How to Prevent Heart Disease

Four lifestyle changes can reduce your risk of coronary heart disease by 50 percent, even if you have a family history. Here's how to prevent heart disease.

When it comes to dangerous conditions like coronary heart disease, family history can feel like a guarantee of illness. If you have a parent, grandparent, or sibling with heart disease, you might assume that there’s no way for you to avoid it too.

How to prevent heart disease

But that’s not the case, according to a study published in the New England Journal of Medicine. The study, which was one of most comprehensive of its kind ever conducted, examined how genetics and lifestyle interact to put you at risk for heart disease. Following more than 55,000 adult subjects, researchers found that even a moderately healthy lifestyle can decrease your odds of developing coronary heart disease (CHD) by nearly 50 percent, even if you have a family history of the condition.

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Heart disease is the leading cause of death in the United States. According to the Centers for Disease Control and Prevention, approximately 610,000 Americans die from heart disease every year, with coronary heart disease causing over half those deaths. Every year, CHD kills an average of 370,000 people in the United States.

Risk factors for heart disease

It can affect men and women of any age or ethnic background, especially those with a family history. The National Heart, Lung, and Blood Institute cautions that those with a father or brother who suffered from heart disease before age 55, or a mother or sister who developed CHD before age 65, are particularly at risk.

Other risk factors for heart disease include health history, such as having diabetes or insulin resistance, and lifestyle factors, such as eating a poor diet or smoking.

It is these factors that can make the most difference in lowering your risk for developing CHD.

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Researchers from Massachusetts General Hospital looked at data on the health and genome of participants from four previous studies. Each participant was assigned a risk level for coronary heart disease of low, medium, or high based on their genetic profile. They were then evaluated for four lifestyle factors: non-obese body-mass index, physical exercise at least once a week, not currently smoking, and eating a moderately healthy diet. Participants were then given a lifestyle rating of unfavorable (zero or one healthy behaviors), intermediate (two behaviors), or favorable (three or four healthy behaviors).

Across all the data, a high genetic risk increased the likelihood of a coronary incident by as much as 90 percent. But even a moderately healthy lifestyle lowered it by nearly 50 percent.

In three out of the four sample populations, high-risk participants with favorable lifestyle factors lowered their risk of developing coronary heart disease by 46 percent. The fourth study looked at evaluated coronary artery calcification, an early warning sign of heart disease. Among those participants, a favorable lifestyle was associated with nearly 50 percent less calcification in each risk category.

Three of the studies from which researchers drew their data were conducted over several decades, allowing them to look at long-term risk levels. They found that over 10 years, those with a high genetic risk and unfavorable lifestyle had an 11 percent risk of a heart attack. But for those with a high genetic risk and a favorable lifestyle, the risk was only 5 percent.

Reducing your risk is not hard

Researchers concluded that making even a few healthy lifestyle changes can significantly reduce your risk of developing heart disease. The bar isn’t set very high, some of the study’s authors noted: to achieve a favorable lifestyle rating, a participant only had to not smoke, meet half of the American Heart Association’s dietary recommendations, and exercise once per week.

“The basic message of our study is that DNA is not destiny,” said senior author Sekar Kathiresan, MD, in a press release from Massachusetts General. “Many individuals — both physicians and members of the general public — have looked on genetic risk as unavoidable, but... that does not appear to be the case.”

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