When it comes to having a healthy heart, experts say much depends on how you live day to day. 

"It all starts with lifestyle,” says Army Lt. Col. Todd Villines, the cardiology consultant to the Army Surgeon General and a practicing cardiologist at Walter Reed National Military Medical Center. “To assess a person’s risk of cardiovascular disease, we need to look at the factors that affect the heart and blood vessels.” 

Villines said risk factors can be divided into two major categories: modifiable and non-modifiable. Some of the modifiable risks include smoking, blood pressure and cholesterol levels. These are things patients can affect by how they live their lives and can be improved with medications, if needed. Non-modifiable risks include a family history of heart attack or stroke that could make someone more vulnerable to cardiovascular disease, although Villines is quick to point out that just because someone is at more risk due to something uncontrollable, such as genetics, it’s not a given that they will suffer from heart disease. 

“I try to engage my patients early on,” said Villines. “That way, I’m able to quantify and help them quantify their risks and figure out the best way to treat those risks before they suffer from a heart attack or stroke.” 

Villines said while smoking is generally associated with causing lung disease, it is the most hazardous risk factor for heart disease and stroke. Smoking causes blood pressure to increase, which in turn puts the heart under more stress, making it vulnerable to cardiac arrest. In addition, smoking leads to damage to the arteries supplying blood to the brain and heart (among other organs), which increases the risk of blood clots that can cause a stroke and/or heart attack. Villines recognizes that it’s hard to kick the habit, but it’s important that people try. Help is available through the Military Health System’s Quit Tobacco program, UCanQuit2.org, as well as local resources.  “Most of our military hospitals and clinics offer some kind of smoking cessation help. It’s never too late to quit.” 

Blood pressure is another modifiable risk factor for heart disease. Villines said hypertension, or high blood pressure, is very common and on the rise in American society, especially with cases of childhood obesity becoming more common. Modifying your diet, including reducing the amount of salt in your food, can help get blood pressure under control. In addition, regular exercise, 30 minutes for at least five days per week, can do a lot to help maintain weight and even reduce stress, both factors for hypertension. Villines said a visit with your doctor can help identify where your blood pressure is and what you can do to get it to where it should be. 

Blood cholesterol levels and diet can play major roles in heart health. Villines said saturated fats in food raise cholesterol levels, which adversely impacts the heart’s health. Processed food and the type of carbohydrates in food, as well as how the meal is prepared, also can affect cholesterol levels. “I really suggest talking with a dietitian and have an honest conversation about what you eat.” 

While there are many habits people can change to help their heart health, Villines said there are some that are out of our control. Family history and genetics play their roles, and the best response is talking to a health professional who can evaluate that history and test for warning signs that could cause cardiovascular disease. Some of that control might include medications, and some factors could be controlled by simply knowing you’re at risk and taking the proper steps. “Know your numbers, and control what you can control,” said Villines. 

Overall, to manage all heart disease risk factors, modifiable and non-modifiable, Villines said people need to start with a discussion with their doctor and dietitian and have those discussions on a regular basis. 

“You really need a whole game plan,” said Villines. “The proper balance of diet, exercise, and where necessary, medications, can ensure your heart and brain remain healthy for a long life.” 

Learn more about tips to keep your heart healthy.