Despite decades of heart-health campaigns, heart attacks are still all too common: Each year, 715,000 people will have a heart attack, or one every 44 seconds, says the Centers for Disease Control and Prevention. Although the stereotypical symptoms and causes of a heart attack are well known — chest pain and a diet high in saturated fat, for example — there are many common risk factors and behaviors doctors say their patients don’t realize can lead to a heart attack, but they wish they knew. The Remedy asked a group of top MDs to reveal those surprising things that can affect whether you have a heart attack.
“A study in the New England Journal of Medicine found that exposure to traffic increases the chance of a heart attack in people already at risk,” says JD Zipkin, MD, associate medical director of Northwell Health-GoHealth Urgent Care in New York City. “Other studies have shown that longer commute times also increase the risk of weight gain, stress, and high blood pressure, all of which are risk factors for heart disease.”
The Remedy Rx: No need to go off the grid. Just be aware of how your commute — and work generally — is affecting your diet and mental health. If you find yourself blowing your top regularly at traffic or scarfing drive-thru burgers several times a week, it might be time to try heart-healthy tactics like relaxation exercises and meal prep.
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“If you don’t usually get the flu vaccine, this statistic may be a good reason to start: Studies have shown that people are an astounding six times more likely to have a heart attack in the week following the flu than after that point or before it,” says Cara Pensabene, MD, of EHE Health in New York. Why? “When you have the flu, the typical immune system response is to react and generate an inflammatory response. Unfortunately, this can also cause inflammation of the heart and blood vessels.”
The Remedy Rx: Every adult should get a flu shot annually, say the Centers for Disease Control and Prevention. While you’re at it, ask your doctor if you should be immunized against other diseases that affect older adults, such as meningitis, pneumonia and shingles.
“An occasional fave-show binge may be practically harmless, but frequent binge-watching leaves you sedentary for long periods, which can be hard on your entire cardiovascular system,” says Pensabene. “The American Heart Association says that most adults are sedentary for six to eight hours a day, and even if those people are moderately active the rest of the time, they are still at higher risk of cardiovascular disease and heart attack.”
The Remedy Rx: The occasional Netflix binge makes life worth living. But make sure you’re getting plenty of physical activity when you’re not on the couch. The AHA recommends that adults get at least 75 minutes of vigorous physical activity (such as running or swimming) or 120 minutes of moderate physical activity (such as brisk walking) each week. If you work a desk job, find ways to be more active during the day, if just standing and walking around more.
Studies show that people who drink diet sodas and other artificially sweetened beverages have a higher risk of metabolic syndrome. That’s when your body has trouble processing insulin, which is a precursor to Type 2 diabetes. And that’s a heart attack risk.
The Remedy Rx: Swap out sugary beverages and diet drinks with tap water, seltzers or homemade fruit-infused water. Avoid any with artificial sweeteners.
A 2016 study published in the International Journal for Equity in Health found that people without a college degree were twice as likely to have a heart attack. “Simply whether you have higher education credentials is not to blame, however,” says Pensabene. “These credentials impact factors like social status, living environment and job satisfaction, which could easily generate stress and a higher likelihood of heart disease.”
The Remedy Rx: Regardless of your educational status, be mindful of stress in all areas of your life — two important heart-healthy tips this study reinforced.
“While patients with heart risk factors may be instructed to take low dose aspirin from their doctors, other over-the-counter medications should be avoided,” says Richard Honaker, MD, chief medical advisor for Your Doctors Online.
The Remedy Rx: Talk with your doctor about all over-the-counter medications and supplements you take. “If you have heart risk factors, it’s important to avoid NSAID anti-inflammatory medications like ibuprofen,” says Honaker.
“Heart attack rates in the U.S. increase during the holidays, from Thanksgiving to Christmas,” says Tomas H. Ayala, MD, FACC, a cardiologist with Mercy Medical Center in Baltimore, Maryland. Why? It might be the stresses related to the season, or the cold weather, which increases the risk of a heart attack (read on to find out why).
The Remedy Rx: Take steps to manage feelings of stress, depression or isolation during the holiday season — relax, meditate, maintain connections, exercise or talk with a professional.
“While heart attacks can occur at any time of the day or night, they are most common early in the morning,” says Ayala. In fact, studies show that heart attacks are five to six times more likely to occur between 1 and 5 am, and morning heart attacks tend to be more severe than those that happen at other times.
The Remedy Rx: Be aware of heart attack symptoms. If chest pain wakes you up in the early morning, don’t assume it’s heartburn.
“Depression is associated with higher risk of heart attack,” says Ayala. Why? Feelings of sadness and isolation tax the heart, just like anxiety or stress.
The Remedy Rx: If you’re feeling socially isolated or depressed, talk to your doctor about the best course of action. You might benefit from talk therapy too.
“Sudden heartbreak, or broken heart syndrome, is a real condition,” says Anuj Shah, MD, a cardiologist and director of Apex Heart and Vascular in New Jersey. “We believe it’s due to a sudden surge of catecholamine, or nerve hormones. Even a sudden surge of negative emotions can lead to heart problems.”
