It is never too late.”
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