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Preventing and Reversing Cardiovascular Disease
Important Information You Should Know

Three dimensional illustration of the human heart and chest.

Facts About Cardiovascular Disease

Cardiovascular disease includes a number of health problems that affect the heart and how well it works. These include coronary artery disease (CAD) and vascular (blood vessel) disease. Cardiovascular disease is, by far, the leading cause of death in the United States.

Coronary artery disease is the narrowing of the arteries that supply blood to the heart. Each year, CAD causes about one million heart attacks. And, 220,000 people who have a heart attack will die before they get to the hospital.

Making even small lifestyle changes can reduce your risk of CAD, heart attack, stroke and other serious cardiovascular conditions.

What Are Risk Factors?

Risk factors are certain conditions that increase your chance of having cardiovascular disease. Nonmodifiable risk factors are risk factors that you cannot change. You can change, control, or be treated for modifiable risk factors.

The more risk factors you have, the greater your chance of having cardiovascular disease. And, the higher the level of each risk factor, such as cholesterol levels, the bigger your risk is.

Nonmodifiable Risk Factors

Getting older. Your risk of cardiovascular disease grows as you get older. About 85 percent of people who die of coronary artery disease are age 65 or older.

Being a man. Men have a greater risk of heart attack than women.

Menopause. A woman's risk of cardiovascular disease is higher after menopause.

Family history. Your chance of having cardiovascular disease is higher if your parents, brothers, sisters or children have the disease. This is especially true if the men were younger than 55 or the women were younger than 65 when they were diagnosed.

Race. The risk of cardiovascular disease is higher among African Americans, Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is partly due to higher rates of high blood pressure, obesity and diabetes in these populations.

Since you can't change any of these risk factors, it is important to focus on the risk factors you CAN change.

Risk Factor Goals

You can set health improvement goals to reduce your risk of cardiovascular disease or keep it from getting worse. Let your family and friends know about your goals so they can offer support and encouragement. You may also find it helpful to talk to your doctor or join a support group.

No smoking sign.

Stop Using Tobacco And Nicotine

Tobacco use is the most preventable risk factor for cardiovascular disease and stroke. Smokers (including cigarette, pipe and cigar smokers) are more than twice as likely than nonsmokers to have a heart attack. Smoking is also the biggest risk factor for sudden cardiac death. Even one or two cigarettes a day greatly increases your risk of a heart attack, stroke and other cardiovascular conditions. Secondhand smoke also increases your risk of cardiovascular disease.

The American Heart Association also warns that vaping systems and e-cigarettes that contain nicotine may contain low levels of toxic chemicals. These devices are not FDA-approved as ways to stop smoking. If you use them, set a date to quit.


✔ Stop using all types of tobacco and nicotine products. If you don't smoke, stay away from others' smoke.

Illustration of BAD LDL Cholesterol.

Lower Your Total Cholesterol, LDL (Bad) Cholesterol and Triglyceride Levels

High levels of lipids (fatty substances, including cholesterol and triglycerides), especially in the form of LDL cholesterol, cause the build-up of fatty deposits in your arteries. This reduces or blocks the flow of blood and oxygen to your heart. Your risk of cardiovascular disease goes up sharply if your total cholesterol levels are 240 mg/di and above.


✔ Total cholesterol less than 200 mg/di.

✔ Your LDL cholesterol should be less than 70 mg/di if you have heart or blood vessel disease. Your LDL level should be less than 100 mg/di if you have a high risk of cardiovascular disease due to diabetes, multiple heart disease risk factors or other medical conditions. Otherwise, your LDL level should be less than 130 mg/di.

Triglycerides less than 150 mg/di.

Illustration of GOOD HDL Cholesterol.

➜ Raise Your HDL (Good) Cholesterol


✔ HDL cholesterol takes the LDL (bad) cholesterol away from the arteries and back to the liver where it can be passed out of the body. High levels of HDL seem to protect against cardiovascular disease. The higher your HDL level, the better. The goal for men is higher than 40 mg/di; for women, above 50 mg/di. A level below 40 mg/di is considered low.

Most patients should have their cholesterol level checked as early as age 20. A cholesterol profile measures your levels of fasting total cholesterol, HDL, LDL and triglycerides. Ask your healthcare provider how often you should have your cholesterol tested.

Photo of Blood Pressure reading.

Lower High Blood Pressure

Blood pressure is a measurement of the pressure, or force, inside the arteries with each heartbeat. High blood pressure causes your heart and kidneys to work harder. This increases your risk of heart attack, heart failure, stroke and kidney disease . High blood pressure is the biggest risk factor for stroke.


✔ The ideal blood pressure for most patients is less than 120/80. If your blood pressure is higher than 130/80, ask your doctor if you need to start or change your treatment to control your blood pressure. Be sure to ask what your ideal blood pressure should be.

✔ Control blood pressure through diet (low salt / DASH diet), exercise, weight management, and medication, if needed. Limit the amount of alcohol you drink; too much can cause high blood pressure.

An insulin reader measure the level of glucose in the blood.

Control Diabetes

Diabetes occurs when the body can't make insulin or use the insulin it has. This causes high blood sugar levels. People with diabetes (especially women) have a greater risk of cardiovascular disease because diabetes increases other risk factors, such as high cholesterol, LDL and triglyceride levels; lower HDL levels; and high blood pressure. Keeping diabetes under control is essential to reduce your risk of heart disease.


