I’m a doctor — here’s how to lower your risk for top cause of death

We hope you’ll take this news to heart.

Despite what headlines might have you believe, the leading cause of death isn’t cancer or injury or even diabetes — it’s heart disease. In the US alone, one person dies of cardiovascular disease every 33 seconds, according to the Centers for Disease Control and Prevention. That amounted to 695,000 deaths in 2021.

Heart disease is an umbrella term that includes a number of serious conditions, such as heart attacks, stroke and even high blood pressure, according to the National Institutes of Health.

And chances are, you’ve already heard about the things you should do to reduce your risks. Think: watching what you eat, increasing physical activity and managing your stress. But putting these steps into practice is easier said than done — especially when life gets busy, and in some cases the risk of heart disease can creep up over time.

That’s why we spoke with Dr. Kinjan Parikh, a cardiologist at NYU Langone Heart, to get her best life hacks for maintaining a healthy heart, how to spot risk factors, methods for prevention and when to seek care.

What are the biggest risk factors for heart disease? 

Everybody can have risk factors. Some we can control, and others we can’t control. Family history, age, gender and ethnicity are uncontrollable and can influence heart disease risk. The primary controllable risk factors include cholesterol levels, blood pressure and, for those with diabetes, blood sugar levels.

How do genetics affect heart health and risk factors for heart disease? 

Heart disease is greatly shaped by genetics. And while you cannot escape the genes you inherit, you can choose how you live — what you eat, whether you exercise, when you see a doctor — and those lifestyle choices can be life-changing. Some people have higher blood pressure or higher cholesterol because of their genetics, so of course, optimizing certain lifestyles often can help get you to a goal and prevent severe cardiac events from happening.

Can you take any steps to lower your risks?

The foundation of heart disease prevention is a healthy lifestyle, including diet and exercise. The Mediterranean diet — rich in fruits, vegetables and healthy fats — is highly recommended. Reducing sodium intake, particularly for blood pressure control, and minimizing sugar and processed foods are additional important dietary steps. Regular exercise, ideally 30 to 45 minutes of moderate intensity three to four times a week, is also essential. If lifestyle changes aren’t sufficient, medication like blood pressure drugs or statins may be necessary to achieve optimal levels.

What is the link between cholesterol and heart disease? Can good cholesterol (HDL) offset the effects of bad cholesterol (LDL)? 

There is a close relationship between cardiovascular disease and cholesterol levels. A lipid test — which shows the levels of the “bad” cholesterol called LDL, the “good” cholesterol called HDL and triglycerides in your blood — assesses your risk for developing heart disease. High LDL levels can lead to plaque buildup, causing blockages that increase the risk of heart attacks and strokes. When we measure cholesterol levels in your blood, what we see is a combination of what your body makes and what you eat. While high levels of HDL can help reduce risk by aiding the removal of LDL from the arteries, it does not completely negate the risks associated with high LDL levels. Both levels should be managed to maintain heart health.

What’s a sign that something might be wrong with your heart?

Classic symptoms include chest pain or pressure, which might also manifest as gastric discomfort. A notable sign is the inability to perform regular physical activities due to shortness of breath or chest pain. Regular exercise can serve as an early warning system for potential heart issues if symptoms change. There’s a common misconception that heart disease primarily affects older men, but it can occur in anyone, regardless of age or gender. Women may be more likely to experience atypical symptoms such as abdominal pain, nausea and/or sweating.

What should you ask your doctor about heart disease risk?

Heart health should be assessed at every annual checkup. This includes checking blood pressure, cholesterol levels, blood sugar levels and possibly EKG. Individuals with increased risk factors might benefit from regular visits to a cardiologist for more specialized care. In summary, you should know your key health numbers: blood pressure, cholesterol levels or blood sugar levels for diabetes management. Understanding these numbers, their targets and how to achieve them through lifestyle changes or medication is essential for proactive management of heart health to significantly reduce the risk of heart disease.

Kinjan Parikh, MD, is a cardiologist at NYU Langone Heart and clinical instructor in the Department of Medicine, the Leon H. Charney Division of Cardiology at NYU Grossman School of Medicine. Her practice ranges from identifying cardiac risk factors to treating advanced heart disease. NYU Langone is among the top 5 hospitals in the country for cardiology and heart surgery, according to U.S. News & World Report’s “Best Hospitals.” Make an appointment with one of our cardiologists or cardiac surgeons.