The Remedy Rx: Don’t suffer in silence. Maintain social connections and seek professional help for your grief if necessary.
“People who have healthier sleep hygiene have a lower risk of heart attacks and heart problems,” says Shah. According to a study done by the CDC, people who slept less than 7 hours a night reported having more heart attacks — along with obesity, Type 2 diabetes and high blood pressure, three conditions that lead to heart disease.
The Remedy Rx: Experts including the American Sleep Foundation recommend that adults get 7 to 9 hours of sleep a night.
“Very loud, frequent snoring could be due to obstructive sleep apnea,” says Shah. Sleep apnea has been associated with high blood pressure and other health problems. And according to the National Sleep Foundation, snoring itself is associated with a risk of cardiovascular disease. People who snore have a higher chance of experiencing a thickening in the carotid artery, which doctors think might be caused by the vibrations of snoring.
The Remedy Rx: If you snore, talk to your doctor.
Diabetes, even prediabetes or borderline diabetes, can increase your risk of a heart attack, says Robert Malizia, associate medical director with Northwell Health-GoHealth Urgent Care. Diabetes causes sugars to build up in the blood. That damages the lining of arteries, which can lead to cardiovascular disease.
The Remedy Rx: The risk of developing Type 2 diabetes increases over age 40, so the American Diabetes Association recommends a regular diabetes screening for all adults over 45. If you have diabetes, take steps to ensure it’s controlled: Make sure you’re compliant with medication, diet, lifestyle recommendations and monitoring.
“Everyone knows cigarette smoking leads to higher risk of heart attacks, but surprisingly, a lot of people have no clue that other forms of tobacco can also increase their risk,” says Shah. “Studies are taking place to find out if vaping increases the risk of heart attacks or not.”
The Remedy Rx: If you smoke or use chewing tobacco, quit. It’s never too late to benefit your heart. “Just as smoking increases your risk of heart attack, after two to three years of quitting, your risk starts approaching that of a non-smoker,” says Kevin Reiter, associate medical director of Northwell Health-GoHealth Urgent Care. Don’t assume vaping is healthy — if you vape, pay attention to what researchers report about its safety.
Just like not getting enough sleep is bad for your heart, so is too much. A review of research published in the Journal of the American Heart Association found that getting more than eight hours can increase your risk of heart disease: Nine hours came with a moderate risk, and 11 hours was associated with a nearly 44 percent increase.
The Remedy Rx: Get seven to nine hours — no more, no less. Talk to your doctor if you’re having trouble staying in the zone.
“People know that too much alcohol can lead to liver problems, but a lot of people don’t realize that too much alcohol also leads to cardiomyopathy — an enlarged and weakened heart — putting people at risk of heart attacks and sudden cardiac arrest,” says Shah.
The Remedy Rx: For heart health and to lower your risk of cancer, experts say men should limit themselves to two alcoholic drinks a day, and women should have no more than one.
“Being in too much cold can lead to vasospasm, or sudden narrowing of the arteries, causing a heart attack,” says Shah. According to Harvard Medical School, about 100 men die of heart attacks each year shortly after shoveling snow.
The Remedy Rx: If you have heart issues, talk to your doctor before shoveling snow this year; you might want to outsource that chore. “I often tell my patients who are not physically fit not to go out in the snow and start shoveling without getting clearance from their cardiologist first,” says Shah.
Having a baby isn’t commonly known as a heart attack risk factor, but it is. “After pregnancy, there’s a higher risk of heart problems, known as postpartum cardiomyopathy, that can lead to heart attacks and arrhythmias,” says Shah.
The Remedy Rx: If you or any loved ones have recently given birth, familiarize yourself with heart attack symptoms that can affect women (and several of them can be nontraditional, like nausea or back or jaw pain) and make sure those close to you know about them.
The idea that stress or shock can cause a heart attack has been around so long, some might assume it’s just a sitcom gag or debunked old wives’ tale. It’s not. “Chronic stress may increase the risk of heart attack, especially in middle-aged men,” says Ayala. “And a sudden acute stress — for example, the loss of a job, the death of a loved one, or even a strong emotional argument — can lead to heart muscle failure and, rarely, to sudden cardiac arrest.”
The Remedy Rx: Keep stress in check, talk with your doctor about heart testing, and eat a heart-healthy diet. “A whole-food, plant-based diet is the foundation for the heart-healthiest diet,” advises Ayala. “If you choose to consume lean animal protein, emphasize fish, especially omega-3 fatty acid fish. I tell my patients to aim for a 45-30-25 diet: 45 percent of calories from low glycemic/whole-grain carbs (mainly veggies, fruits and legumes), 30 percent from lean protein and 25 percent from fats.”
“Having breast cancer, and a few other types of cancers, can lead to a higher chance of heart attacks — due to cancer itself, as well as certain chemotherapy or radiation therapy,” says Shah.
The Remedy Rx: If you’ve been treated for breast cancer, ask your doctor about your heart attack risk, and be alert for possible symptoms. And to live your happiest and healthiest life, don’t miss these 40 Things Cardiologists Do to Protect Their Hearts.