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How To Prevent and Control Coronary Heart Disease Risk Factors

You can prevent and control many coronary heart disease (CHD) risk factors with lifestyle changes and medicines. Examples of these controllable risk factors include high blood cholesterol, high blood pressure, and overweight and obesity. Only a few risk factors—such as age, gender, and family history—can't be controlled.

To reduce your risk of CHD and heart attack, try to control each risk factor you can. The good news is that many lifestyle changes help control several CHD risk factors at the same time. For example, physical activity may lower your blood pressure, help control diabetes and prediabetes, reduce stress, and help control your weight.

A Lifelong Approach

Many lifestyle habits begin during childhood. Thus, parents and families should encourage their children to make heart healthy choices, such as following a healthy diet and being physically active. Make following a healthy lifestyle a family goal.

To achieve this goal, you should learn about key health measures, such as weight, body mass index (BMI), waist circumference, and your child's BMI-for-age percentile. For more information about BMI in adults and children, go to "Coronary Heart Disease Risk Factors."

Be aware of your and your family members' blood pressure, blood cholesterol, and blood sugar levels. Once you know these numbers, you can work to bring them into, or keep them within, a healthy range.

Making lifestyle changes can be hard. But if you make these changes as a family, it may be easier for everyone to prevent or control their CHD risk factors.

For tips on how to help your children adopt healthy habits, visit the National Heart, Lung, and Blood Institute's (NHLBI's) We Can!® Ways to Enhance Children's Activity & Nutrition Web site.

Lifestyle Changes

A healthy lifestyle can lower the risk of CHD. If you already have CHD, a healthy lifestyle may prevent it from getting worse. A healthy lifestyle includes:

  • Following a healthy diet
  • Being physically active
  • Maintaining a healthy weight
  • Quitting smoking
  • Managing stress

Following a Healthy Diet

A healthy diet is an important part of a healthy lifestyle. To lower your risk of CHD and heart attack, you and your family should follow a diet that is:

  • Low in saturated and trans fats. Saturated fats are found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods. Trans fats are found in some fried and processed foods. Both types of fat raise your low-density lipoprotein (LDL), or "bad," cholesterol level.
  • High in the types of fat found in fish and olive oil. These fats are rich in omega-3 fatty acids. Omega-3 fatty acids lower your risk of heart attack, in part by helping prevent blood clots.
  • High in fiber. Fiber is found in whole grains, fruits, and vegetables. A fiber-rich diet not only helps lower your LDL cholesterol level, but also provides nutrients that may help protect against CHD.
  • Low in salt and sugar. A low-salt diet can help you manage your blood pressure. A low-sugar diet can help you prevent weight gain and control diabetes and prediabetes.

Research suggests that drinking small to moderate amounts of alcohol regularly also can lower your risk of CHD. One drink a day can lower your risk by raising your high-density lipoprotein (HDL), or "good," cholesterol level. One drink is a glass of wine, beer, or a small amount of hard liquor.

If you don't drink, this isn't a recommendation to start using alcohol. If you're pregnant, if you're planning to become pregnant, or if you have another health condition that could make alcohol use harmful, you shouldn't drink.

Also, too much alcohol can cause you to gain weight and raise your blood pressure and triglyceride level. In women, even one drink a day may raise the risk of certain types of cancer.

Teach your children how to make healthy food choices. For example, have them help you shop for and make healthy foods. Set a good example by following the same heart healthy diet that you ask your children to follow.

For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," "Your Guide to Lowering Your Blood Pressure With DASH," and "Your Guide to Lowering Your Cholesterol With TLC." All of these resources provide general information about healthy eating.

Being Physically Active

You don't have to be an athlete to lower your risk of CHD. You can benefit from as little as 60 minutes of moderate-intensity aerobic activity per week.

For major health benefits, adults should do at least 150 minutes (2.5 hours) of moderate-intensity aerobic activity or 75 minutes (1 hour and 15 minutes) of vigorous-intensity aerobic activity each week.

Another option is to do a combination of both. A general rule is that 2 minutes of moderate-intensity activity counts the same as 1 minute of vigorous-intensity activity.

The more active you are, the more you'll benefit. If you're obese, or if you haven't been active in the past, start physical activity slowly and build up the intensity over time.

Children and youth should do 60 minutes or more of physical activity every day. A great way to encourage physical activity is to do it as a family. You also may want to limit your children's TV, video, and computer time to encourage them to be more active.

If you have CHD or symptoms such as chest pain and dizziness, talk with your doctor before you start a new exercise plan. Find out how much and what kinds of physical activity are safe for you. Avoid exercising outdoors when air pollution levels are high or the temperature is very hot or cold.

