Lifestyle Changes That Keep Your Heart Healthy, A Cardiologist’s Code

You can lower the risk of heart disease by as much as 82 per cent simply by adopting certain lifestyle changes. Read on for more on how to keep your heart healthy.

By D Tejaswi
19 Sep 2022

India has the highest burden of acute coronary syndrome, a condition associated with sudden, reduced blood flow to the heart, notes Medical Journal Armed Forces India, 2020. As per World Health Organisation (WHO), India reported 27 per cent of deaths attributed to cardiovascular disease (CVD) in 2016. Cardiovascular disease, an umbrella term that affects the heart and blood vessels, includes many different conditions such as coronary artery disease, angina, and heart failure.


“Heart disease (or coronary artery disease, a type of cardiovascular disease) occurs when the arteries that supply blood to the heart muscle become hardened and narrowed due to a buildup of plaque on the arteries’ inner walls,” says Dr Vanita Arora, senior consultant, cardiac electrophysiologist and interventional cardiologist at Indraprastha Apollo Hospitals, New Delhi.


“While procedures such as bypass or angioplasty help blood and oxygen flow more easily to the heart, the condition of your blood vessels continues to remain poor unless you alter your lifestyle and control your risk factors,” she adds.


The Right Way To Make Lifestyle Changes

  • Pick one behaviour at a time: Start making changes that are easy to implement. For instance, if you are someone who often has a diet high in saturated fats, and consumes excessive amounts of alcohol (consuming more than 4 drinks on any day), Dr Arora suggests that you should first cut down on alcohol and then skim the cakes, biscuits, and sausages from your diet (these contain saturated fats).


  • Be consistent: Practicing consistency instills discipline and gets you closer to your heart health goals. Remember to take small actions, every day. “While, it can be pretty tough to let go of old habits, choosing a simple action you can do on a daily basis can make it easier. This could mean making sure you get that 30-minute walk or eating your greens,” says Dr Arora.


  • Involve a buddy: “Setting small intentions, working along with your doctor, getting health checks on time, and seeking support from loved ones helps minimise the risk of heart diseases,” says Dr Arora.


Risk Factors For Heart Diseases: Start Here

While certain risk factors for heart disease may not be under your control (ageing, family history, ethnic background) but there are other risk factors that you can minimise with your actions. These would include: cutting smoking and alcohol consumption, staying active and managing stress. Seek professional help to emerge stronger against factors that are not under your direct control. These include controlling diabetes, high blood pressure and high cholesterol. Other factors that also pose a risk for heart health include having high levels of CRP (C-reactive protein) in the blood, exposure to toxic pollution, having obstructive sleep apnea, and the usage of high-dose birth control pills. Studies show that women who use high-dose birth control pills (oral contraceptives) are more likely to have a heart attack or stroke. Here’s how some common risk factors influence your heart health.


Ditch Smoking

Smoking increases the formation of plaque in blood vessels. The chemicals found in cigarettes cause blood to thicken and form clots inside veins and arteries. “There is simply no safe way to smoke. Low-tar and low-nicotine cigarettes do not lessen the risks of heart disease or other smoking-related diseases,” says Dr Arora.


Manage High Blood Pressure

Also known as hypertension, high blood pressure is an important risk factor for stroke. Hypertension forces the heart to work harder to pump blood to the rest of the body. This causes the left ventricle to thicken.


Reduce High Blood Cholesterol

Your body already makes all the cholesterol it needs but over time extra cholesterol and fat circulating in the blood causes buildup in arteries, called plaque, making arteries narrower.


Now that you know about the risk factors for heart disease, here are some health checks you should be taking with the help of a doctor.


Health Checks for A Healthy Heart: When To Schedule A Heart Health Test

“The most important thing you can do to care for your heart health is to get your health checks done, at the right time. Taking the screenings at the right time helps your doctor to identify potential problems early so you can get the treatment you need,” says Dr Arora. Here are the tests you should take:


1. Lipoprotein Profile

A blood test that counts the levels of triglycerides, LDL "bad" cholesterol, and HDL "good" cholesterol (another form of fat in the blood).


Preparation: A 9–12 hour fast is required before the test.

Why: To determine whether you possess any of the following: high levels of triglycerides, low levels of HDL cholesterol, and high levels of total and LDL cholesterol in the blood.

When: Should be performed at least once every five years. Your doctor could decide to repeat the test more regularly depending on the findings.


2. Blood Pressure

A simple, painless test that involves inflating the cuff with a small hand pump.


Why: Determines whether you have prehypertension or high blood pressure, known as hypertension. Both are risk factors for heart disease.

When: At least every 2 years, or more often if you have high blood pressure or prehypertension.


3. Fasting Plasma Glucose

It is recommended to use this test to diagnose diabetes.


Preparation: After you have fasted overnight, you are given a blood test the following morning.

Why: To determine whether you already have diabetes or are at risk for developing it. You have diabetes if your fasting plasma glucose levels in two tests on different days are 126 mg/dL or greater. You may have prediabetes if your levels are between 100 and 125 mg/dL, which increases your risk of developing diabetes. Diabetes significantly increases the risk of heart disease and other illnesses.

When: Starting at age 45 and should be repeated once in at least every three years. You should get this test more frequently done if you are diagnosed with higher risk of diabetes.


