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How To Prevent and Control Coronary Heart Disease Risk Factors

You can prevent and control many coronary heart disease (CHD) risk factors with heart-healthy lifestyle changes and medicines. Examples of risk factors you can control include high blood cholesterol, high blood pressure, and overweight and obesity. Only a few risk factors—such as age, gender, and family history—can’t be controlled.

To reduce your risk of CHD and heart attack, try to control each risk factor you can. The good news is that many lifestyle changes help control several CHD risk factors at the same time. For example, physical activity may lower your blood pressure, help control diabetes and prediabetes, reduce stress, and help control your weight.

Heart-Healthy Lifestyle Changes

A heart-healthy lifestyle can lower the risk of CHD. If you already have CHD, a heart-healthy lifestyle may prevent it from getting worse. Heart-healthy lifestyle changes include:

Many lifestyle habits begin during childhood. Thus, parents and families should encourage their children to make heart-healthy choices, such as following a healthy diet and being physically active. Make following a healthy lifestyle a family goal. Making lifestyle changes can be hard. But if you make these changes as a family, it may be easier for everyone to prevent or control their CHD risk factors.

For tips on how to help your children adopt healthy habits, visit We Can!® Ways to Enhance Children’s Activity & Nutrition.

Heart-Healthy Eating

Your doctor may recommend heart-healthy eating, which should include:

  • Fat-free or low-fat dairy products, such as skim milk
  • Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
  • Fruits, such as apples, bananas, oranges, pears, and prunes
  • Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
  • Vegetables, such as broccoli, cabbage, and carrots
  • Whole grains, such as oatmeal, brown rice, and corn tortillas

When following a heart-healthy diet, you should avoid eating:

  • A lot of red meat
  • Palm and coconut oils
  • Sugary foods and beverages

Two nutrients in your diet make blood cholesterol levels rise:

  • Saturated fat—found mostly in foods that come from animals
  • Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats.

Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:

If you eat: Try to eat no more than:

1,200 calories a day

 8 grams of saturated fat a day

1,500 calories a day

10 grams of saturated fat a day

1,800 calories a day

12 grams of saturated fat a day

2,000 calories a day

13 grams of saturated fat a day

2,500 calories a day

17 grams of saturated fat a day

Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels.

Some sources of monounsaturated and polyunsaturated fats are:

  • Avocados
  • Corn, sunflower, and soybean oils
  • Nuts and seeds, such as walnuts
  • Olive, canola, peanut, safflower, and sesame oils
  • Peanut butter
  • Salmon and trout
  • Tofu


You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.

Dietary Approaches to Stop Hypertension

Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.

The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH.


Try to limit alcohol intake. Too much alcohol can raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain.

Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is:

  • 12 ounces of beer
  • 5 ounces of wine
  • 1½ ounces of liquor

Maintaining a Healthy Weight

Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.

Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out NHLBI’s online BMI calculator or talk to your doctor. A BMI:

  • Below 18.5 is a sign that you are underweight.
  • Between 18.5 and 24.9 is in the normal range.
  • Between 25 and 29.9 is considered overweight.
  • Of 30 or more is considered obese.

A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.

Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk

If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.

Managing Stress

Research shows that the most commonly reported “trigger” for a heart attack is an emotionally upsetting event—particularly one involving anger. Also, some of the ways people cope with stress—such as drinking, smoking, or overeating—aren’t healthy.

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:

  • A stress management program.
  • Meditation
  • Physical activity
  • Relaxation therapy
  • Talking things out with friends or family

Physical Activity

Routine physical activity can lower many CHD risk factors, including LDL (“bad”) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the “good” cholesterol that helps prevent CHD.

Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week, or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.

Read more about physical activity at:

Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.

Quitting Smoking

If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.

Read more about quitting smoking at Smoking and Your Heart.


Sometimes lifestyle changes aren’t enough to control your blood cholesterol levels. For example, you may need statin medications to control or lower your cholesterol. By lowering your cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have:

  • Coronary heart disease, peripheral artery disease, or had a prior stroke
  • Diabetes
  • High LDL cholesterol levels

Doctors may discuss beginning statin treatment with those who have an elevated risk for developing heart disease or having a stroke.

Your doctor also may prescribe other medications to:

  • Decrease your chance of having a heart attack or dying suddenly.
  • Lower your blood pressure.
  • Prevent blood clots, which can lead to heart attack or stroke.
  • Prevent or delay the need for a procedure or surgery, such as percutaneous coronary intervention or coronary artery bypass grafting.  
  • Reduce your heart’s workload and relieve CHD.

Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart-healthy lifestyle, even if you take medicines to treat your CHD.

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Updated: October 23, 2015