For more information about physical activity, go to the U.S. Department of Health and Human Services' (HHS') "2008 Physical Activity Guidelines for Americans," the Health Topics Physical Activity and Your Heart article, and the NHLBI's "Your Guide to Physical Activity and Your Heart."

Maintaining a Healthy Weight

Following a healthy diet and being physically active can help you maintain a healthy weight. Controlling your weight helps you control CHD risk factors.

If you're overweight or obese, try to lose weight. A loss of just 5 to 10 percent of your current weight can lower your risk of CHD.

To lose weight, cut back your calorie intake and do more physical activity. Eat smaller portions and choose lower calorie foods. Don't feel that you have to finish the entrees served at restaurants. Many restaurant portions are oversized and have too many calories for the average person.

For overweight children and teens, slowing the rate of weight gain is important. However, reduced-calorie diets aren't advised, unless approved by a doctor.

Quitting Smoking

If you smoke, quit. Smoking can raise your risk of CHD and heart attack and worsen other CHD risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.

If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.

You can help your children avoid smoking or quit smoking. Talk with them about the health effects of smoking. Teach them how to handle peer pressure to smoke.

Teens who have parents who smoke are more likely to smoke themselves. Set a good example by not smoking or quitting smoking. Set firm rules about no tobacco use in your home.

If you have a child who smokes, help him or her create a plan to quit. Offer your child information and resources on how to quit. Stress the natural rewards that come with quitting, such as freedom from addiction, better fitness and sports performance, and improved appearance. Reinforce the decision to quit with praise.

For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the NHLBI's "Your Guide to a Healthy Heart."

For more information about children and smoking, go to HHS' Kids and Smoking Web page and the Centers for Disease Control and Prevention's Smoking and Tobacco Use Web page.

Managing Stress

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Having supportive people in your life with whom you can share your feelings or concerns can help relieve stress.

Physical activity, medicine, and relaxation therapy also can help relieve stress. You may want to consider taking part in a stress management program.

Other Lifestyle Concerns

If making lifestyle changes is hard for you, try taking things one step at a time. Learn about the benefits of lifestyle changes. Talk with your doctor, and read some of the resources in "Links to Other Information About Coronary Heart Disease Risk Factors."

Figure out what's stopping you from making or sticking to your lifestyle changes. Try to find ways to overcome these issues. For example, if you're too tired to exercise after work, you may want to try working out before you go to work.

Make a plan to carry out your lifestyle changes that includes specific, realistic goals. Act on your plan and work toward your goals. You may want to do so with the help of a support group or supportive friends and family.

Reward yourself for the gains you've made. Think about what you need to do to maintain your lifestyle changes and avoid unhealthy habits.

Don't give up if you go off your diet or exercise plan or start smoking again. Instead, find out what you need to do to get back on track so you can meet your goals. Many people find that it takes more than one try to make long-term lifestyle changes.

Changing the eating and activity habits of children takes time. Start with small, easy steps. For example, cut out after-dinner snacks or go for an after-dinner walk instead of watching TV.

Set a good example, and try to get your children involved in choosing a new healthy step to take each day. If you make lifestyle changes a group effort, it will make them easier.


Sometimes lifestyle changes aren't enough to control your blood pressure, cholesterol levels, or other CHD risk factors. Your doctor also may prescribe medicines. For example, you may need medicines to:

  • Lower your LDL cholesterol
  • Lower your blood pressure
  • Lower your blood sugar level
  • Prevent blood clots and/or inflammation

Take your medicines as prescribed. Don't cut back on the dosage unless your doctor tells you to. If you have side effects or other problems related to your medicines, talk with your doctor. He or she may be able to provide other options.

You should still follow a heart healthy lifestyle, even if you take medicines to control your CHD risk factors.

® We Can! is a registered trademark of HHS.


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Know the Facts and Act Fast!

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When a heart attack happens, any delays in treatment can be deadly. 

Knowing the warning symptoms of a heart attack and how to take action can save your life or someone else’s.

The NHLBI has created a new series of informative, easy-to-read heart attack materials to help the public better understand the facts about heart attacks and how to act fast to save a life.

Click the links to download or order the NHLBI's new heart attack materials:

“Don’t Take a Chance With a Heart Attack: Know the Facts and Act Fast” (also available in Spanish)

“Heart Attack: Know the Symptoms. Take Action.”

“Learn What a Heart Attack Feels Like—It Could Save Your Life”

February 01, 2011 Last Updated Icon

The NHLBI updates Health Topics articles on a biennial cycle based on a thorough review of research findings and new literature. The articles also are updated as needed if important new research is published. The date on each Health Topics article reflects when the content was originally posted or last revised.

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