Your Mightiest Muscle

When your doctor is worried about your cholesterol levels, there is a reason: People with high total cholesterol levels have nearly twice the risk of heart disease as those with optimal levels, according to the Centers for Disease Control and Prevention (CDC).

Cholesterol is a fat-like substance that our bodies create and use naturally. But we also take in cholesterol through food that’s animal-based, and it can build up inside your artery walls. Eventually, this buildup can cause atherosclerosis, which occurs when substances accumulate along the artery walls and form plaque.

As the arteries narrow and stiffen from the buildup, the flow of blood slows or even stops, which is what happens during a heart attack. (If this occurs in arteries to the brain, it causes a stroke.) A simple blood test can tell you whether you have dangerous cholesterol levels.

Nearly one-third of American adults have high blood pressure (also called hypertension), a major risk factor for both heart attacks and strokes. Blood pressure is the force with which blood pushes against the walls of the arteries.

While your blood pressure might change throughout the day—for example, it will increase temporarily when you exercise or when you’re feeling especially stressed—the concern is when blood pressure is consistently high. That’s because constantly elevated blood pressure causes the heart to work harder to pump blood to the rest of the body.

High blood pressure also fuels inflammation and the process of atherosclerosis. Common risk factors for high blood pressure include family history, being overweight, not getting enough exercise, smoking, stress, drinking too much alcohol and consuming too much salt. You should have your blood pressure tested as part of regular checkups. If you’re at risk, you also may want to purchase a blood pressure monitor so you can check your levels at home.

Diabetes can have a profound effect on the heart. In fact, people with diabetes are two to four times more likely to develop cardiovascular disease than those who don’t have diabetes. Blood sugar affects the lining of the arteries and leads to much more buildup of plaque and accelerates atherosclerosis, especially in women.

The resulting diminished blood flow leads to some of the serious complications of diabetes, such as nerve damage. Risk factors for type 2 diabetes (the preventable kind) include being overweight, not getting enough exercise, and having low HDL (good) cholesterol and high blood pressure levels.

We’ve covered the major risks. Now, here comes the good news.

Eighty-two percent of all heart disease can be prevented by knowing your risk and controlling your risk with lifestyle changes. Eating a diet high in fruits and vegetables is the perfect place to start. Then, try to eliminate processed foods—think of anything that comes in a package—and reduce your sugar intake.

"As Benjamin Franklin said, 'An ounce of prevention is worth a pound of a cure,' " says board-certified interventional cardiologist Dr. Stuart Smalheiser of Beaufort Memorial Heart Specialists. "Heart disease can be slowed with simple lifestyle changes."

Regular exercise is also essential. Exercise increases HDL and lowers LDL (the bad cholesterol) and also helps control diabetes or prevent the development of type 2 diabetes. It lowers blood pressure and ultimately cuts your risk of heart disease. Yet another powerful step is to quit smoking. And if you have diabetes or high cholesterol or high blood pressure levels, talk to your doctor about medication. With each improvement in your lifestyle, over time, your heart will thank you—and you’ll reap the benefits of a healthier (and longer!) life.