• Cardiovascular Disease

    Reducing Your Risk

    Reducing the risk of cardiovascular disease takes 2 approaches—lifestyle modification and medications. Both are commonly used simultaneously.

    Lifestyle Modification

    Changing health behaviors is by far, the most challenging way to reduce risk, but it is also the most effective and long-lasting. The more modifications you can make, the more you may be able to reduce your risk of cardiovascular and other diseases.

    Quit Smoking

    Smoking is the biggest contributor to disease and early death in the United States. Talk to your doctor about how to successfully quit. When you quit smoking, the benefits to the heart and blood vessels are immediate. The longer you quit, the more your body can heal and the more you reduce your risk of complications.
    You can also reduce your risk by avoiding secondhand smoke.

    Eating a Healthful Diet

    Eating healthfully can contribute to lower cholesterol and blood pressure levels. It can also reduce the risk of type 2 diabetes by helping to maintain an appropriate weight. To follow a heart-healthy diet, you should:
    • Limit your intake of total fat, saturated fat, trans fats, and cholesterol.
    • Eat 5 or more servings of a variety of fruits and vegetables per day.
    heart-healthy diet
    • Choose 6 or more servings per day of a variety of grain products, especially whole grains.
    • Reduce your intake of refined carbohydrates.
    • Limit intake of foods that are high in calories, but low in nutrition.
    • Eat 6 grams or less of salt per day.

    Exercise Regularly

    Regular exercise can help you lose weight, lower cholesterol and blood pressure levels, and reduce your risk of diabetes. It reduces stress and helps with overall well-being. Try to get at least 30 minutes of exercise per day on most days of the week. This includes aerobic exercise and strength training.
    Talk to your doctor before engaging in physical activity.

    Drink Alcohol in Moderation

    Light to moderate alcohol intake has been shown to reduce the risk of heart disease. However, there is not enough evidence to suggest that nondrinkers start drinking in order to protect the heart. Heavy drinking actually increases your risk of high blood pressure and heart disease. Moderation is a no more than 2 drinks per day for men and no more than 1 drink per day for women.

    Maintain a Healthy Weight

    Maintaining a healthy weight can help you decrease your risk of developing diabetes and high blood pressure. First, use the body mass index (BMI) to get a sense of your target weight, keeping in mind the BMI is an imperfect gauge. To lose weight, you need to burn more calories than you take in. Maintaining your weight requires a balance between calorie consumption and expenditure. While dieting alone will help you lose weight in the short run, it is difficult to keep the weight off without a combination of diet and regular exercise.


    While medications are convenient to take, they can cause adverse effects and tend to compensate for, rather than solve, the underlying problem. For these reasons, medications are usually prescribed only when lifestyle modifications have proved ineffective by themselves. If you have a chronic disorder, it is important to follow your treatment plan, including taking medications as prescribed. If you have side effects, talk to your doctor.


    A doctor will prescribe an antihypertensive to reduce high blood pressure and to lower overall cardiovascular disease risk. Antihypertensives work in several ways. They rid the body of excess fluids, slow down the pace of the heart, dilate blood vessels, or block the effects of chemicals that cause them to constrict. You may have to go through a trial period with different medications to find out which work best for you. Some are used in combination. Examples include:
    • Alpha 1-selective adrenoceptor blockers
    • Angiotensin-converting enzyme (ACE) inhibitors
    • Angiotensin receptor blockers
    • Beta blockers
    • Calcium-channel blockers
    • Centrally acting sympathoplegic drugs
    • Diuretics
    • Ganglion-blocking agents
    • Postganglionic sympathetic nerve terminal blockers
    • Vasodilators


    Antiplatelets interfere with the formation of blood clots that can lead to heart attack, stroke, or gangrene.
    Low-dose aspirin is most commonly prescribed antiplatelet agent used to reduce the risk of cardiovascular disease. Other more expensive drugs, like clopidogrel, are often used in people who already have cardiovascular disease.

    Cholesterol-lowering Agents

    Based on your overall cardiovascular risk and your success with dietary changes, your doctor may recommend drugs to lower cholesterol. Some drugs are better than others at lowering high low-density lipoprotein (LDL) or total cholesterol, raising low levels of high-density lipoprotein (HDL) cholesterol, or lowering triglyceride levels. Examples include:
    • Statins
    • Bile-acid sequestrants
    • Fibrates
    • Nicotinic acid drugs
    • Drugs that reduce cholesterol absorption

    Glucose Control

    Many people with diabetes can control their blood glucose levels through a combination of healthy eating, exercise, and weight loss. If these lifestyle changes don’t work, diabetes medications may be in order. Depending on the agent, anti-diabetic medications may work by stimulating your pancreas to make more insulin, reducing the amount of glucose made by your liver, slowing the absorption of dietary carbohydrates (a major source of blood glucose), or increasing the sensitivity of cells to insulin. Examples include:
    • Sulfonylureas
    • Biguanides
    • Alpha-glucosidase inhibitor
    • Thiazolidinediones
    • Meglitinide
    • Dipeptidyl peptidase-4 inhibitors
    • If your pancreas no longer makes insulin at all, you will need insulin injections


    Cardiovascular disease prevention overview. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T116873/Cardiovascular-disease-prevention-overview. Updated September 5, 2016. Accessed October 27, 2016.

    DASH diet. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 3, 2013. Accessed September 22, 2015.

    Diabetes mellitus type 2 prevention. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T170319/DASH-diet. Updated April 29, 2016. Accessed October 27, 2016.

    Overview of atherosclerosis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/cardiovascular-disorders/arteriosclerosis/atherosclerosis. Updated September 2012. Accessed October 27, 2016.

    Overview of hypertension. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/cardiovascular-disorders/hypertension/overview-of-hypertension. Updated July 2016. Accessed October 27, 2016.

    Types of blood pressure medications. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Types-of-Blood-Pressure-Medications%5FUCM%5F303247%5FArticle.jsp. Updated August 26, 2016. Accessed October 27, 2016.

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