Overview: Disorders & prevention

All of the disorders we discuss in this section – hypertension, atherosclerosis, angina and, of course, heart attack – have an impact on our heart health. And all of them (except for a couple of rare types of angina that are caused by blood-vessel spasms) can largely be controlled by our own lifestyle choices.

Exercising, eating a healthy diet, and avoiding smoking and drinking all lower our risk of developing hypertension (high blood pressure), atherosclerosis (clogged arteries), and stable or unstable angina. And lowering the risk of hypertension and atherosclerosis and lowers our risk of having a heart attack.

Lifestyle and heart health often walk hand-in-hand.

One of the earliest investigations into the impact of exercise on cardiovascular disease was a 1953 study of London Transport workers. The investigators reviewed death and sickness records for some 31,000 men who worked in the public transport system on the buses, trams, and trains as either drivers or conductors. They found that the drivers, whose jobs required them to sit all day long, were 2.5 times more likely to have coronary heart disease than the conductors, whose jobs kept them on their feet*.

Since then, study after study has confirmed the link between exercise and cardiovascular health. 

And the same is true of the food we eat: The so-called Mediterranean diet, which is high in vegetables, whole grains, fish, fruit, beans, and nuts, and low in meat, dairy foods, and sugary sweets, has been linked to lower rates of heart disease since the 1960s.

More recently, warnings about the health dangers of eating ultra-processed foods have been in the news, and while the definition of “ultra-processed” isn’t entirely clear, most of us probably agree that we know it when we see it. Sodas, store-bought snacks and candy, most breakfast cereals, fast foods, and foods containing hydrogenated oils, artificial flavorings, and preservatives are all on the list.

According to a 2022 study published in the American Journal of Clinical Nutrition, Americans get more than half of their daily calories from ultra-processed food, and population-based studies link it with cardiovascular diseases, obesity, type 2 diabetes, and some cancers.

So the good news about this section is that we are talking about a range of cardiovascular diseases that we ourselves can help prevent. The bad news is that many of us haven’t yet gotten the message: People who stay fit, stay trim, and eat a healthy diet live longer, and they also live better.

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* And speaking of feet:  A nice footnote here is that the lead author of the study, Jeremy Morris, commuted to work by walking and using public transport until his death at the impressively advanced age of 99.