Improve Your Cardiovascular Health with Eight Essential Steps

Earlier this year, the American Heart Association (AHA) released “Life’s Essential 8,” a checklist of components essential for good cardiovascular health. The list includes diet, physical activity, nicotine exposure, sleep, body mass index (BMI), blood lipids, blood glucose, and blood pressure.

If you want to protect the health of your heart and blood vessels and lower your risk of heart attack and stroke, where’s the best place to start?

Begin with the Four Bs

“‘Life’s Essential 8’ can be divided into health behaviors and health factors. Behaviors can be challenging to change, so I like to start with the modifiable risk factors that sometimes can be easier to control,” says Lakshmi Nambiar, MD, FACC, a board-certified cardiologist at Weill Cornell Medicine’s Wellness and Prevention Center. “I tell my patients to know your 4 Bs—blood pressure, blood glucose, blood lipids, and BMI—and work on getting them into the goal range through both lifestyle modifications and medications. When patients can better manage their hypertension, diabetes, high cholesterol, and/or obesity, they reduce their risk of developing cardiovascular disease (CVD) and deaths caused by CVD.”

Get Enough Sleep

Health experts at the AHA added sleep to their checklist of essential items due to growing evidence that inadequate sleep can have detrimental effects on cardiovascular health.

“Sleep and cardiovascular health are closely linked. Your heart is a muscle: When you sleep, your heart rate slows down and your blood pressure dips, which essentially gives your heart a chance to rejuvenate itself,” explains Dr. Nambiar.

“Poor sleep can raise your blood pressure, increase inflammation, and affect blood sugar, contributing to weight gain, diabetes, and coronary artery disease.”

She notes that getting sleep of adequate quality and duration can be especially challenging for women, since many women work multiple jobs or night shifts and are often the primary caretakers for their families as well.

When to See a Specialist

If you have persistent sleep problems like insomnia, consult a sleep specialist.

“Sleep-related breathing disorders, such as obstructive sleep apnea (OSA), can contribute to various cardiovascular diseases if left untreated. See a doctor who specializes in sleep medicine if you note any of the following symptoms while you sleep: snoring, gasping, or breathing pauses,” says Dr. Nambiar. “People with OSA often report excessive daytime sleepiness and/or difficulty concentrating. Untreated OSA can lead to worsening hypertension, heart failure, and atrial fibrillation, a type of abnormal heart rhythm.”

Diet and Exercise

“Healthy eating and physical activity can lower your blood pressure and cholesterol, reducing your risk of developing cardiovascular disease. A hearthealthy diet consists of plant foods, fruits, vegetables, lean proteins, and healthy fats,” says Dr. Nambiar. She recommends adopting the following dietary strategies:

• Use healthy fats like olive oil instead of saturated fats like butter.
• Eat lean protein like chicken or fish instead of fatty meats like ground beef, sausage, bacon, or hot dogs.
• Eat more foods high in soluble fiber, including legumes (beans, peas, and lentils), whole grains, and vegetables.

“In terms of exercise, you want to aim for 150–300 minutes of physical activity every week. Try walking for 30–45 minutes a day at least five days a week,” advises Dr. Nambiar. “When I discuss exercise with my patients, they often tell me they do not know where to start. If you are sedentary, start with just a few minutes of walking every day.”

Your Mental and Emotional Health

The AHA advisory also notes that psychological health is a factor that plays a role in your cardiovascular health.

“We are increasingly finding that there is a mind-heart-body connection. One example of this is stress-induced cardiomyopathy, or ‘broken heart syndrome,’ in which an acute, extreme emotional stress can severely weaken your heart function. This type of cardiovascular event is more commonly seen in women,” explains Dr. Nambiar.

She adds, “Anxiety, depression, and chronic stress increase your risk of cardiovascular disease. Directly, they can increase inflammation, affecting your blood pressure, blood glucose, and blood lipids. Indirectly, they can affect your health-promoting behaviors and your resilience in dealing with health issues. It is critical to optimize your mental health when managing cardiovascular health.”

Finally, remember that all the items on the “Life’s Essential 8” checklist can be beneficial even if you already have been diagnosed with CVD, such as coronary artery disease or other heart disease.

“’Life’s Essential 8 is also about preventing the progression of already existing disease. The best example of this is smoking. If you are able to change one health behavior, I would say stop smoking. Quitting smoking will significantly reduce your risk of developing further cardiovascular events, even if you’ve had a heart attack in the past,” explains Dr. Nambiar.

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