Related Story: 7 Ways To Control High Blood Sugar In The Morning


4. Body Mass Index (BMI) and Waist Circumference

BMI is a measure of your weight in relation to your height. Waist circumference is a measure of the fat around your middle.


Why: To find out if your body type raises your risk of heart disease. You are considered overweight if your BMI is 25 or greater. Obesity is defined as having a BMI of 30 or greater. Obesity and being overweight are both risk factors for heart disease. Women who have waists larger than 35 inches are more likely to get heart disease and other serious illnesses. Men are more at risk when their waists are larger than 40 inches.

When: Every 2 years, or more often if your doctor recommends it. There are also several tests that can determine whether you already have heart disease. Ask your doctor whether you need a stress test, an electrocardiogram (ECG or EKG), or another diagnostic test.


4 Lifestyle Changes For A Healthier Heart

“You can keep your heart healthy if you eat a nutritious diet, engage in regular exercise, maintain a healthy weight, and give up smoking. However, following just one or two of these big four habits isn’t enough to protect your heart. It is essential to adopt and follow all four lifestyle habits in order to maintain a healthy heart,” says Dr Arora.


Here are some easy, exclusive tips shared by Dr Arora to help lower the risk of heart disease.


1. Go DASH

DASH diet helps you lower your blood pressure. DASH stands for “Dietary Approaches to Stop Hypertension.” The DASH eating plan emphasises fruits, vegetables, whole-grain foods, and low-fat or fat-free milk and milk products. It is rich in magnesium, potassium, and calcium, as well as protein and fibre. It is low in saturated and total fat and cholesterol and limits red meat, sweets, and beverages with added sugars. If you follow the DASH eating plan, you are likely to reduce your blood pressure, says Nutrients, 2019. Here are other guidelines for a healthy heart.


  • Choose a variety of grains every day; at least half of them should be whole grains.
  • Every day, select a range of fruits and vegetables.
  • Opt for a diet that is low in cholesterol, trans fats, and saturated fat.
  • Opt for foods and drinks with little added sugar.
  • Maintain a balance between the calories you consume and those you burn off through exercise.


Related Story: What To Eat For A Healthy Heart


2. Limit Your Salt Intake

Too much sodium causes fluid retention which may increase blood pressure, a risk factor for heart disease. You can prevent and control high blood pressure by cutting down on salt and other forms of sodium. The key is to consume no more than 5 grams of salt per person per day, recommends WHO.


“Though there's an increased push for lower sodium intakes, reducing sodium too much — below 3 grams per day — may as well negatively impact heart health. Low levels of sodium cause a dip in blood pressure and result in elevated cholesterol levels, which increases the risk of heart diseases,” says Dr Arora. According to a study done on 833 heart failure patients, eating less sodium—less than 2,500 mg per day—was associated with a considerably higher risk of mortality or hospitalisation, compared to a non-restricted-sodium diet, notes JACC: Heart Failure, 2016.


“The takeaway is to avoid high-sodium, unhealthy foods like fast foods but not lower the salt intake to less than the recommended, 5 grams a day per person,” says the doctor.


Related Story: Is Salt Really Bad For You?


3. Keep Moving

Being physically active is a key component of having a healthy heart. “It's one of your best weapons for protecting your arteries from damage caused by excessive cholesterol, high blood sugar, and high blood pressure that can cause a heart attack or stroke,” explains Dr Arora.


You need a combination of different types of exercises to upkeep your heart healthy. Mainly, you should practice a combination of resistance and aerobic training to help burn calories, trim extra fat from your waist, tone your muscles and increase your fitness levels, finds Plos One, 2019.


“Even if you are new to exercise, you can start with a 20-minute walk and gradually build up to at least 40 minutes of moderate-intensity physical activity,” says Dr Arora. Exercise improves the muscles' ability to pull oxygen out of the blood, reducing the need for the heart to pump more blood to the muscles, confirms Frontiers in Cardiovascular Medicine, 2019. Here are some other activities, and everyday opportunities to move around.


  • Take the stairs instead of the elevator, both up and down.
  • Park a few blocks away and then continue on foot.
  • If you're using public transit, get off a few stops early and go on foot for a few blocks.
  • Take a quick walk around the neighbourhood.
  • Lift weights, practice some easy yoga poses, or ride a stationary bike.


Related Story: Finding Joy Through Exercise


4. Work On Your Smoking Habits

Research shows that even if you smoke, the good news is that just one year after you stop smoking, your heart disease risk will drop by more than half. In a population-based case-control study with 1282 cases, it is determined that the chances of myocardial infarction or coronary death decrease rapidly for ex-smokers in a year and after around 3 years, they are no different from those who had never smoked, notes the Journal of Clinical Epidemiology.


Related Story: How To Cut Back And Quit Smoking


“As you prepare to quit smoking, consider enrolling yourself in a support group. Support groups offer many practical tips to control tobacco habits,” says Dr Arora. There are medicines and supplements which help reduce the urge to smoke. These include nicotine gums (available over the counter), the nicotine patch (available over the counter and by prescription), a nicotine inhaler (by prescription only), and a nicotine nasal spray (by prescription only). “While each of these drugs can aid in quitting smoking, these are not safe for everyone. Do consult a doctor before self-medicating,” adds Dr Arora.


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