Best ways to protect your heart

Many people fail to take the proven steps to prevent heart attacks and strokes. The strategies listed below are ranked by the number of heart attacks and strokes they could prevent in American adults over the next 30 years, according to a special report in the July 29, 2008, issue of Circulation.

Lower your blood pressure

GoalA systolic (upper) level under 140 and a diastolic (lower) level under 90.
Problems prevented6.2 million heart attacks, 7 million strokes.
What you can doGet your blood pressure checked at least once a year. If it's high, cut back on salt, lose excess weight, and exercise more. If drugs are necessary, our CR Best Buy Drugs recommendation for most people is a generic diuretic, especially a thiazide diuretic.

Improve your cholesterol levels

GoalAn LDL (bad) cholesterol under 160 for people at low risk of heart attack, 130 for those at intermediate risk, and 100 for those at high risk. (To determine your risk, use our online calculator.)
Problems prevented9.6 million heart attacks, 3 million strokes.
What you can doMen 35 and older as well as women 45 and older with coronary risk factors, such as high blood pressure, should get tested at least every five years. Other adults might consider testing, too. If your levels are high, control your weight, exercise more, quit smoking, and eat a heart-healthy diet. If medication is necessary, our CR Best Buy Drugs recommendations for most people are generic lovastatin, pravastatin, or simvastatin.

Lose excess weight

GoalA body mass index (BMI) under 30 (the cutoff for obesity) and preferably under 25 (the cutoff for being overweight).
Problems prevented7.1 million heart attacks, 1.1 million strokes.
What you can doDetermine your BMI by multiplying your weight in pounds by 703, then dividing by your height squared in inches. (Or use our online calculator.) Even simpler: Measure your waist. Men with a waistline over 40 inches and women with a measurement over 35 inches should lose weight.

Control your blood sugar level

GoalA fasting blood glucose level under 110 for people who do not have diabetes, and preferably under 100; an A1C level, a measure of long-term blood sugar control, under 7 percent for people who already have the condition.
Problems prevented4.8 million heart attacks, 0.6 million strokes.
What you can doConsider getting your blood sugar level measured, especially if you're at high risk for type 2 diabetes because of high blood pressure or cholesterol levels or excess weight. The same lifestyle changes that lower blood pressure and cholesterol can lower blood sugar, too. Our CR Best Buy Drugs recommendation for most people with type 2 diabetes is generic metformin, alone or combined with other drugs.

Stop smoking

GoalQuit—for good.
Problems prevented3.3 million heart attacks, 1.4 million strokes.
What you can doTalk with a doctor about the best smoking-cessation program for you and be examined for smoking-related illness.

Consider low-dose aspirin

GoalTake a low-dose (81 milligrams) aspirin daily if appropriate.
Problems prevented3.4 million heart attacks, 0.3 million strokes.
What you can doTalk to a doctor about your risk of heart attack, stroke, and gastrointestinal bleeding starting at age 45 for men and 55 for women. Use our calculator to see whether the benefits of aspirin outweigh its risks for you.