Reducing Risks When You Have Heart Disease

People with heart disease are at increased risk for suffering a heart attack or sudden cardiac death. But there is evidence that risk factor modification can help people with coronary artery disease (CAD). Taking steps like lowering your blood pressure and cholesterol can improve survival and quality of life if you have heart disease. Here are some therapies to help protect your heart.


The American Heart Association and American College of Cardiology jointly released guidelines on secondary prevention for people with cardiovascular disease. Their recommendations reflect data gleaned from large scale clinical trials that have identified which preventive therapies work best. Check to see which advice you are already using correctly, and which you may want to discuss with your doctor.




There are many options to help you quit smoking. Strategies that may work for you include:

  • Counseling
  • A nicotine patch, gum, spray, or inhaler
  • A formal smoking cessation program
  • Drug therapy, such as varenicline or antidepressants, such as bupropion

A combination of therapies is generally more effective in helping people quit.

Blood Pressure


  • Aim for a blood pressure less than 140/90.
  • If you have chronic kidney disease or diabetes, keep blood pressure less than 130/80.


Remember that high blood pressure does not have symptoms, so you will not know you have it or if it changes. Consider buying a reliable home monitoring device so you can check your blood pressure on a regular basis.



You should have a blood test called a fasting lipid profile. Desirable ranges of lipid levels are:

  • LDL (bad) cholesterol less than 100 milligrams per deciliter (mg/dL).
  • Non-HDL cholesterol (combination of bad cholesterol) less than 130 mg/dL if triglycerides are greater than 200 mg/dL.

Your doctor will evaluate your lipid levels and help you determine what is desirable for you.


  • Follow a low-fat diet.
  • Reduce intake of saturated fat, trans fat, and cholesterol.
  • Increase consumption of omega-3 fatty acids, found in fatty fish, like salmon. You may also want to talk to your doctor about taking omega-3 supplements.
  • If you are overweight, lose weight. Aim to maintain a healthy weight.
  • Exercise regularly—Check with your doctor for guidelines on starting an exercise program.
  • Talk with your doctor about whether you need to take cholesterol-lowering medication.

Physical Inactivity


Physical activity includes both aerobics and weight training:


  • Your doctor should approve the type and amount of exercise you do.
  • Try to perform at least 30 minutes of moderate intensity activity, such as brisk walking, on most days of the week
  • Incorporate more physical activity by increasing daily activities, like walking, cycling, gardening, or household work.
  • Include 2 days per week of strength training.



Have a waist measurement and body mass index (BMI) calculation.

  • The desirable BMI range is 18.5-24.9 kg/m².
  • Desirable waist measurements are no more than 40 inches (102 centimeters) for men, and no more than 35 inches (89 centimeters) for women.


If your weight is not in the target range, start weight management and medically supervised physical activity programs.



If you have diabetes:

  • Have your HbA1c tested regularly. The HbA1c test provides information about your diabetes management over the past few months.
  • Aim for HbA1c below 7%.


  • If blood sugar is too high, intensify therapy to control blood sugar.
  • Address other risks, such as weight, activity level, blood pressure, and cholesterol.

Drug Therapy


Ask your doctor to evaluate your need for preventive drugs.


  • Aspirin is recommended for most people with CAD. If you cannot take aspirin, your doctor may recommend another type of blood thinner.
  • If you are at high risk or have had a heart attack, your doctor may recommend other medications, such as ACE inhibitors, beta-blockers, and cholesterol-lowering medication.

Other Recommendations


It is important that you take steps to stay healthy, like getting a yearly flu shot.

You should also talk to your doctor about your mental health, which can impact your overall health. Tell your doctor if are feeling depressed or anxious or if you are having problems sleeping.


American Heart Association
National Heart, Lung, and Blood Institute


Canadian Cardiovascular Society
Heart & Stroke Foundation of Canada


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Smith S, Allen J, Blair S, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic cardiovascular disease: 2006 update. J Am Coll Cardiol. 2006;47(10):2130-2139.
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Last reviewed November 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 1/31/2014

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