✔ Hemoglobin A1c less than 6.5 if you have diabetes; less than 5.7 if you do not have diabetes. See your doctor on a regular basis. A level between 5.7 and 6.4 is considered to be pre-diabetic or insulin resistant.

A body weight scale.

Maintain A Healthy Body Weight

The more you weigh, the harder your heart has to work to give your body nutrients. Research shows that being overweight can lead to diabetes and cardiovascular disease. If you are overweight or obese, you are more likely to have high levels of blood cholesterol and triglycerides, high blood pressure, diabetes, and low HDL levels.

How your weight is distributed also is important. If you carry your weight in the middle, your risk of cardiovascular disease is higher than people who carry their weight in their arms and legs. Waist measurements are one way to know how fat is distributed. For men, waist circumference should be less than 40 inches. For women, waist circumference should be less than 35 inches.

Your Body Mass Index (BMI) is a number calculated from your height and weight. Doctors often use BMI as a way to tell if a person is overweight, underweight or at a healthy weight.

To calculate your BMI, divide your weight (in kilograms) by your height (in meters squared). Metric conversions are: pounds divided by 2.2 = kg; inches multiplied by 0.0254 = meters.

For example, a woman who weighs 140 pounds and is 5 feet, 6 inches tall has a BMI of 23.

140 lbs divided by 2.2 = 64 kg
5'6" = 66" X 0.0254 = 1.68
1.682 = 2.82
64 divided by 2.82 = 22.69

Your healthcare provider can help you calculate your BMI.

A normal BMI between 18.5 - 24.9 kg/m2. Overweight is defined as having a BMI higher than 25. A BMI higher than 30 is considered obese.


✔ A normal BMI between 18.5 - 24.9 kg/m2.

✔ Men's waist measurement less than 40 inches; less than 35 inches for women.

✔ Achieve and maintain a healthy weight. A diet and exercise program will help you reach your goal weight.

A girl breaks from exercising.

➜ Exercise

The heart is a muscle and needs a workout to stay strong and healthy. Exercise makes it easier for the heart to pump blood through your body. Activity and exercise also help lower blood pressure and bad cholesterol levels, improve blood sugar levels, reduce stress, control your weight, and help you quit smoking.


✔ Moderate exercise 30 minutes a day, most days. More vigorous activities offer more benefits. Exercise should be aerobic, which means it uses the large muscle groups. Aerobic activities include brisk walking, cycling, swimming, jumping rope and jogging. If you walk for exercise, aim for 10,000 steps a day (measured with a pedometer). Talk to your doctor before you start any exercise program.

A heart healthy meal.

➜ Follow A Heart-Healthy Diet

The old saying , "You are what you eat," maybe truer than ever, especially when it comes to cardiovascular disease. Four risk factors are related to diet: High blood pressure, high blood cholesterol, diabetes and obesity.


✔ Eat a Mediterranean diet. Choose plenty of whole or plant-based foods, including fruits, vegetables, whole grains and nuts. Choose monosaturated fats from olive oil, olives, nuts and avocados. Omega-3 fats are also heart-healthy. They are found in tuna, salmon, flaxseed and walnuts. Avoid foods that are high in sodium, saturated fat and cholesterol.

Other Risk Factors

Stress: Although stress is not considered a traditional risk factor, some studies show that high levels of stress/poor stress management can lead to cardiovascular disease. If you have other risk factors for cardiovascular disease, stress can make things worse.

Manage stress by practicing relaxation techniques, time management and setting realistic goals. You can also manage stress with massage, Tai Chi, guided imagery, meditation and yoga.

Drinking too much alcohol: Drinking too much alcohol can cause high blood pressure, heart failure and stroke. It is also linked to high triglyceride levels, irregular heartbeats, obesity and cancer. Research shows that having one drink per day (4 oz. of wine, 12 oz. of beer, or 1-1/2 oz. of 80-proof spirits) can reduce your risk of heart disease. But, the American Heart Association does not recommend that non-drinkers start using alcohol or that drinkers increase the amount they drink.

Know Your Risk Factors

If you have a family history of cardiovascular disease or high cholesterol, it is even more important to decrease your other risk factors. Have your cholesterol levels tested every year. Know your numbers, including blood pressure, BMI, waist circumference and hemoglobin A1c. Make sure you follow-up with your healthcare provider every year for a checkup.

*This information is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.

© Copyright 1995-2021 The Cleveland Clinic Foundation. All rights reserved.

Healthy Community Initiative (HCI):

The Healthy Community Initiative is a collaborative effort between Cleveland Clinic and community partners to promote optimal health and wellness. Based on the community health needs assessment and utilizing combined resources within our local communities, Healthy Community Initiative programs will be customized around three core areas: education, nutrition and physical activity.

Live Long Lyndhurst Health and Wellness Initiative (HWI):

Live Long Lyndhurst is a Health and Wellness Initiative between the City of Lyndhurst, Cleveland Clinic Community Outreach, Legacy Village, Cleveland Metroparks at Acacia, The Fedeli Group, the YMCA, South Euclid - Lyndhurst Schools, Second Sole and Anthem BlueCross BlueShield.


➤ Hillcrest Family YMCA

➤ Legacy Village

➤ Live Long Lyndhurst

➤ South Euclid - Lyndhurst Schools

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