Copy reprinted courtesy The New York Times

By Leana S. Wen

Heart disease is the leading cause of death in the United States. The Centers for Disease Control and Prevention estimates that 1 in 5 deaths is attributed to the condition.

With February being American Heart Month, now is a good time to consider steps everyone can take to optimize heart health. Here are five:

1) Manage your underlying medical conditions. High blood pressure, diabetes, high cholesterol and obesity are all major risk factors for heart disease. People with these ailments can reduce their chance of developing heart attacks and strokes by controlling these underlying conditions.

Small changes make a big difference. For instance, a meta-analysis of 48 clinical trials found that every five-point drop in systolic blood pressure can cut the risk of cardiovascular events by 10 percent.

High blood pressure and many other chronic conditions can be managed with lifestyle changes, medications or both. Everyone should visit their primary care physician at least once a year for preventive care. The provider will tailor screening exams based on your age and risk factors. The earlier that chronic conditions are detected, the sooner they can be treated.

2) Reduce substance use. Smoking elevates the risk of heart attacks by increasing plaque buildup, damaging blood vessels and worsening cholesterol. Studies have implicated secondhand smoke as well; nonsmokers with chronic exposure to smoke at home or work have a 25 to 30 percent elevated risk of heart disease.

Excessive alcohol intake is also linked to adverse cardiovascular events. One European study found that people reporting moderate or high alcohol consumption had a whopping 4.5-fold increase in progression to heart failure. Recent research also associated daily marijuana use with a 34 percent increased risk of developing heart failure.

3) Exercise. A large study involving 30 years of medical records from 100,000 adults found that people who followed the CDC’s recommendation for at least 150 weekly minutes (or a little more than 20 minutes a day) of moderate or high-intensity exercise had a 31 percent decrease in cardiovascular mortality.

Those who exercise more than the recommended amount reap even more benefits. But as a 2022 meta-analysis found, even those who worked out for only 75 weekly minutes (just over 11 minutes a day) had a 17 percent lower chance of progressing to heart disease.

People who are already exercising can work to increase length, intensity and variety of their sessions. And those who have yet to get started should know that a little physical activity goes a long way to improve their heart health.

4) Be mindful of food choices. Just about everyone already knows that reducing their intake of salty and fatty products can protect their hearts. But consumers should also be on the lookout for ultra-processed food. These are the opposite of whole foods such as vegetables, meat, fruit, milk, nuts and legumes. Some nutritionists argue that ultra-processed products shouldn’t even be called food since they are industrial formulations laden with flavorings, preservatives and other additives.

A landmark 2021 study in the Journal of the American College of Cardiology demonstrated just how harmful these products can be. Researchers revealed that each daily serving of ultra-processed food increased the risk of cardiovascular death by 9 percent.

In the United States, these substances account for 58 percent of total calorie consumption. It will be very difficult for people to avoid them altogether, but knowing their negative effects can guide better nutritional choices.

5) Aim for at least seven hours of sleep. That sleep is essential to mental health and overall well-being should not be news, but readers might be surprised to learn how closely linked sleep is with heart health.

The research is so compelling that in 2022, the American Heart Association added sleep to its key behaviors that people can adopt to improve cardiovascular health. This change was based on decades of data: Those who slept less than seven hours a night had higher chances of developing diabetes, hypertension and obesity. Studies have also demonstrated links between sleep irregularity and coronary artery abnormalities.

This is another behavior change that is probably easier said than done. Many people working long hours have caregiving and other personal responsibilities that make it difficult to fit in adequate sleep. Shift workers and others who work nighttime hours might not be able to alter their sleep irregularity. But again, knowing the importance of sleep might help people aim for healthy choices.

All of these lifestyle changes would be easier with the help of health-promoting government policies. For example, policymakers could incentivize whole foods over ultra-processed junk and improve neighborhood walkability. Until such reforms are made, individuals should be aware of the small changes they can make in their lives that can add up to long-lasting improvements to their cardiovascular health.