Nearly half of U.S. adults are living with heart disease,but not everyone understands the range of conditions that encompasses. Heart disease is a commonly used term that most frequently refers to coronary artery disease, but also includes conditions like arrhythmias (abnormal heart rhythms), heart failure, heart valve disease, congenital heart disease, aortic disease, and more.
The prevalence of heart disease increases with age. While it only affects 1% of people aged 18 to 44, it jumps to 14% among people aged 65 to 74, and 24% in people 75 and older.
The good news is there are several steps you can take to reduce your risk of developing heart disease as you age. Swapping an ultra-processed snack for a piece of fruit or whole grains is one step toward a more heart-healthy diet. Consistently exercising and not smoking are important prevention methods, too. Each of these preventive steps can help stave off two of the biggest risk factors for heart disease: hypertension (high blood pressure) and high cholesterol.
Perhaps an underrated component of a healthy lifestyle and cardiac health is sleep. The ideal amount of sleep will vary from person to person. However, the American Heart Association recommendsseven to nine hoursof sleep nightly to improve cardiovascular health.
This Heart Health Awareness Month, here’s how you can implement more heart-healthy habits in your everyday life, and advancements in the cardiology field you should know about.
—Christopher Lee, MD, cardiologist and Verywell Health Medical Expert Board member
In the Headlines
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Consistent Sleep Is Essential for Heart Health, Just Like Diet and Exercise
Here’s How Long You Should Walk Every Day to Keep Your Heart Healthy
3 Reasons to Eat More Mushrooms for Heart Health
Ask the Expert
Christopher Lee, MDCardiologistChristopher Lee, MD, is a board-certified cardiologist and internal medicine physician based in San Francisco, CA.Read more
Christopher Lee, MDCardiologist
Christopher Lee, MD
Cardiologist
Christopher Lee, MD, is a board-certified cardiologist and internal medicine physician based in San Francisco, CA.Read more
Christopher Lee, MD, is a board-certified cardiologist and internal medicine physician based in San Francisco, CA.
For someone who is just beginning to monitor blood pressure and cholesterol levels, is it more important to start with a focus on diet or exercise?
Dr. Lee:Both diet and exercise are important when thinking about controlling your blood pressure and cholesterol levels. But if you are going to start with one, improving your dietary habits plays the most critical role. Dietary plans such as theDASH dietandMediterranean dietsignificantly improve blood pressure, cholesterol levels, and weight management. No amount of exercise can compensate for poor dietary habits.
When does high blood pressure warrant medication, and which classes of medication are typically prescribed first?
Dr. Lee:Doctors stage high blood pressure according to the American College of Cardiology and American Heart Association Guidelines from 2017,defining stage I hypertension as a systolic blood pressure ranging from 130-139 mmHg and a diastolic blood pressure of 80-89 mmHg. If you have been diagnosed with hypertension, our initial interventions to improve your blood pressure include weight loss, dietary changes, and increasing your level of physical activity.
If your blood pressure remains elevated, we will consider starting a medication. We also calculate your 10-year risk of cardiac events to help make this decision. Medication therapy is individualized per patient, but some of the more common first-line medications we use includediuretics(such as hydrochlorothiazide or chlorthalidone),ACE inhibitors/ARBs (such as lisinopril or losartan), andcalcium channel blockers(such as amlodipine).
Who is a good candidate for a statin, and what do you wish people with high cholesterol knew about statins?
Dr. Lee:Statins are the most commonly used medications to lower cholesterol. However, doctors look at more than just your cholesterol levels to determine whether you are a good candidate for a statin. If you have not previously suffered a cardiac event, we use statins for “primary prevention,” or to prevent or delay an initial cardiac event.
We also consider your sex, blood pressure, ethnicity, smoking status, and whether you have been diagnosed with diabetes to determine your risk of having a cardiac event within the next 10 years. If you have an elevated risk, you are a good candidate for starting a statin. If you have previously had a cardiac event, statins are used for “secondary prevention,” or to prevent major adverse cardiac events and death.
I think that statins are often unfairly vilified. A significant percentage of patients who may benefit from statins stop their medications due to perceived side effects. Statin-induced side effects are rare, but one of the most commonly mentioned side effects is muscle pain. However, one study showed that when patients were either given a statin, a placebo, or neither, the majority of side effects that developed while patients took a statin also developed among those taking a placebo pill.
