How to Know if You’re At Risk of a Heart Attack

Heart disease is the number one killer in the U.S. And heart attacks happen all the time — in fact, one happens in the U.S. every 40 seconds. 

There are many risk factors for heart disease. Some you can control, but others you cannot. The good news is that, even if you are at increased risk of a heart attack, there are actions you can take to reduce your risk.

Read on to learn what heart attack risks you might have, and how you can keep your heart healthy. 

What is a heart attack?

A heart attack happens when blood flow to the heart gets blocked. In a heart attack, this most often happens when plaque — a fatty cholesterol deposit in the arteries — breaks off and blocks a coronary artery. The coronary arteries are the blood vessels that surround the heart. These supply the heart with oxygen — and if they get blocked, the heart muscle begins to die. 

A heart attack may start with mild symptoms or discomfort, but it can also occur quickly and intensely. The most common symptoms to look out for are:

• Chest pain or tightness

• Pain in the jaw or neck or shoulders

• Shortness of breath

• Dizziness

• Nausea or vomiting

About 20% of heart attacks are silent, meaning you have no known symptoms of a heart attack and don’t know that you’ve had one afterward.

Do you need to worry about having a heart attack?

More than half of American adults have a risk factor for heart disease and are at increased risk of a heart attack. You may be able to change some risk factors, such as smoking and your diet. But there are others that you can’t change, like your family history and your age.

There are tools and calculators to help determine how high your risk of having a heart attack or stroke in the next 10 years is. If you’re concerned, talk with your healthcare provider about your personal risk.

The most common risk factors for a heart attack that you may be able to do something about include:

• Smoking

• High blood pressure

• High cholesterol

• Overweight or obesity

• Diabetes  

• A diet high in saturated or trans fats

• Lack of exercise 

• Heavy alcohol use

There are also risk factors that you can’t control. These include:

• Family history of heart attacks

• Increasing age

• Race and ethnicity (non-Hispanic Black and non-Hispanic white adults are at highest risk)

Drugs that increase your risk of heart attack

Many recreational drugs can negatively affect the heart and increase your risk of a heart attack. Even in young, healthy people who have no other risk factors for heart disease, certain drugs can affect heart rate, heart rhythm, and blood pressure. They can increase your risk for a heart attack or stroke.

These drugs include: 

• Cocaine

• Heroin

• Amphetamines

• Lysergic acid diethylamide (LSD)

• Ecstasy

• Cannabis

If you are at risk for a heart attack, what should you do?

If you are at risk for a heart attack, there are steps you can take to reduce your risk. Arteries can start developing plaque in midlife, but you might not have any symptoms for decades. It’s also important to know that — regardless of your age or even whether you already have known heart disease — it’s not too late to make healthy changes. You can actually reverse heart disease with lifestyle changes. 

Here is what you can do to reduce your risk of a heart attack:

1. Evaluate your lifestyle, which includes your diet, your exercise habits, and smoking.

2. Consider getting tests done to evaluate your heart health.

3. Control health conditions, such as diabetes, high cholesterol, and high blood pressure.

4. Discuss medications that may lower your risk of a heart attack, such as an aspirin or a statin, with your healthcare provider.

5. Regularly monitor your heart health.

What lifestyle changes are most important to prevent a heart attack?

The most important lifestyle changes to reduce your heart attack risk include:

• Avoid smoking (tobacco or cannabis)

• Have a healthy weight

• Follow a heart-healthy diet

• Do regular physical exercise

• Avoid excessive alcohol (limit to less than 1 to 2 drinks per day) 

• Try to get at least 7 hours of sleep per night

Even if you have an increased genetic risk for heart disease, making lifestyle changes can decrease your risk of heart disease by almost 50%.

Best exercises for heart health

The best exercises for your heart health will be the ones you enjoy and can do regularly. Exercise is very important for heart health — it helps you reduce blood pressure, maintain a healthy weight, and improve your cholesterol levels.

In order to reduce your heart attack risk, your exercise goal should be either:

• Moderate-intensity exercise, like walking or gardening, for 150 minutes per week (20 to 30 minutes per day) 

• Vigorous-intensity exercise, like running or swimming laps, for 75 minutes per week (10 to 20 minutes per day) 

Eating a heart-healthy diet

Your diet has a big impact on your heart health. A heart healthy diet means having a diet that is high in: 

• Fruits

• Vegetables

• Fiber

• Whole grains

• Healthy fats

Heart healthy foods include: 

• Nuts

• Legumes, like beans and lentils

• Whole grains, like brown rice, quinoa, and oats

• Fruits and vegetables, fresh or frozen

• Fatty fish, like salmon or trout

• Soy products, like edamame, tempeh, and tofu

• Healthy fats, like olive oil, canola oil, and flaxseed oil

There are certain foods you should avoid, including: 

• Red meat

• Processed meat

• Fried foods

• Trans fats

• Sugary foods with added sugar or high fructose corn syrup 

Monitoring your heart health

Heart health can be optimized with regular monitoring and testing. If you’re at increased risk, you may need to be more proactive about your heart testing and monitoring. 

You may want to consider doing the following:

• Check in with your healthcare provider: Have a checkup at least once per year to evaluate your blood pressure and do lab tests. If you have a health condition that increases your risk, such as diabetes, then check in more frequently.

• Find out your risk for a heart attack or stroke: If it’s high, then ask your healthcare provider about ways to lower it, such as taking aspirin or a statin.

• Check blood tests to evaluate your heart health: These may include cholesterol, high sensitivity C-reactive protein (hs-CRP), and homocysteine, or even newer tests like trimethylamine N-oxide (TMAO).

• Consider tests of your heart function: These might include an electrocardiogram, echocardiogram, stress test, coronary CT Scan, or cardiac MRI. The best test for you will depend on your age, your risk factors, and whether you’re having any symptoms.

• Monitor your heart health: You can do this at home by using a home blood pressure monitor or heart rate monitor.

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Written by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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