Lifestyle choices now can have an impact on your future heart health

If you’re in your 40s or 50s, heart disease may seem like something you only need to worry about down the road. After all, the average age of a person having a heart attack for the first time is 65 for men and 72 for women, according to the American Heart Association.1 But heart disease can happen at any age – high blood pressure, diabetes, high cholesterol and obesity are putting younger people (age 35 to 64) at risk.2 “It’s really important to focus on your heart especially once you hit your 40s,” says Nieca Goldberg, M.D., medical director of Atria Health in New York City and a clinical associate professor of medicine at NYU Grossman School of Medicine. 

For women, paying attention to your heart health is especially critical as you approach menopause. “Menopause itself doesn’t cause cardiovascular disease. But certain risk factors do increase around the time of menopause, like weight gain, sleep problems and possibly even elevated cholesterol levels,” Dr. Goldberg says. Men may also see their risk of heart disease rise in middle age, thanks to weight gain, poor diet and being more sedentary, she adds. And in men, in addition to the traditional symptoms of heart disease, subtle signs like erectile dysfunction, which has been linked to an increased risk of heart disease, may also occur.3

The good news is that there is plenty you can do in your 40s and 50s to reduce heart disease risk, she says. Here are some of Dr. Goldberg’s top tips:

1. Stay active

The American Heart Association recommends 150 minutes of moderate aerobic activity a week (for example, walking for 30 minutes five days a week), along with weight training at least twice a week.4 Remember to check with your doctor before starting any exercise regimen.

But don’t feel defeated if you can’t meet the guidelines – what’s important is to simply move more. “I encourage people to think creatively about how they can get more activity in their daily life, especially if they have trouble fitting in exercise at the gym. For example, if you have an errand that is only a mile or two away, can you walk instead of drive?” says Dr. Goldberg. “The more active you are, the bigger benefits you’ll get.”

2. Eat a balanced diet

A Mediterranean-style diet – one that’s rich in fruits, vegetables, legumes, nuts, oily fish like salmon and sardines, and healthy fats such as olive oil – has been shown to consistently reduce the risk of heart disease, notes Dr. Goldberg.

3. Get enough rest

When you burned the midnight oil in your 20s and 30s, your body may have been forgiving. But as you get older, it’s important to get your rest. A 2022 study by the American Heart Association found that people who slept between 7 and 9 hours a night were least likely to develop cardiovascular disease.5

“Sleep difficulties are associated with weight gain, higher blood pressure and an irregular heartbeat,” explains Dr. Goldberg. If you have trouble nodding off, try these basic sleep hygiene tips:

  • Go to bed and wake up at consistent times 
  • Limit caffeine after noon if you’re sensitive to its effects
  • Get regular exercise
  • Avoid screen time an hour or two before bed

If those tips don’t help, talk to your doctor, who may refer you to a sleep specialist.

4. Manage stress

Chronic stress can raise the risk of heart disease. Elevated levels of stress hormones such as cortisol can raise blood pressure and possibly even cholesterol, says Dr. Goldberg. Those effects can be worse if you already have underlying heart disease. A study published in 2021 in the Journal of the American Medical Association found that patients with coronary heart disease who experienced high levels of mental stress were more than twice as likely to experience a cardiovascular event (such as a heart attack) over a 5-year period, compared with those who didn’t experience as much stress.6 

One good option is to try a mindfulness app, advises Dr. Goldberg. Research suggests that mindfulness may also lower blood pressure.7

5. Avoid smoking and drinking

Both can be toxic to your heart, says Dr. Goldberg. Smoking is linked to about one-third of all deaths from heart disease, according to the American Heart Association. The good news is that within one year of quitting, the risk of heart disease goes down by half.8

While light drinking has been linked to lower heart disease risk, that could be because those people have a healthier lifestyle overall, notes Dr. Goldberg. A study published in 2022 in JAMA Network Open found that people with moderate alcohol consumption (1 to 2 drinks a day) had a 30% higher risk of developing high blood pressure and a 40% higher risk of developing heart disease compared with those who drank less than that.9.   The study also noted that while there are differences based on consumption amount, alcohol consumption at all levels was associated with increased risk of cardiovascular diseases.

6. Know your heart-disease and stroke risk

Knowing your risk level is key to protecting your heart and staying healthy. If you’re between the ages of 30 to 79, use the American Heart Association’s PREVENT™ online calculator to estimate your risk of having a heart attack or stroke over the next decade. 

“Much of the time, risk factors can be improved with lifestyle changes, but sometimes cholesterol or blood pressure medications are needed,” says Dr. Goldberg. Once you know your risk, you can work with your doctor to figure out the best treatment plan for you.  

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