Despite everything we know about how important our heart is for our overall health, heart disease is the number-one killer of both men and women in the United States and is responsible for an estimated 655,000 deaths each year, according to the CDC.
And while heart disease might seem like a problem that only affects older people, heart attacks are increasingly common in younger people. In fact, research presented at the American College of Cardiology’s 68th Annual Scientific Session suggests that as many as one in five patients who suffer a heart attack are 40 or younger.
One of the factors behind the statistics: “The obesity rate has doubled in adults, up from 15 percent in the 1970s to now 34 percent, according to government statistics,” says Richard E. Collins, M.D., Nebraska-based cardiologist and author of The Cooking Cardiologist. Other risk factors, such as smoking, poor diet, diabetes, and substance abuse, also contribute.
The good news: Almost all cardiovascular disease can be prevented by managing blood sugar, blood pressure, and cholesterol, notes Alexandra Lajoie, M.D., a non-invasive cardiologist at Providence Saint John’s Health Center in Santa Monica, CA. “Maintaining healthy lifestyle habits and making heart-healthy diet choices can treat these cardiac risk factors.”
Here are six heart-healthy habits that cardiologists want you to adopt to keep your ticker happy through the years.
1. Don’t smoke
In case you needed another reason to quit, Tae Yang, M.D., an interventional cardiologist at Orange Coast Medical Center’s MemorialCare Heart & Vascular Institute in California, believes the single most important thing you can do for your heart health is to not smoke.
“Smoking cigarettes is strongly associated with heart disease,” he says. “This is a modifiable condition, and every effort should be made for smokers to stop smoking.” He recommends checking out the SAMHSA website for a full list of programs and initiatives that can help you finally stop smoking.
2. Commit to an exercise routine
Exercise is one of the best ways to treat high blood pressure, blood sugar, and cholesterol, and maintain a healthy body weight, says Lajoie. In fact, she sees the biggest drops in cholesterol levels in her patients who start a good exercise regimen. Research backs this up, with one Lipids in Health and Disease study showing that physically-active women had higher levels of HDL (good cholesterol) than sedentary women.
Read More: Could You Have Prediabetes Without Even Realizing It?
Even for individuals with a genetic predisposition to heart disease, exercise can be an effective treatment, as shown by one study from Stanford University School of Medicine.
The American Heart Association recommends at least 150 minutes of heart-pumping physical activity each week, which translates to about 30 minutes of physical activity five days out of the week.
Finding the right type of exercise for you is a great first step. “It’s important to identify what you enjoy and then find activities around that,” says Roger E. Adams, Ph.D., CISSN, doctor of nutrition, personal trainer, and founder of eatrightfitness. “For example, if you enjoy being outdoors, then an indoor workout like weight training or a spin class is likely not for you.”
Adams’ recommendation: Make a list of activities you like (from hiking to yoga to walking) and focus your movement goals on them. Since this is one of the most helpful heart-healthy habits you can adopt, it’s crucial you actually stick with it.
3. Get Quality Sleep
Though you might not think to categorize it amongst heart-healthy habits, good sleep quality is also important for cardiac health, says Lajoie.
First, make note of the American Heart Association’s recommendation of seven to nine hours of shut-eye a night. If you have trouble settling down, “get sufficient exercise (but not in the evenings before bedtime) and avoid screens within two hours of when you plan to go to sleep,” she suggests. “If your mind tends to race or wander when going to sleep, try meditation apps before bed.”
Another sleep-related issue to keep tabs on: sleep apnea. “Sleep apnea is a disorder that causes people to stop breathing during sleep, and it has a high prevalence in patients with heart disease,” she says. “If untreated, sleep apnea can cause high blood pressure, arrhythmias, and heart failure.” Maintaining a healthy body weight is key for warding off sleep apnea, she says. If you’re concerned about the condition, though, talk to your doctor.
4. Optimize Your Diet
When it comes to protecting your heart, a few healthy eating tweaks go a long way.
First, the American Heart Association recommends filling at least half your plate with fruits and veggies at each meal in order to consume 4.5 cups of each per day.
It’s important that you also consume lean meats and fish, which can help lower cholesterol and reduce inflammation, which decreases your risk of vascular disease. “Lean meats and fish are good sources of protein that provide satiety without saturated fats or sugars,” says Lajoie. “They are also a good source of polyunsaturated fatty acids, which are great for heart health.”
Read More: Want To Try The Mediterranean Diet? Here’s Exactly What To Eat
You might also want to cut back on salt intake, since consuming excess sodium can increase your blood pressure and up your risk for heart disease. In a state of high blood pressure (a.k.a. hypertension), “the blood vessels that go to all of your organs are under extra stress and pressure buildup, which can lead to microvascular damage and plaque buildup, contributing to heart disease and stroke risk,” says Yang.
For more heart-healthy diet tips, check out the National Institutes of Health (NIH)-recommended DASH (Dietary Approaches to Stop Hypertension) Diet, which is lower in sodium, trans and saturated fats, and cholesterol.
5. Take Action to Reduce Stress
There’s no denying that we live in stressful times—and the effects of stress can be damaging to our health, especially our heart health. In fact, stress is directly correlated to an increase in blood pressure and cholesterol levels, according to the American Heart Association.
“Anxiety, stress, and exhaustion are true killers of the heart,” says Collins. In fact, research published in The Lancet connected emotional stress and an increased risk of heart disease. Another study published in the British Medical Journal, meanwhile, found that individuals with stress-related disorders such as PTSD had an increased risk for cardiovascular disease.
Consider incorporating stress-reducing techniques, such as meditation or yoga, into your daily routine. And if you’re skeptical about these heart-healthy habits’ effectiveness, know this: One study published in Evidence-Based Complementary and Alternative Medicine found that participating in yoga decreased systolic blood pressure averages by 4.17 mm Hg and diastolic averages by 3.62 mm Hg.