What advancements in heart disease treatment are you most excited about from the past year?
Dr. Lee:The use of glucagon-like peptide-1 (GLP-1) receptor agonists (e.g.,Wegovy and Ozempic) for both weight loss and cardiovascular health has been an exciting development in the world of cardiology. GLP-1 agonists have traditionally been used in the treatment of diabetes, but more recent data has shown that they can also reduce major adverse cardiovascular events.
Prior trials have established that GLP-1 agonists are most helpful in patients with (or at high risk of)atheroscleroticcardiovascular disease with type 2 diabetes.Arecent trialpublished in theNew England Journal of Medicinefound that weekly injections of semaglutide (the active ingredient in Wegovy and Ozempic) reduced the risk of heart attack and stroke in patients with overweight or obesity if they had pre-existing cardiovascular disease even if theydidn’thave diabetes.
Managing High Blood Pressure
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How Often Should You Check Your Own Blood Pressure?
5 Beginner-Friendly Workouts That Can Lower Your Blood Pressure
Diet or Exercise: Which One Is Better for Managing Blood Pressure?
Managing High Cholesterol
Is apoB More Important to Measure than Cholesterol?The Best Way to Enjoy Eggs If You Have High Cholesterol, According to DietitiansDrug Nexletol Lowers Cholesterol Without the Side Effects of Statins
Is apoB More Important to Measure than Cholesterol?
The Best Way to Enjoy Eggs If You Have High Cholesterol, According to Dietitians
Drug Nexletol Lowers Cholesterol Without the Side Effects of Statins
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsao CW, Aday AW, Almarzooq ZI, et al.Heart disease and stroke statistics—2023 update: a report from the american heart association.Circulation. 2023;147(8). doi:10.1161/CIR.0000000000001123Centers for Disease Control and Prevention.Heart disease prevalence.Colantonio LD, Booth JN 3rd, Bress AP, Whelton PK, Shimbo D, Levitan EB, Howard G, Safford MM, Muntner P.2017 ACC/AHA blood pressure treatment guideline recommendations and cardiovascular risk.J Am Coll Cardiol. 2018 Sep 11;72(11):1187-1197. doi:10.1016/j.jacc.2018.05.074Marso SP, Bain SC, Consoli A, et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsao CW, Aday AW, Almarzooq ZI, et al.Heart disease and stroke statistics—2023 update: a report from the american heart association.Circulation. 2023;147(8). doi:10.1161/CIR.0000000000001123Centers for Disease Control and Prevention.Heart disease prevalence.Colantonio LD, Booth JN 3rd, Bress AP, Whelton PK, Shimbo D, Levitan EB, Howard G, Safford MM, Muntner P.2017 ACC/AHA blood pressure treatment guideline recommendations and cardiovascular risk.J Am Coll Cardiol. 2018 Sep 11;72(11):1187-1197. doi:10.1016/j.jacc.2018.05.074Marso SP, Bain SC, Consoli A, et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tsao CW, Aday AW, Almarzooq ZI, et al.Heart disease and stroke statistics—2023 update: a report from the american heart association.Circulation. 2023;147(8). doi:10.1161/CIR.0000000000001123Centers for Disease Control and Prevention.Heart disease prevalence.Colantonio LD, Booth JN 3rd, Bress AP, Whelton PK, Shimbo D, Levitan EB, Howard G, Safford MM, Muntner P.2017 ACC/AHA blood pressure treatment guideline recommendations and cardiovascular risk.J Am Coll Cardiol. 2018 Sep 11;72(11):1187-1197. doi:10.1016/j.jacc.2018.05.074Marso SP, Bain SC, Consoli A, et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141
Tsao CW, Aday AW, Almarzooq ZI, et al.Heart disease and stroke statistics—2023 update: a report from the american heart association.Circulation. 2023;147(8). doi:10.1161/CIR.0000000000001123
Centers for Disease Control and Prevention.Heart disease prevalence.
Colantonio LD, Booth JN 3rd, Bress AP, Whelton PK, Shimbo D, Levitan EB, Howard G, Safford MM, Muntner P.2017 ACC/AHA blood pressure treatment guideline recommendations and cardiovascular risk.J Am Coll Cardiol. 2018 Sep 11;72(11):1187-1197. doi:10.1016/j.jacc.2018.05.074
Marso SP, Bain SC, Consoli A, et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141
